A recent study published aimed to improve the dietary habits of women with gestational diabetes using myfood24

Gestational diabetes mellitus (GDM) occurs in 1 in 20 pregnancies and typically affects women in their third trimester. Many hormonal changes occur in pregnancy, in particular insulin-resistant hormones such as oestrogen and progesterone increase, causing elevated blood glucose levels. In order to deal with increased blood glucose, the body needs to produce more insulin.

GDM occurs when the body is unable to produce enough insulin to meet the demand. GDM increases the risk of complications in pregnancy for both the mother and baby, for example: pre-eclampsia, premature birth and stillbirth. GDM can develop in any pregnant woman, but those with a BMI above 30 or with a family history of diabetes are at an increased risk. In most cases, blood glucose levels return to normal post-pregnancy, however within 5 years of giving birth 50% of women with GDM will develop type 2 diabetes.

Dietary and lifestyle changes such as exercise are recommended for treatment of GDM in order to reduce blood glucose levels. Such dietary changes include promotion of foods with a low glycaemic index and reducing portion sizes. If after 2 weeks of dietary modifications, blood glucose levels are still not within the target range (fasting: <5.3 mmol/L, 1hr after meal: <7.8 mmol/L) medication will be required for the rest of the pregnancy. The self-management of diet and glucose monitoring can be demanding and can lead to increased levels of distress.

Dietary assessment by a dietitian forms part of the standard care at diagnosis. Such forms of dietary assessment is cumbersome for both the dietitian and mother-to-be and can be subject to misinterpretation leading to inaccurate results.

myfood24 has the capacity to reduce the burden of dietary assessment and the chance of misleading results. Due to the self-reporting element and feedback provided it also has the potential to empower mothers-to-be and reduce their feelings of distress.

In a recent study looking to improve dietary habits of women newly diagnosed with GDM, myfood24 was used to assess dietary intake alongside glucose monitoring.

The women were asked to self-complete their dietary intake using myfood24 as part of the standard antenatal care. Alongside this care, the women were asked to complete a user questionnaire to assess usability (user experience, ease of understanding and ease of use) of myfood24.

Ease of Use

The study found that most women thought myfood24 was ‘straightforward’ to use. The portion images were highlighted as a particularly useful feature, as were the reminder prompts, the women felt that these features led to a more accurate account of that they’d eaten.

“I thought that [myfood24] made me remember things. It was more specific. I think it was easy to forget when you’re writing it down. You know because it reminded you –have you remembered to put a drink down here, have you remember to put a snack down there.”

Improving Health Literacy

In regards to positive impact on food choices and behaviours, the most valuable feature of myfood24 was the feedback produced. Women found that this feedback increased their knowledge of dietary intake and enabled them to understand what dietary choices and portion sizes would be more suitable.

“I was like ooh I shouldn’t have eaten that or oh, I’ve had a really good day today.”

Increasing Sense of Control

Not only did the feedback motivate women to make better choices in the future but they also felt it provided them with the reassurance they needed to make these choices, reducing their dependence on the dietitian and increasing their sense of control.

 “Once you can see it in numbers and can see the picture of it, it’s harder just to shrug off and think I’m fine… I couldn’t just go with it.”

Dietary Changes

The process of recalling their daily intake in combination with the feedback they received led them to consider dietary changes – other studies have shown that this improves uptake of self-monitoring and leads to dietary changes.

“A week’s worth of days in front of you it does make you think about what you’re eating and how much”

Clinical Application 

Ultimately, myfood24 could be used by women with GDM to improve their health literacy leading to increased self-efficacy and self-management skills and to improve their dietary choices and behaviours. Health practitioners could also benefit from myfood24 through a reduction in workload, this would allow more time to be spent on education and support for patients to enhance the service provided.