***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Background Behavior Change Communications ( BCC ) play a decisive role in modifying socio-cultural norms affecting the perception and nutritional practice s during pregnancy . Objective To examine the effectiveness of ‘ Trials of Improved Practice s ’ ( TIPs ) on dietary and iron-folate intake during pregnancy . Design Community based quasi experimental study with a control group Setting Four villages of Chiraigaon Community Development Block of Varanasi , India from May 2010 and recruited from August 2010 . End line assessment , after 12 weeks of intervention , was completed in April 2011 . Participants Pregnant women in 13–28 weeks of gestation Intervention  TIPs was implemented in addition to ongoing essential obstetric care services in two villages through 3 home ( assessment , negotiation and evaluation ) visits and only assessment and evaluation visits in the other two control villages . Interpersonal communication , endorsing the active participation of family members and home based reminder material s were the TIPs based strategies . The effect of TIPs was assessed by comparing key outcome variables at baseline and after 12 weeks of intervention . Outcome Measures Hemoglobin% , anemia prevalence , weight gain , compliance for iron-folate supplementation and dietary intake of calorie , protein , calcium and iron . Results A total of 86 participants completed the study . At the end , mean hemoglobin levels were 11.5±1.24 g/dl and 10.37±1.38 g/dl in the TIPs and control groups , respectively . The prevalence of anemia reduced by half in TIPs group and increased by 2.4 % in the control group . Weight gain ( grams/week ) was significantly ( p<0.01 ) higher in TIPs group ( 326.9±91.8 vs. 244.6±97.4 ) . More than 85 % of the PW in TIPs group were compliant for Iron-folate and only 38 % were compliant among controls . The mean intake of protein increased by 1.78gm in intervention group and decreased by 1.81 gm in controls ( p<0.05 ) . More than two thirds of PW in TIPs group were taking one extra meal and only one third of controls were doing the same . Conclusion TIPs found to be an effective approach to improve the nutritional status of pregnant women in the study area . TIPs strategy could be further explored on larger sample representing different socio-cultural and geographical areas . Trial Registration Clinical Trial Registry of India BACKGROUND Consistent evidence of an influence of maternal dietary intake during pregnancy on infant body size and composition in human population s is lacking , despite robust evidence in animal models . OBJECTIVE We sought to evaluate the influence of maternal macronutrient intake and balance during pregnancy on neonatal body size and composition , including fat mass and fat-free mass . STUDY DESIGN The analysis was conducted among 1040 mother-offspring pairs enrolled in the prospect i ve prebirth observational cohort : the Healthy Start Study . Diet during pregnancy was collected using repeated 24-hour dietary recalls ( up to 8) . Direct measures of body composition were obtained using air displacement plethysmography . The National Cancer Institute measurement error model was used to estimate usual dietary intake during pregnancy . Multivariable partition ( nonisocaloric ) and nutrient density ( isocaloric ) linear regression models were used to test the associations between maternal dietary intake and neonatal body composition . RESULTS The median macronutrient composition during pregnancy was 32.2 % from fat , 15.0 % from protein , and 47.8 % from carbohydrates . In the partition multivariate regression model , individual macronutrient intake values were not associated with birthweight or fat-free mass , but were associated with fat mass . Respectively , 418 kJ increases in total fat , saturated fat , unsaturated fat , and total carbohydrates were associated with 4.2-g ( P = .03 ) , 11.1-g ( P = .003 ) , 5.9-g ( P = .04 ) , and 2.9-g ( P = .02 ) increases in neonatal fat mass , independent of prepregnancy body mass index . In the nutrient density multivariate regression model , macronutrient balance was not associated with fat mass , fat-free mass , or birthweight after adjustment for prepregnancy body mass index . CONCLUSION Neonatal adiposity , but not birthweight , is independently associated with increased maternal intake of total fat , saturated fat , unsaturated fat , and total carbohydrates , but not protein , suggesting that most forms of increased caloric intake contribute to fetal fat accretion Background Although it is known that lifestyle behaviors of pregnant women are closely related to maternal and fetal health , number of data concerning efficacy of intervention on lifestyle during pregnancy is limited . The purpose of this study is to determine the effect of lifestyle interventions on improving dietary habits and lifestyle behaviors , ensuring gestational weight gain ( GWG ) within recommended levels and limiting postpartum weight retention ( PWR ) . Methods The study was conducted as a r and omized controlled trial in a family health center located in Istanbul , Turkey , between June 2011 and July 2012 . The primary outcomes were GWG , and the proportion of pregnant women whose GWG was within the Institute of Medicine ( IOM ) guidelines . One hundred two pregnant women with gestation ≤12 weeks , age ≥18 years , gravidity ≤2 , and who did not intend to lose weight in prepregnancy period were r and omly included in this study as intervention ( n = 51 ) and control ( n = 51 ) groups . The study was completed with 45 women for each group . The control group received routine antenatal care . The intervention group was received an individualized lifestyle intervention focusing on healthy lifestyle , diet , exercise , and weight monitoring as four sessions at 12–15 , 16–18 , 20–24 , and 37 weeks gestation . Lifestyle behaviors were evaluated with Health-Promoting Lifestyle Profile-II . Dietary habits were assessed by 3-day dietary recalls , and weight was followed from pregnancy until 6 weeks postpartum . Results The lifestyle interventions had a significant effect on improving lifestyle behaviors , protein intake , percentage of energy from protein , calcium , magnesium , iron , zinc , and vegetable intakes when adjusted for confounders ( p < 0.05 ) . The proportion of women who were within the IOM recommendations was higher in the intervention group ( 51.1 % ) than in the control group ( 28.9 % ) The odds ratio for GWG within IOM was statistically significant between the groups ( OR = 0.59 , 95 % CI , 0.45–0.72 ) . There were no difference between groups in terms of the other dietary intakes , total GWG , and PWR ( p > 0.05 ) . Conclusions Lifestyle intervention improves the lifestyle behaviors during pregnancy and increases the appropriate GWG for prepregnancy body mass index ( BMI ) , but it has a limited effect in terms of improving dietary habits and has no effect on PWR BACKGROUND The role played by dairy product intake during pregnancy on neonatal outcomes has raised interest in the last few years . However , studies on this association remain scarce . Thus , the aim of this study was to determine the association between dairy product consumption during pregnancy and neonatal and maternal outcomes . METHODS A prospect i ve study was conducted with 98 pregnant women , aged 18 - 40 , from the city of Porto , Portugal . Socio-demographic and lifestyle characteristics were assessed through a question naire . Dairy product consumption was assessed with a three-day food diary completed during the first and second trimesters . Postpartum medical records were examined for neonatal and maternal outcomes . Multivariate linear regression analyses were performed to assess the association between dairy intake and neonatal and maternal outcomes , adjusting for dietary variables and maternal characteristics . RESULTS Compared to the first trimester pregnant women had higher energy intake and lower calcium , iodine and yogurt intake in the second trimester ( P<0.05 ) . Total dairy and yogurt intake in the first trimester were positively associated with head circumference and placental weight ( respectively β=0.002 , P=0.014 , β=0.333 , P=0.012 ) . Change in total dairy intake between the second and first trimester was negatively associated with maternal weight gain during pregnancy ( β=-0.007 , P=0.020 ) . CONCLUSION The findings of this study suggest that dairy product intake during pregnancy may have an effect on neonatal head circumference , placental weight , and gestational weight gain Previous studies revealed associations of urinary Cd ( U-Cd ) , a chronic Cd exposure biomarker , with  blood pressure ( BP ) in non-pregnant adults . However , the evidence regarding trimester-specific blood pressure in pregnancy and U-Cd and effect modification by dietary intake of micronutrients is scarce . We r and omly selected 653 women from the Omega Study cohort .  U-Cd was quantified by inductively coupled plasma mass spectrometry . Trimester-specific , systolic ( SBP ) and diastolic blood pressure ( DBP ) were determined employing st and ard protocol s and mean arterial pressure ( MAP ) was also calculated . Associations of SBP , DBP , and MAP with U-Cd tertiles ( ≤0.21 ; 0.22–0.41 ; ≥0.42 μg/g Cr ) were assessed using multivariable linear regression models . We also explored effect modification by pre-pregnancy BMI ( ≤25 or > 25 kg/m2 ) or low/high micronutrients intake . After adjusting confounders in women with elevated ( upper tertile ) as compared with those with low ( lowest tertile ) U-Cd ( ≥0.42 vs. ≤0.21 μg/g Cr , respectively ) had reduced third trimester MAP ( −1.8 ; 95 % confidence interval ( CI ) = −3.1 , −0.5 mmHg ) and second trimester MAP ( −1.1 ; 95 % CI = −2.3 , −0.03 mmHg ) . A significant decrease in third-trimester MAP associated with increased U-Cd was observed only among normal/underweight women ( BMI ≤ 25 kg/m2 ) and women with high dietary intake of micronutrients ( calcium , magnesium , zinc , and selenium ) . Notably , U-Cd concentrations increased with the increased consumption of zinc and non-heme iron food sources . No significant differences in U-Cd concentrations were found in preeclamptic women compared with non-preeclamptic women . Our study provides evidence that dietary intake of micronutrients should be taken into account when assessing the health effects of Cd in pregnant women BACKGROUND Maternal diet during pregnancy has been suggested to influence bone health in later life . OBJECTIVE We assessed the association of  maternal first-trimester dietary intake during pregnancy with childhood bone mass .  DESIGN In a prospect i ve cohort study in 2819 mothers and their children , we measured first-trimester daily energy , protein , fat , carbohydrate , calcium , phosphorus , and magnesium intakes by using a food-frequency question naire and homocysteine , folate , and vitamin B-12 concentrations in venous blood . We measured childhood total body bone mass by using dual-energy X-ray absorptiometry at the median age of 6.0 y. RESULTS Higher first-trimester maternal protein , calcium , and phosphorus intakes and vitamin B-12 concentrations were associated with higher childhood bone mass , whereas carbohydrate intake and homocysteine concentrations were associated with lower childhood bone mass ( all P-trend < 0.01 ) . Maternal fat , magnesium intake , and folate concentrations were not associated with childhood bone mass . In the fully adjusted regression model that included all dietary factors significantly associated with childhood bone mass , maternal phosphorus intake and homocysteine concentrations most-strongly predicted childhood bone mineral content ( BMC ) [ β = 2.8 ( 95 % CI : 1.1 , 4.5 ) and β = -1.8 ( 95 % CI : -3.6 , 0.1 ) g per SD increase , respectively ] , whereas maternal protein intake and vitamin B-12 concentrations most strongly predicted BMC adjusted for bone area [ β = 2.1 ( 95 % CI : 0.7 , 3.5 ) and β = 1.8 ( 95 % CI : 0.4 , 3.2 ) g per SD increase , respectively ] . CONCLUSION Maternal first-trimester dietary factors are associated with childhood bone mass , suggesting that fetal nutritional exposures may permanently influence bone development Obese pregnant women are the focus of numerous dietary and lifestyle intervention studies , however there is a paucity of literature examining the habitual dietary and lifestyle habits of this population . This paper aims to assess maternal dietary and lifestyle habits in an obese cohort , in order to identify priority areas to be addressed in future studies and in clinical practice . This prospect i ve observational study recruited 100 pregnant women with a body mass index 30.0–39.9 kg/m2 from routine antenatal clinics .  Dietary intakes were assessed using a 3-day food diary and a structured lifestyle question 
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Conclusion These results are consistent with a lack of improvement in calcium dietary intake during pregnancy and confirm the gap between HICs and LMICs , with alarmingly low intakes recorded for pregnant women in LMICs .