Delta Healthy Sprouts: Participants' Postnatal Diet Quality and Food Habits

Abstract

The early postpartum period is a critical time for many women because excessive gestational weight gain and postnatal weight retention put them at risk for short and long term obesity. Given that poor diet quality and poor dietary choices can negatively affect the health of women and that of their offspring, the nutrition of postpartum women deserves considerable attention. The Delta Healthy Sprouts Project is a randomized, controlled, comparative trial designed to test the effectiveness of two maternal, infant, and early childhood home visiting curricula on weight status, dietary intake, and other health behaviors of mothers and their infants residing in the rural Mississippi Delta. The objective of this study was to compare the longitudinal diet quality and food habits of participants enrolled in the two treatment arms of this project.The Parents as Teachers (PAT) control arm followed the nationally recognized, evidence based, Parents as Teachers® curriculum. The Parents as Teachers Enhanced (PATE) experimental arm built upon the PAT curriculum by adding culturally tailored, maternal weight management and early childhood obesity prevention components. Following 6 months of intervention in the gestational period, women were followed for an additional 12 months of intervention in the postnatal period. Dietary data was gathered from participants using multiple pass 24‐hour dietary recalls via the Nutrition Data System for Research software. Diet quality was calculated from this data using the Healthy Eating Index‐2010 which measures adherence to the 2010 Dietary Guidelines for Americans. The Healthy Eating Index‐2010 total score ranges from 0 to 100 points. Participants also completed surveys addressing socio‐demographic characteristics and food practices.Postnatal retention rates were 83% (25/30) and 88% (21/24) for the PAT and PATE arms. The majority of both PAT and PATE participants were African American (97% and 96%), single (87% and 92%), receiving government food assistance (93% and 83%), young (mean age = 24 and 23 years), and obese (mean body mass index = 30 and 32 kg/m2). Mean total HEI‐2010 scores for postnatal months 1, 4, 6, 8 and 12 were 37, 37, 40, 39, and 36 in the PAT arm. Corresponding mean scores were 42, 42, 40, 46, and 38 in the PATE arm. Mean scores in the PATE arm were significantly higher across time as compared to the PAT arm. Significant effects for time and the interaction between treatment and time were not apparent. Of the 575 PAT and 462 PATE participant meal occasions, 8% and 7% occurred in a delicatessen, restaurant, cafeteria, or fast food establishment. Additionally, 77% (23/30) of PAT and 83% (20/24) of PATE participants reported eating breakfast regularly (i.e., for every dietary recall).Results suggest that neither treatment was effective at improving the diet quality of this cohort of rural, Southern, primarily African American women in the postnatal period. Future research will investigate the impact of the food environment (e.g., type and proximity of food outlets to participants' homes) on participants' nutrition.Support or Funding InformationSupported by the USDA Agricultural Research Service with in kind support from the Delta Health Alliance.