Understanding Nutrition Behaviours of Women with Gestational Diabetes

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Hui, Amy Leung
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Gestational Diabetes (GDM) is considered a high-risk pregnancy. Nutrition management plays a critical role in GDM management. How women with GDM make food choice decisions and how they follow dietary advice have not been fully investigated especially how stress and anxiety during a GDM pregnancy influence dietary management. This study used a mixed methods approach. Qualitative and quantitative data were collected concurrently and analysed together to answer research questions on factors that affected women with GDM at 26-38 gestational weeks in making food choice decisions, the stress and anxiety that they experienced, and the barriers that they encountered when following dietary advice. The results showed: 1. Despite of the dietary recommendations from the healthcare professionals, food choice decisions were still strongly influenced by individual factors such as personal food preference, cravings, and hunger. Women sought information from different sources to adapt to the dietary changes, especially when the health services information provided was too general, and when some of the dietary advice conflicted with their eating habits. Difficulties in dealing with cravings, food portion size, hunger, and eating out led to a sense of decreased control and to stress and frustration. 2. The GDM diagnosis triggered stress in some women. Women who were on insulin were more likely to experience dietary management related stress compared to the ones on diet treatment only. Anxiety was explained as the fear of the macrosomia and labor complications. These kinds of fear could be aggravated by abnormal blood glucose readings and hence triggered some emotional breakdown and coping actions. 3. Underlying beliefs such as behavioural, normative, and self-efficacy beliefs can produce barriers to following dietary advice. Other factors such as environmental constraints and lack of knowledge added more challenges to following dietary advice. Quick adaptation to dietary management in a short time period was not easy for women with first time diagnosed GDM and created emotional distress, often leading to unhealthy dietary coping strategies. The above results concluded that women with first time diagnosed GDM faced challenges of quick adaptation of dietary behavioral changes in a limited time frame. These challenges were rooted in the expected health behavior changes that are often in conflict with the individual’s behavioral, normative, and self-efficacy beliefs. Stress and anxiety generated in the process of GDM management sometimes led to altered dietary behaviors to cope with blood glucose control.
Nutrition, Gestational Diabetes