Background: Adolescents are increasingly susceptible to obesity, and thus at risk of later non-communicable diseases, due to changes in food choices, physical activity levels and exposure to an obesogenic environment. This review aimed to synthesize the literature investigating the effectiveness of health education interventions delivered in school settings to prevent overweight and obesity and/ or reduce BMI in adolescents, and to explore the key features of effectiveness.Methods: A systematic search of electronic databases including MEDLINE, CINAHL, PsychINFO and ERIC for papers published from Jan 2006 was carried out in 2020, following PRISMA guidelines. Studies that evaluated health education interventions in 10–19-year-olds delivered in schools in high-income countries, with a control group and reported BMI/BMI z-score were selected. Three researchers screened titles and abstracts, conducted data extraction and assessed quality of the full text publications. A third of the papers from each set were cross-checked by another reviewer. A meta-analysis of a sub-set of studies was conducted for BMI z-score.Results: Thirty-three interventions based on 39 publications were included in the review. Most studies evaluated multi-component interventions using health education to improve behaviours related to diet, physical activity and body composition measures. Fourteen interventions were associated with reduced BMI/BMI z-score. Most interventions (n = 22) were delivered by teachers in classroom settings, 19 of which trained teachers before the intervention. The multi-component interventions (n = 26) included strategies such as environment modifications (n = 10), digital interventions (n = 15) and parent involvement (n = 16). Fourteen studies had a low risk of bias, followed by 10 with medium and nine with a high risk of bias. Fourteen studies were included in a random-effects meta-analysis for BMI z-score. The pooled estimate of this meta-analysis showed a small difference between intervention and control in change in BMI z-score (− 0.06 [95% CI -0.10, − 0.03]). A funnel plot indicated that some degree of publication bias was operating, and hence the effect size might be inflated.Conclusions: Findings from our review suggest that school-based health education interventions have the public health potential to lower BMI towards a healthier range in adolescents. Multi-component interventions involving key stakeholders such as teachers and parents and digital components are a promising strategy.

Objective: To examine prevalence, risk factors, and consequences of maternal obesity; and provide evidence on current policies and programs to manage maternal obesity in India.Methods: This is a mixed‐methods study. We analyzed the National Family Health Survey (NFHS)‐4 data (2015–16) to estimate the prevalence and risk factors of obesity, followed by a desk review of literature and stakeholder mapping with interviews to develop policy guidance.Results: National prevalence of obesity (defined by WHO as body mass index ≥25) was comparable among pregnant (12%) and postpartum women (13%) ≥20 years of age. A high prevalence of obesity (>40%) was observed in over 30 districts in multiple states. Older maternal age, urban residence, increasing wealth quintile, and secondary education were associated with increased odds of obesity among pregnant and postpartum women; higher education increased odds among postpartum women only (OR 1.90; 95% CI, 1.44–2.52). Dietary variables were not associated with obesity. Several implementation challenges across healthcare system blocks were observed at policy level.Conclusion: Overall prevalence of obesity in India during and after pregnancy is high, with huge variation across districts. Policy and programs must be state‐specific focusing on prevention, screening, and management of obesity among pregnant and postpartum women.

Optimum nutrition and weight before and during pregnancy are associated with a lower risk of conditions such as pre-eclampsia and gestational diabetes. There is a lack of user-friendly tools in most clinical settings to support healthcare practitioners (HCPs) in implementing them. This study aimed to evaluate the acceptability of (1) using a nutrition checklist designed by the International Federation of Gynecology and Obstetrics (FIGO) for nutritional screening of women in the preconception and early pregnancy period and (2) routine discussion of nutrition and weight in clinical care. An online cross-sectional survey was conducted with women (aged 18–45) and HCPs (e.g., general practitioners, obstetricians, and midwives). Quantitative statistical analysis and qualitative content analysis were performed. The concept and content of the checklist were acceptable to women (n = 251) and HCPs (n = 47) (over 80% in both groups). Several barriers exist to implementation such as lack of time, training for HCPs, and the need for sensitive and non-stigmatizing communication. Routine discussion of nutrition was considered important by both groups; however, results suggest that nutrition is not regularly discussed in perinatal visits in the UK. The FIGO nutrition checklist presents a valuable resource for use in clinical practice, offering long-term and intergenerational benefits for both mother and baby.

Introduction: The interconception period is considered a time when parents are likely to engage with health messages and are in frequent contact with healthcare professionals. Through this scoping review and policy analysis, we synthesized articles and guidelines on interconception care to provide recommendations to improve health outcomes for parents, infants and future generations.Methods: Four databases were searched systematically, using Medical Subject Headings and free‐text terms based on ‘interconception’ and ‘postpartum.’ Selected articles included systematic reviews, pilot studies and guidelines on interconception and postpartum interventions published globally and in English by UK public health organizations and government agencies between 1 January 2010 and 12 January 2021. Thirty percent of titles, abstracts and full‐text papers were double‐screened. The description table of identified guidelines was used as a template to qualitatively generate key categories, which later developed into a framework of six domains. Findings are described using a narrative synthesis approach.Results: We found 47 documents with guidelines, 29 systematic reviews and 6 pilot studies on interconception and postpartum care. Six domains were generated as follows: interconception care, nutrition‐specific, nutrition‐sensitive, personal‐centred care, health professional, and multistakeholder approach. Interconception care opportunities include the postpartum period, family planning, routine practice and risk assessments. Health and nonhealthcare professionals with roles to play in the interconception period include general pratitioners, health visitors, dieticians, nutritionists, health psychologists, community groups, local authorities and charities such as Tommy's and First Step Nutrition.Conclusions: The interconception and postpartum periods offer crucial opportunities to intervene, to reduce possible long‐term effects of suboptimal nutrition. Although the policy analysis for this scoping review focused on the United Kingdom, the literature review had a global focus and the recommendations can have wider implications for other countries.

Objective To explore the knowledge of Developmental Origins of Health and Disease (DOHaD) concepts among midwives and obstetricians and to identify barriers and facilitators for clinicians to engage women and their partners before or early in pregnancy on risk factors associated with DOHaD, and thus to embed the concept of DOHaD in routine clinical practice. Methods A qualitative study using semi-structured interviews will be conducted in Ghana, India, Pakistan, Brazil, the UK, and USA in collaboration with the International Confederation of Midwives and the International Federation of Obstetricians and Gynecologists. Participants will be contacted via email and telephone interviews will be conducted until data saturation followed by inductive thematic analysis. Results Findings from this exploratory study will provide new knowledge about the perspectives of midwives and obstetricians on DOHaD and their role in preventing the intergenerational passage of non-communicable disease (NCD) risk and improving preconception care. Conclusion This study will help us understand the current use of DOHaD principles in international maternity care and how this can be improved. Bringing DOHaD to clinical practice will help healthcare practitioners adopt a long-term approach in the prevention of NCDs and childhood obesity and will help women to enter pregnancy in optimum health.