Adherence to the Lebanese National Dietary and Lifestyle Guidelines for Pregnancy and Its Association With Postpartum Weight Retention

Abstract

The Lebanese National Dietary and Lifestyle Guidelines for Pregnancy (DLGP) were developed to foster maternal and child health. The study aims to examine adherence to the DLGP and investigate its association with postpartum weight retention at 6 months (PPWR6). This study is based on the Mother and Infant Nutrition Assessment prospective cohort study conducted among pregnant women in Lebanon (n = 152). Pregnant women were recruited during their first trimester and were followed up until 6 months after delivery. Data on the socio-economic, anthropometric and lifestyle characteristics of participants were collected. A validated FFQ was used to examine dietary intake during the second trimester. A composite score was calculated for the adherence to the DLGP, with high adherence defined as belonging to the third tertile of the score. PPWR6 was calculated as the difference between pre-pregnancy weight and weight at 6 months postpartum, and high PPWR6 was defined as belonging to the third tertile of PPWR6 (≥ 5.4 kg). Multiple logistic regression was used to examine associations between adherence to guidelines and PPWR6. The proportion of participants adhering was lowest for guidelines regarding saturated fats (1.3%), sugar (13.8%), hydration (21.7%), adequate gestational weight gain (37.5%), omega-3 supplementation (38.8%) and salt (44.1%). Average PPWR6 was 3.9 kg, with 34.2% of participants retaining ≥ 5 kg. While no association was observed between any of the individual guidelines with PPWR6, participants with high adherence to the DLGP had 77% lower odds of a PPWR6 more than 5.4 kg, compared to those in the first and second tertiles (adjusted OR: 0.23, 95% CI: 0.09, 0.58). The findings of this study highlighted important gaps in adherence to the DLGP, along with a direct association between higher DLGP adherence and lower PPWR. These findings underscore the need for comprehensive strategies to promote healthier practices during pregnancy and mitigate long-term risks of obesity and related chronic diseases.