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Sequential Introduction of Exercise First Followed by Nutrition Improves Program Adherence During Pregnancy: a

Taniya S Nagpal^1,2,3, Harry Prapavessis^2,3, Christina G Campbell⁴

¹R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, University of Western Ontario, 2245, 3-M Centre, London, Ontario, N6A 3K7, Canada.

International Journal of Behavioral Medicine

|December 25, 2019

Summary

Introducing exercise before nutrition during pregnancy significantly improved adherence to health recommendations. This sequential approach positively impacted gestational weight gain, offering a more effective strategy for prenatal wellness programs.

Keywords:

Adherence Behavior change Exercise Gestational weight gain Nutrition Pregnancy

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Area of Science:

Obstetrics and Gynecology
Maternal Health
Behavioral Science in Medicine

Background:

Simultaneous adherence to nutrition and exercise recommendations during pregnancy presents challenges.
Investigating sequential versus simultaneous introduction of behaviors is crucial for optimizing prenatal interventions.

Purpose of the Study:

To compare adherence rates between sequential (nutrition-first or exercise-first) and simultaneous introduction of nutrition and exercise behaviors during pregnancy.
To evaluate the impact of different behavioral introduction strategies on secondary maternal and infant health outcomes.

Main Methods:

A randomized controlled trial (NCT02804061) with 88 participants stratified by body mass index (BMI).
Three groups: A (simultaneous nutrition and exercise), B (nutrition first, exercise added at 25 weeks), C (exercise first, nutrition added at 25 weeks).
Intervention included weekly weighing, supervised walking, and nutrition counseling; adherence measured by goal achievement percentage.

Main Results:

Group C (exercise-first) demonstrated significantly higher adherence (80.2%) compared to Group A (60.9%) and Group B (66.8%).
Group C showed significantly lower gestational weight gain (7.7 kg) compared to Group B (9.8 kg).
A trend favored Group C for preventing excessive gestational weight gain, though not statistically significant.

Conclusions:

Introducing exercise before nutrition at 25 weeks gestation enhances adherence to combined behavioral interventions.
This sequential strategy positively influences key health outcomes, including gestational weight management.