Antenatal dietary concordance among mothers and fathers and gestational weight gain: a longitudinal study

Roger Figueroa,Augustine Kang,Elsie M Taveras,Fernanda Neri Mini,Kirsten K Davison,Jaclyn A Saltzman

doi:10.1186/s12889-020-09182-7

Abstract

BackgroundParent-child dietary concordance is associated with child diet, but the clinical implications of mother-father dietary concordance during pregnancy are unknown. This study evaluates antenatal mother-father dietary concordance and associations with gestational weight gain (GWG).MethodsMother-father (n = 111) dyads with low income reported their fruit/vegetable (FV), fast food (FF), and sugar-sweetened beverage (SSB) consumption frequency during the first trimester of pregnancy. From electronic health records, we collected height and self-reported pre-pregnancy weight and calculated pre-pregnancy body mass index (BMI). The primary outcome was excessive GWG for pre-pregnancy BMI. Dyads were categorized as healthy or unhealthy concordant (consuming similarly high or low amounts of FV, FF, or SSB), or mother-healthy or father-healthy discordant (consuming different amounts of FV, FF, or SSB). Multivariable and logistic regressions analyzed associations between dietary concordance and GWG.ResultsMothers were Hispanic (25%), 43% White, 6% Black, and 23% Asian or Other. Most mothers were employed (62%) making <$50,000/year (64%). Average maternal GWG was 11.6 kg (SD = 6.40), and 36% had excessive GWG. Mothers in the mother-healthy discordant FV group (OR = 4.84; 95% CI = 1.29, 18.22) and the unhealthy concordant FF group (OR = 7.08; 95% CI = 2.08, 24.12) had higher odds for excessive GWG, compared to healthy concordant dyads. SSB concordance was associated with higher GWG in unadjusted, but not adjusted models.ConclusionsMothers had higher risk for excessive GWG when both partners had unhealthy FF consumption frequency, and when fathers had unhealthy FV consumption frequency. These findings imply that fathers should be involved in educational opportunities regarding dietary intake during pregnancy.

Highlights

Parent-child dietary concordance is associated with child diet, but the clinical implications of motherfather dietary concordance during pregnancy are unknown
To the best of our knowledge, few studies have investigated the clinical implications of dietary concordance on health outcomes, which is surprising given that the concept of health concordance has existed in the literature for decades [15]
This may be due to limited research investigating the role of direction in concordance; healthy behavioral concordance is likely to have a different effect on health outcomes compared to unhealthy behavioral concordance

Summary

Introduction

Parent-child dietary concordance is associated with child diet, but the clinical implications of motherfather dietary concordance during pregnancy are unknown. Unhealthy or excessive food consumption is consistently linked to higher risk for excessive GWG in large and diverse samples of expecting mothers [9, 11, 12, 23] These studies suggest that maternal diet during pregnancy is associated with GWG and child weight, but they focus only on mother-child dyads without attention to the larger family context in which mothers and children are embedded. No studies have considered dietary concordance between parents in the antenatal period, which may be a critical period influencing child health outcomes [22] This represents a substantial gap in the literature given that fathers’ beliefs, attitudes and behaviors are associated with a number of other maternal pre-, ante- and postnatal health behaviors and outcomes—such as receiving prenatal care, smoking, and breastfeeding duration [14, 26]

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