Master Thesis MSc in Marketing

Author:
Svetoslava Stefanova

Academic Supervisor:
Jessica Aschemann-Witzel

Qualitative study of womens dietary habits and nutritional preferences in the pre- and postpregnancy period

Aarhus School of usiness ! Aarhus "niversity #une $%&&

Table of contents

'( Abstract((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((() ''( 'ntroduction(((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((* '''( +iterature ,eview((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((&( 'ntrapersonal factors affecting dietary choice((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((&(&( .nowledge of nutrition re/uirements of pregnancy(((((((((((((((((((((((((((((((((((((((((((((((((((((&($( 0ausea and vomiting in pregnancy((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((1 &()( Attitudes towards weight gain in pregnancy(((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((2 $( 'nterpersonal factors((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((&$ $(&( 'ncome((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((&$ '3( Methodology(((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((&3( ,esults((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((($4 &( 5re-pregnancy period((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((($4 3'( 6onclusion(((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((*1 3''( 'mplications for research and practice((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((7& 3'''( ,eferences:(((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((7) '8( Appendi9(((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((-)

'( Abstract

Aim: The research aims to investigate what is parents behavior and what eating strategies do they adopt in the period of transition to parenthood !ts see"ing to provide #nderstanding over how yo#ng women change their eating habits in the different stages they go thro#gh between pregnancy and "indergarten and what factors are basic determinants for their dietary choice $children% income% mar"eting campaigns% family and friends etc & !t is also loo"ing to show if the parents are cons#ming healthy or #nhealthy foods and what is the effect over the body weight Method: A '#alitative method is chosen in cond#cting the following st#dy to gain deep insight into parents eating habits and their change of lifestyle with transition to parenthood !nterviews were cond#cted thro#gh e-mail with 1( mothers from )astern )#rope Findings: The st#dy showed that both pregnancy and giving birth bring changes in womens eating habits The period of pregnancy is disting#ished with transition to a healthier diet% while the postpregnancy period is related with a t#rn towards #nhealthy and irreg#lar eating Practical Implications: The res#lts of the st#dy can be #sed from weight and mar"eting management in developing prod#cts and campaigns% which stim#late cons#mer behavior towards healthy eating and proper weight gain and loss An ade'#ate diet of the mother d#ring the pregnancy will ass#re a healthy growing of the fet#s and less ris" of diseases afterwards

!! !ntrod#ction

+Transitions are periods of change where there are shifts in lifestyles from one stage to another, $-rice et al 2...& -regnancy and the transition to parenthood mar" a ma/or developmental period with important implications for parents% for the infant0parent relationship and the infants development 1any researches has shown that the birth of a child is often accompanied with more stress than any other developmental stage and is considered as the most f#ndamental change of the family life-cycle $2owan et al 134(% -riel 5 6esser 2..2& The concept of transitions wor"s in collaboration with that of tra/ectories in the life co#rse perspective $7evine 2 1 % 2..(& A life co#rse perspective observes peoples behavior 0 what choices do they ma"e abo#t food and eating and what are the most important factors% affecting those choices $8ozin - % 133.& -eople often report that when some normal life transitions occ#r% they are ma"ing small ad/#stments in their food choice tra/ectories to adapt to new food choice settings $eg passing on a healthier diet when getting pregnant% eating more fr#its and vegetables when becoming parents% eating more fast foods when b#sy with the activities of school-aged children& $7evine 2 and 9lson 2 % 1331& +Some ma/or t#rning points in food choice tra/ectories are related to ma/or life-changing events, $7evine 2 1 % 2..(& 6ecoming a parent may well be related as a ma/or lifechanging event The transition to parenthood is one of the most significant events in peoples life that can be e:perienced $2owan 2 - and 2owan - A % 1333; -olomeno < 2..=& 6ecoming a parent doesnt affect only the eating habits of the person; the change affects all levels of family life% incl#ding the relationship in the co#ple and the responsibility the partners share in the family% daily activities and ro#tine% e:pression of intimacy between them% and professional involvement $2owan 2 - and 2owan - A % 1333; -olomeno 2..=& -arents might also change their eating habits in congr#ence with childs needs and become more responsible abo#t n#trition and healthiness of the cons#med food !ts been proved in many st#dies that marriage and parenthood can affect the '#ality of the diet $Schafer 8 6 and Schafer ) % 1343; 8oos > et all 2..1; 7evine 2

and 9lson 2 % 1332&% can bring more concerns for n#trition and health% motivate for food choices $@agerh 8 A 5 Wandel 1 % 1333&% bring concerns for body weight and provo"e body dissatisfaction $Saltonstall 8 % 133*; 8ozin - et all% 2..1& -arents might transit to both healthy and #nhealthy diet% depending on the infl#ence of different factors The following research will st#dy some of the factors% which mainly affect mothers eating habits and the change in n#trition that they trigger A growing body of literat#re st#dies the healthiness of the food that children cons#me and the increasing role they play in the family d#ring the b#ying decisions process $2hristensen - % 2..?; ABrgaard 1 et al.% 2..C& )stablishing healthy eating habits is from a great importance and lots of emphasis is p#t on that recently% as an increasing prevalence of childhood and ad#lt obesity is observed $Doo"er A % 2.1.& -arents shape childrens perceptions and strongly determine their early choices with food and eating% providing both genes and environments for children $Savage J et all 2..C& +-arents select the foods of the family diet% serve as models of eating that children learn to em#late% and #se feeding practices to enco#rage the development of c#lt#rally appropriate eating patterns and behaviors in children, $Savage J et all 2..C& Th#s% as providing healthy food for their children is being of a great importance for parents $Alderson T and 9gden J % 1333; SBndergaard D and )delenbos 1 % 2..C&% +they might be a large healthinterested target gro#p among cons#mers, $Aschemann-Witzel J % 2.1.& They also might provide n#trition to their babies thro#gh the food they cons#me d#ring pregnancy St#dying parents eating habits and how they change in time might be of great importance for childrens health management The c#rrent research aims to investigate what is parents behavior and what eating strategies do they adopt in the period of transition to parenthood !ts see"ing to provide #nderstanding over how yo#ng women change their eating habits in the different stages they go thro#gh between pregnancy and "indergarten and what factors are basic determinants for their dietary choice $children% income% mar"eting campaigns% family and friends etc & !t is also loo"ing to show if the parents are cons#ming healthy or #nhealthy foods and what is the effect over the body weight

!!! Eiterat#re 8eview

When women initially become pregnant% they often thin" that they need to cons#me a significantly larger n#mber of calories% to ass#re the growing of the fet#s +An ade'#ate diet d#ring pregnancy maintains the n#tritional stat#s of the mother at a level that conserves her own body tiss#es and contrib#tes to the normal development and birth of a healthy% f#ll-term baby, $Ati 2 et al 2..2& As many researches show% d#ring the pregnancy women often become aware of n#trition% see" health advice and change their diets $Anderson A S % 2..1& The healthy development of the baby and maintaining a good body weight may be an incentive and motivator for positive dietary change at this time !t may also be a good time to target women with healthy food choices and give them advises for a healthy eating 1any factors might affect the dietary choice of the pregnant woman !ntrapersonal factors are s#ch individ#als characteristics that infl#ence the specific food choices a person ma"es% whereas interpersonal are s#ch as income% relationships with family members% child and friends etc $@owles ) % 2..4& +They have a collective impact and may interact with individ#al characteristics to infl#ence healthy eating by pregnant women, $@owles ) % 2..4&

1 !ntrapersonal factors affecting dietary choice

1.1. Knowledge of nutrition requirements of pregnancy

-regnancy is a time of social% psychological% behavioral% and biological change in womenFs lives !t is a time of life when women become more aware abo#t health and n#trition and their impact over the body% especially when those are related to the o#tcomes of pregnancy $9lson 2 % 2..(& Still many parents might lac" the "nowledge what act#ally a healthy diet is The aim of many health and n#trition organizations and different a#thorities is to give advice and help mothers to achieve the birth of a healthy

infant Therefore they have developed specific recommendations for pregnant women related to n#trient inta"e of food% the #se of vitamin and mineral s#pplements% proper weight gain d#ring the period% and physical activity $Allen E D % 2..1; !nst 1ed% 133.& Dealthy eating d#ring pregnancy is defined as the ability to maintain healthf#l eating habits% which are related to p#rchasing% preparing and cons#ming healthy meals% as well as ma"ing food choices% conformable to the n#trition re'#irements of pregnancy $@owles ) % 2..4& @ood choices are considered healthy% when the mother is cons#ming appropriate amo#nts of fr#its and vegetables according to the recommended levels for pregnancy% or #nhealthy% when she is eating less than the recommended amo#nts of mil" or vegetable servings and cons#ming foods high in fat and calories b#t low n#trient content $>eorge > et all% 2..(& While most pregnant women are aware that they m#st +eat healthy foods, to help the fet#s grow% few act#ally have a "nowledge for the specific n#tritional demands of the baby% and therefore may not eat according to the re'#irements of the pregnancy and th#s maintain #nhealthy diet $@owles ) % 2..2& +Women may cons#me foods high in fat b#t low in protein% vitamins% and minerals; the res#lt may be ade'#ate maternal weight gain b#t inade'#ate n#tritional inta"e, $Aaronson E and 1acnee 2 % 1343& )d#cating mothers and giving them a good n#trition advice may help to clear #p some of the conf#sions they might have abo#t the food 1any social and governmental campaigns are wor"ing in that direction Dowever% a st#dy cond#cted by >oody and his colleag#es $133?& fo#nd that health ed#cation can be misinterpreted or mis#nderstood by mothers and that they often ma"e their dietary choice in the conte:t of their social% c#lt#ral% and economic sit#ation The report concl#ded that despite mothers were highly aware of healthy eating campaigns% many of them did not #nderta"e any changes in diet in conformity with government recommendations $6lincoe A % 2..(& 1others might feel the period of pregnancy as liberating and start cons#ming foods according to their cravings% which in many occasions might mean establishing an #nhealthy diet +They might need stim#li or e:planations other than those which simply rest on the idea of a rational response to information, $>oody et all% 133?& 6ecoming a parent is an important step in peoples lives and the change of their eating habits might be a significant and stressf#l event Therefore mothers sho#ld be ed#cated

abo#t the effects of an #nhealthy diet and awareness abo#t healthy choices sho#ld be b#ild Womens perceptions of what constit#tes eating healthy and what is the effect over the baby may infl#ence their cons#mer behavior Some women change their eating habits in pregnancy as they start to cons#me foods they consider +better to eat%, s#ch as fr#its and vegetables% and limit salty snac"s $@owles 5 >abrielson% 2..(; @owles et all% 2..(; 8ifas-Shiman S et all% 2..=& Women who are eating better d#ring pregnancy are aware that they have healthy diets They believe that in order to maintain these healthy habits d#ring the period% they have to cons#me protein and eat well-balanced meals $@owles et al % 2..(& @actors that facilitate their healthy eating habits are family s#pport% "nowledge of healthy foods% willingness to prepare separate meals for themselves% healthy food choices on the mar"et and eating meals at home Dowever% cravings% demands on time% and na#sea are barriers to healthy eating $@owles et al % 2..(& !dentifying barriers and facilitators to healthy eating is an important step in designing effective n#trition prod#cts and mar"eting campaigns to improve dietary '#ality in pregnant women

1.2. ausea and !omiting in pregnancy

Aa#sea and vomiting are among the most common symptoms e:perienced by women in pregnancy These problems can have a profo#nd effect over the mothers daily life and her family They ca#se discomfort and affect her ability to eat and the individ#al food choices she ma"es 8esearches show that seventy to 4(G of pregnant women e:perience the symptoms of na#sea and (.G report having vomiting% and 1*G of pregnant women report na#sea and vomiting beyond 2. wee"s of gestation $Jewel 7 and Ho#ng > % 2..*; Eacroi: 8 et all% 2...;& !t is pop#larly "nown as Imorning sic"ness% b#t many women find these physiological symptoms persist thro#gho#t the day and even into the night $Eacroi: 8 et al% 2...& This problem may affect the eating habits of the mother and she might need to consider some changes in the food she cons#mes in order to prevent the symptoms The diet might become #nhealthy% #nvaried% irreg#lar% which might also affect the n#trition of the baby d#ring the period 2ommon problems that also occ#r are depression and relationship problems and many mothers might be fearf#l of another

pregnancy $<olins"i J 2..4& Aa#sea and vomiting are #npleasant symptoms% which have effect on a womanFs family% her wor" and relationships% b#t mostly on her eating habits $>adsby 8 et al% 133*; Jewell 7 and Ho#ng > % 2..*& St#dying the foods that women can bear to eat d#ring the period might help for some companies to create prod#cts% mothers will be willing to b#y 8esearches show that women mostly s#ffer from light symptoms of na#sea and vomiting The most common advice given to mothers by specialists is to eat Ilittle and often in order to prevent hypoglycemia% which may e:acerbate the problem $Tiran 7 2..=& +!n cases of mild to moderate na#sea and vomiting% women #s#ally e:periment with dietary adaptations% eating only foods that appeal and do not e:acerbate symptoms, $Tiran 7 2..=& Anyway the problem may re'#ire a change in the lifestyle of the mother and her diet in order to provide a healthy growing of the baby d#ring the period

1.". Attitudes towards weight gain in pregnancy

All over the world the body is an important aspect of womens personal self and a way to comm#nicate with others in society +!nherent is the c#lt#ral notion of bea#ty and the optimal size and shape of the body, $Delman 2 % 2...& Society reveres the slim ideal and the press#re for women to maintain perfect body shape is e:tremely high $>arner 7 1 et al % 134.; Striegel-1oore 8 D et al % 134=& Thro#gho#t the life cycle women of all ages e:perience weight concerns and body dissatisfaction $Stevens 2 and Tiggemann 1 % 1334& 6eing overweight might bring stress to women% as the body has become an e:pression for s#ccess and achievement Eife events might be related to weight change and mainly motherhood transition has a great impact over the body The body may change dramatically and that might affect the womens self perception% their relationships with the partner% society and the baby After giving birth women might not li"e the changes that occ#rred in their bodies and might find that distressing $Wal"er E % 1334& 8et#rning to their old body shape and weight may be diffic#lt and not always achievable $Jen"in W 5 Tiggemann 1 % 133C& The iss#e becomes more salient when society doesnt place s#ch a high val#e on mothering or baby 3

care-ta"ing as it places on thinness $Stern > 5 Jr#c"man E % 134*& 1any mothers may therefore #nderval#e motherhood and pregnancy and de-val#e their +larger% maternal body, beca#se it is socially less accepted from esthetical point of view $7avis-@loyd 8 ) % 133?& !f women strongly val#e their body shape in the pre-pregnancy period% it might be e:tremely diffic#lt for them to accept the new role and the eating habits they have to ac'#ire d#ring motherhood A few st#dies indicate that the weight and body shape changes d#ring pregnancy are liberating for some women and bothersome to others% and the difference may lie in the pre-pregnancy dieting histories and weight characteristics of women $>enevie E and 1argolies ) % 134C& What was typical for women dieting for weight loss was episodes of overeating d#ring pregnancy% feelings of dissatisfaction abo#t the changes which occ#rred with shape in pregnancy% and plans to start a diet% following childbirth $@airb#rn 2 > and Welch S E % 133.& 8esearches also show that body size from the period before women get pregnant has been negatively associated with attit#des towards weight gain in pregnancy and attit#des towards body shape in postpregnancy $2opper 8 E et al % 133(& 6#t mostly the ris" of becoming overweight after the pregnancy in the long r#n increases two to three times beca#se of overeating and #ncontrolled diet $>#nderson ) - et al 2...& A st#dy cond#cted by Thorsdottir and 6irgisdottir $1334& showed that mothers who gained more than recommended d#ring pregnancy retained more weight in the postpregnancy period than those who were in the norms 8easons% mentioned as basic for the weight retention are disappointment with body shape% s#rprise% symptoms of eating disorders% red#ced self-esteem% and depressive symptoms at 1 year postpart#m $Jen"in and Triggemann% 133C; Wal"er E 9 % 133C; Stein A and @airb#rn 2 > % 133=& 6ecoming a parent has also been described as a Icrisis $Eeifer 1 % 13CC; -ines 7 % 13C4; 9sofs"y D J et al % 134(& re'#iring str#ggle and ad/#stment to the new role for parents who ma"e the transition to mat#rity and growth According to Aicholson $1333& the postpart#m period is heavy for womenK they are happy to give birth and have a child and in the meantime #nhappy with the losses that this event brings to their lives -regnancy indicates the beginning of a life stage in which women start considering the needs of their child so important as their personal n#tritional needs and weight goals $7evine 2 and 9lson 2 % 1332; >ordon J 6 and Tobias A % 134?& +Transitions in family roles related to

1.

marital stat#s and parenthood are perceived by women to be lin"ed to changes in dietary behaviors, $7evine 2 and 9lson 2 % 1331& !t might be diffic#lt for mothers to establish reg#lar eating habits as pregnancy brings disr#ption to ro#tine% sleep and mealtimes $-atel - et al% 2..(& !n many st#dies women report to face problems with establishing and maintaining a healthy diet $Stein A 5 @airb#rn 2 > % 133=& 6eca#se of the demands of the infant they may not have the same time as before% energy or freedom to #tilize previo#s strategies for weight control $-atel - et al% 2..(& 7#ring the postpart#m period v#lnerable mothers might not be able to fight preocc#pations with body shape and weight% which intensify and may precipitate eating disorders $Welch S E et al % 133C& 8ecent st#dies have shown that mothers% habit#ally dieting for weight loss before pregnancy% gained more weight d#ring that period They also consider themselves more irresponsible regarding weight d#ring pregnancy $Abrams 6 et all% 2..1; 2onway 8 et all% 1333& S#ch eating disorders are relatively common amongst women of childbearing age with a prevalence of 102G $@airb#rn 2 > 5 6eglin S % 133.& They are characterized by e:treme concerns abo#t body shape and weight% which can greatly affect eating habits of women and change their behavior d#ring pregnancy $-atel - et al% 2..(& 2onway et all $1333& fo#nd that% despite similarities in n#trient inta"es% those mothers who were #s#ally restraining themselves from eating in the pre-pregnancy period had a higher proportion of weight gain% which was above the recommended amo#nt The comparison was made with #nrestrained eaters $1ela J % 8ogers - J % 1334& + The data s#ggests that repeated cycles of dieting and overeating may distort ones ability to perceive internal h#nger and satiety cl#es, $LS 7D% 133=& !n order to prevent mothers from s#ch a disr#ptive attit#de% weight management sho#ld provide more information and n#tritional choices for women in the pre and postpregnancy period in order for them to b#ild and maintain a healthy lifestyle and good body shape The following research aims to st#dy the eating behavior of women d#ring the different phases of pregnancy and e:amine their weight concerns To #nderstand what are womens eating habits and the strategies they #se to cope with the new e:periences d#ring pregnancy and postpregnancy period% their diets and e:ercise behaviors will be observed The res#lts might help the weight management to create prod#cts% according to womens preferences for healthy and dietary food choice

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$( 'nterpersonal factors !nterpersonal factors have strong infl#ence over pregnant womens ability to eat healthy foods !nterpersonal determinants of healthy eating incl#de income% interactions with family members% friends and s#pport from others

2.1. Income

Eow income is a social factor% which is commonly associated with #nhealthy eating $@inch 6 % 2..*& The limited financial reso#rces of women may prevent them from providing healthy n#tritional diet for the period of pregnancy $6er"owitz > 5 -apierni" ) % 133*& St#dies show that low-income pregnant women often cons#me less fr#its and vegetables and have a lower inta"e of lean so#rces of protein and whole grainsMall comparatively high-cost foods $8ogers ! et all% 1334; Wynn S et all% 133?& This eating behavior can lead to lower inta"es of macron#trients% vitamins% and minerals $8ogers ! et al % 1334&% and can lead to low infant birth weight $Wynn S et al % 133?& A st#dy of (1* 6ritish pregnant women shows that in distinction from those gro#ps with higher income% low-income women are yo#nger% have an increased probability of stillbirth or low birth weight babies% and their dietary inta"e of n#tritional food is poor% which means less whole grain and dairy prod#cts% fr#its and vegetables 9ne e:planation for this is the high cost of these foods $Wynn S et all% 133?& Th#s% womans ability to implement a n#tritionally ade'#ate diet may be negatively affected by the income as it increases their inability to provide healthy food $6er"owitz > 5 -apierni" ) % 133*& Ho#ng mothers need to #se their food b#dget caref#lly and b#y food that can provide more calories and can be easily stored; therefore many of their choices incl#de ine:pensive% high on fat and carbohydrates foods $Stevens 2 % 2.1.& 7epending on whether these yo#ng women receive assistance from the government or not% they have different personal e:perience with providing food for their families $Stevens 2 % 2.1.& !n several st#dies% yo#ng mothers reported that they were perceptive of p#blic health messages and #nderstood the need to maintain n#tritional diet% s#ch as to increase the

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cons#mption of fresh fr#its and vegetables and whole grain prod#cts $2ollins 1 ) et al% 2...; Stevens 2 % 2..?; Stevens 2 A % 2..=& The reasons given for poor n#trition and obesity in their lives incl#ded the high cost of fresh foods% cravings for #nhealthy prod#cts d#ring some periods% lac" of available s#permar"ets in the area they live% and the need to rely on nonperishable high-density foods d#ring times of food insec#rity each month $2enter on D#nger and -overty% 2..2& @#rthermore% several st#dies also have shown that low income can lead to perceived stress and depression among mothers% which are allied with ris"ier health and n#trition behaviors in pregnant women and new mothers $Wal"er E 9 % 1343; Wal"er E 9 et al % 1333& 2onversely% social s#pport and family care is associated with more positive health behaviors $Wal"er E 9 et al % 1333& Eow income might be a big problem for mothers living in co#ntries from )astern )#rope They might face food insec#rity or other diffic#lties to provide healthy and n#tritional diet for the baby and themselves Still despite economic limitations and the negative infl#ence of stress% women might find different strategies to provide ade'#ate dietary inta"e for them and their children !nfl#enced by different factors they might find reso#rces to eat the re'#ired healthy foods and enact different health behaviors

2.2. Marital status and social support

1arital stat#s might greatly impact mothers eating behavior St#dies cond#cted in )#rope proved that after marriage women increase the cons#mption of snac"s and dessert% decrease alcohol $7eshm#"h-Tas"ar - % et all% 2..C& and also incl#de more fr#its and vegetables in their diets $6illson D % -ryer J % 5 Aichols 8 % 1333& than #nmarried individ#als Some other st#dies fo#nd that it was easier for pregnant women with family s#pport to engage in healthy eating @#rthermore% single women or those who spend lots of time alone% tend to eat fre'#ently at fast food resta#rants with friends !n part to f#lfill socialization needs% they often cons#me #nhealthy high fat foods $@owles ) et al % 2..(& A positive relationship has been fo#nd between +social s#pport and positive health

1*

practices in pregnancy% which incl#de healthy eating patterns% e:ercise% and dr#g and alcohol avoidance, $2annella 6 % 2..=& Het% a general concl#sion cannot be made 1arriage and friendships might affect mothers diets in a positive or negative way The following st#dy will observe the effect of those factors over the mothers eating habits and the changes that they overtoo" #nder their infl#ence

2.". Parents#children relationship

A life co#rse perspective incorporates m#ltiple concepts with importance for #nderstanding food choices +These concepts incl#de tra/ectories% transitions% t#rning points% lives in place and time% and timing of events in lives, $7evine 2 1 % 2..(& 6ecoming a parent is an event that might affect both parents and children dietary behavior A healthy dietary inta"e of pregnant women is important not /#st for the mother b#t it also has an infl#ence on maternal and baby health% and th#s may e:ert an infl#ence over the health of yo#nger and older generations $van Tei/lingen ) et al% 1334& Ad#lts ma"e food choices for the whole family +-arental attit#des m#st certainly affect their children indirectly thro#gh the foods p#rchased for and served in the ho#sehold% thereby also infl#encing the childrens e:pos#re and% hence% perhaps their habits and preferences, $Wardle J % 133(& Dence there is an opport#nity for healthy eating habits to be established in early age That is why it is vital parents to be well informed abo#t appropriate diets and targeted with healthy choices of food both for them and their children +The conditions in which foods are chosen% the lives of the parents ma"ing the choices% and the foods available to be chosen are constantly changing, $7evine 2 1 % 2..(& Significant social and economic trends% which affect the food choices incl#de changes in the conditions related with maternal employment and parental ho#rs of employment $-resser D 6 % 1333; 6#rea# of Eabor Statistics % 2..(& and time spent preparing and eating meals at home $6lisard A et all 2..2; 7evine 2 1 et all 2..*; Jacobs J A et all 2..1& 6eca#se of the b#sy daily ro#tine% mothers might adopt #nhealthy eating habits% which they #nconscio#sly might transfer over the child According to Aielsen $2..2&% an 1?

increasing proportion of food that parents and children eat is prepared and cons#med away from home The eating c#lt#re is drastically changing and this is related to changes in food cons#mption% changes in n#trient inta"e% s#ch as increases in calorie cons#mption $2hanm#gam - et all 2..*&; +and a disproportionately high level of dietary fat% sat#rated fat% cholesterol% sodi#m% and calories and a low level of fr#its and vegetables% dietary fiber% calci#m% and iron% associated with meals eaten away from home, $>#thrie J @ et all% 2..2& 8ecently st#dies prove that mar"eting campaigns significantly infl#ence parents choices for food -regnant mothers might be especially v#lnerable as they might tend to eat according to cravings and personal taste As the baby absorbs some components from the food that the mother cons#mes% #nhealthy eating might have a negative effect over the childs n#trition and growth -arents are a ma/or mediator of childrens access to food and determine their eating habits after the birth $>ier S et al% 2..C& -arents infl#ence childrens dietary behavior by the types of foods they b#y or allow their children to b#y $>ier S et al% 2..C& Sometimes parents might adopt #nhealthy eating habits and infl#ence negatively to their children by increasing the cons#mption of fat and s#gar d#ring the day @ast food is a type of food that is mar"eted directly both to ad#lts and their children and often preferred when the family is o#t St#dies show that the cons#mption of s#ch food is steadily increasing despite the fact that ad#lts fre'#ency of dining in fast-food resta#rants is associated with increased body weight and obesity $@rench A % Darnac" E % and Jeffery 8 % 2...; -ereira A et al 2..*& @actors infl#encing the decision of heaving s#ch #nhealthy meals might be cravings and preferences The b#sy daily ro#tine of the parents might also be a factor for the increasing cons#mption of that "ind of food 1others% who have been at wor" the whole day% might not have the time to prepare hot and healthy dish afterwards This might predetermine bad eating habits and #nhealthy diet for the whole family As parents interact with children daily% they have the opport#nity to improve their food choices $6irch E E 5 @isher J A % 1334& +@amily members can infl#ence the food preferences of their children by providing healthy food choices% offering m#ltiple opport#nities to prepare and eat new foods% and serving as positive role models thro#gh their own food choices, $Jalich J et all% 2..3& 2hildren might also affect parents eating

1(

behavior thro#gh the foods they re'#est 6y re'#esting food prod#cts they determine the choice for the whole family as% food prod#cts% which are most often re'#ested by children% are most often bo#ght on re'#est $Ward S and Wac"man 7 % 13C2& 8esearch s#ggests that fast-food mar"eting infl#ences childrens food preferences and what they repeatedly as" their parents to b#y for them $Dastings > et al 2..*; !nstit#te of 1edicine 2..=b& !f parents b#y fast food for their children and constantly go to s#ch resta#rants% they might not be able to resist the temptation and increase their cons#mption of this type of food The same can be said for any prod#ct re'#ested by the child Th#s% children might also affect parents dietary choices and predetermine both healthy and #nhealthy eating The following research will st#dy the relationship parents-children and how their eating behavior is affected from each other !t will loo" also on the factors% which infl#ence their choice and preferences for food% incl#ding the cons#mption of fast-food and advertising

'3( Methodology

N#alitative research is very appropriate when the aim of the research is to give a more profo#nd #nderstanding of an iss#e% incl#ding the ro#tines and interactions of the respondents in everyday life $2arson 7 et al % 2..1; @lic" L % 2..3& The central ideas g#iding the method are mostly what disting#ish the '#alitative research from '#antitative research According to @lic" $2..3& the main characteristics of the '#alitative st#dy are +the correct choice of appropriate methods and theories; the researchers reflection on their research as part of the process of "nowledge prod#ction; and the variety of approaches and methods, $@lic" L % 2..3&

Appropriateness of methods and theories N#antitative methods li"e e:periments or s#rveys cannot be #sed in every area of research A problem that might arise with this type of research is the inability to identify 1=

and isolate variables to be #sed in the e:periment 9r it might be really hard to ass#re big eno#gh representative samples for the research% as the phenomena can be st#died only in a few cases All these sit#ations re'#ire the #se of '#alitative methods $@lic" L % 2..3& According to @lic" $2..3&% for the st#dy of comple: iss#es is good to be #sed '#alitative methods The cr#cial factor for choosing the e:act method is the ob/ect #nder st#dy There is no form#lation of variables% b#t the ob/ects are represented in their everyday conte:t Therefore the fields of st#dy of the '#alitative methods are to show how the respondents interact in their everyday life A typical feat#re of the methods is openness towards their ob/ects The aim is to discover and develop something new% not to test what is already "nown as with '#antitative research +Also% while in '#antitative research the validity e:cl#sively follows abstract academic criteria of science% in the '#alitative research it is assessed with reference to the ob/ect #nder st#dy The central criteria here depend on whether the findings are empirically tested or whether the appropriate methods are selected and applied !t depends also on the relevance of the findings and the refle:ivity of proceedings, $@lic" L % 2..3& N#alitative research st#dies the "nowledge and ro#tines of the participants +!t demonstrates the variety of perspectives on the ob/ect and starts from the s#b/ective and social meanings related to it, $@lic" L % 2..3& !t ta"es into acco#nt that beca#se of the different perspectives and social stat#s of the participants% they have different viewpoints and e:perience which affects the res#lts of the st#dy $@lic" L % 2..3&

Reflexivity of the researcher and the research As @lic" states% #nli"e '#antitative research% '#alitative methods ta"e the information gathered from the interviews with the respondents as clearly form#lated part of "nowledge instead of considering it an interviewing variable A min#s of the '#alitative research is that it carries the s#b/ectivity of the researcher and the interviewees% which can affect the res#lts of the st#dy The field process incl#des the following stepsK the researcher reflects on the ob/ects actions% observes their impressions% irritations% feelings

1C

and so on% forms interpretations and doc#ment them in research diaries or conte:t protocols $@lic" L % 2..3& Variety of approaches and methods <ario#s theoretical approaches form the '#alitative research and +their methods characterize the disc#ssions and the research practice, $@lic" L % 2..3& The first starting point is s#b/ective viewpoints +A second string of research st#dies the ma"ing and co#rse of interactions% while a third see"s to reconstr#ct the str#ct#res of the social field and the latent meaning of practices, $@lic" L % 2..3& The history of the '#alitative research and its development in time pres#pposes this variety of approaches% which evolved partly in parallel and partly in se'#ence There is no single method% b#t many different approaches may be #sed according to the research '#estions and the research tradition $@lic" L % 2..3& The appropriateness of methods is a central feat#re of the '#alitative research @or almost every proced#re it is possible to define for which partic#lar research ob/ect it was developed The leading point is that for the p#rpose of the st#dy there is no other s#itable method Lnli"e the '#antitative research% where everything that cannot be investigated by partic#lar method is e:cl#ded from the research% with the '#alitative research the ob/ect and '#estions #nder st#dy represent the point of reference for the selection and eval#ation of methods The research is also strongly directed to everyday life; it aims to investigate participants everyday "nowledge and e:periences The interviews are sit#ated in their everyday conte:t; the conversations are advisory and stim#late the comm#nication $@lic" L % 2..3& +Accordingly% '#alitative data collection% analytical and interpretative proced#res are bo#nd% to a considerable e:tent% to the notion of concept#alityK data are collected in their nat#ral conte:t% and statements are analyzed in the conte:t of an e:tended answer or a narrative% or the total co#rse of an interview% or even in the biography of the interview partner, $@lic" L % 2..3& According to @lic" $2..3&% d#ring the research process the greatest attention is paid to the variety of information reported by the interviewees Another important thing is the

14

capability of the researcher to reflect the answers of the ob/ects #nder st#dy in the best manner Dis actions and observations d#ring the investigation are considered an essential part of the research and every so#rce of personal opinion and infl#ence sho#ld be eliminated 1oreover the researcher sho#ld master the techni'#es of the '#alitative research% which incl#de the #nderstanding of comple: relationships% rather than /#st e:plaining the sit#ation by isolating single relationship% s#ch as +ca#se-and-effect, +Lnderstanding is oriented% in the sense of methodically controlled #nderstanding of otherness% towards comprehension of the perspective of the other party, $@lic" L % 2..3& !n order for this perspective to be f#lfilled and to allow the respondents as m#ch freedom as possible% the collection of the data in '#alitative research sho#ld reflect the principle of openness $Doffmann-8iem% 134.&K the '#estions are form#lated in an opened manner and the proced#re of observations is not strict b#t is cond#cted also in an open fashion $@lic" L % 2..3& N#alitative research is mainly te:t-based discipline despite the growing importance of vis#al data as a so#rce s#ch as photos or films $@lic"% 2..3& +!t prod#ces data in the form of te:ts- for e:ample transcribed interviews or ethnographic fieldwor" notes 0 and concentrates% in the ma/ority of its interpretative proced#res% on the te:t#al medi#m as a basis for its wor", $@lic"% 2..3& N#alitative and '#antitative research can be combined as they are compatible with each other Wilson $1342& Dowever% '#alitative research needs the #se of different approaches when manip#lating with the data !t can #se a narrative interview or a '#estionnaire% for e:ample $@lic"% 2..3& N#alitative research covers a specific area of the relation between iss#e and method $6ec"er D S % 133=& +@#rthermore% only in a very restricted way is it compatible with the logic of research familiar from e:perimental or '#antitative research, $@lic"% 2..3& N#antitative research is a very strict process and can be neatly arranged !t is remar"able with a linear se'#ence of the concept#al% methodological and empirical steps The steps are going consec#tively and can be treated separately A m#t#al interdependence of every single stage of the process can be observed in '#alitative research and this sho#ld be ta"en into acco#nt m#ch more $>laser and Stra#ss% 13=C&

13

According to @lic" $2..3& the traditional version of '#antitative research has the following stepsK first we constr#ct a model of the ass#med conditions and relations of the phenomena Then% we derive hypotheses% which are operationalized and tested against empirical conditions +The concrete or empirical +ob/ects, of research% li"e a certain field or real persons% have the stat#s of e:emplary against which ass#med general relations are tested, $@lic"% 2..3& The aim is to ass#re representativeness of the st#dy A f#rther aim is to discriminate separate variables from the comple: relations and to test them The ob/ect of research is following the theories and methods $@lic"% 2..3& While the research process of the '#antitative method is more linear and theory oriented% the '#alitative research observes more the data and the field #nder st#dy% r#nning away from theoretical ass#mptions 1ain difference is that the theories sho#ld not be assigned to the s#b/ect #nder st#dy The researcher +discovers, $@lic"% 2..3& and creates them while he is wor"ing with the information in the field The choice of the respondents is made according to their appropriateness to the st#died topic They sho#ldnt form +a representative sample of a general pop#lation, $@lic"% 2..3& The aim is not to isolate separate variables from the comple: relations b#t rather to increase comple:ity and to p#t more meaning into them 1ethods also have to be applicable to the iss#e #nder st#dy and their choice have to be made very caref#lly $@lic"% 2..3& Th#s% '#alitative method is chosen in cond#cting the following st#dy to gain deep insight into parents eating habits and their change of lifestyle with transition to parenthood The method is a combination of e-mail interviews and new media $@aceboo"& !nterviews were cond#cted with 1( mothers from )astern )#rope There are so many practical benefits of incorporating comp#ter-mediated-comm#nication $212& into '#alitative research designs $1ann 2 % 2...& Some of the most important gains are the followingK

2.

Extending access to participants According to 1ann $2...&% comp#ter-mediated-comm#nication is a medi#m that allows the researcher to pass the bo#ndaries of time and space% which might limit face-to-face research The following options become possibleK 2omp#ter-mediated-comm#nication gives opport#nity for wide geographical access !t also ma"es easier the comm#nication between colleag#es who may be on different sites or in different continents $2ohen J % 133=& The !nternet allows cross-c#lt#ral collations of s#b/ects beca#se% as a global system% has the access to local newsgro#ps in many co#ntries and in many lang#ages $2oomber 8 % 133C& 212 also enables researchers to get in to#ch with respondents% diffic#lt to contact with by reg#lar face-to-face means of comm#nication% li"e mothers at home with small children $1ann 2 % 2...& 9ther positive feat#re of the 212 is its appropriateness for some sensitive personal s#b/ects% which participants might be hesitating to disc#ss face-to-face with a researcher $1ann 2 % 2...& +Aot only does comp#ter-mediated-comm#nication have the potential to def#se the embarrassment that might be present one-to-one% b#t it also allows gro#ps to spea" abo#t sensitive iss#es in an open and candid way witho#t the fear of /#dgement or shyness that characterize face-to-face gro#ps, $Sweet 2 % 1333& !t also allows some researches to be cond#cted in politically sensitive or dangero#s areas $Eee 8 % 133*& and gives access to people in places which have closed or restricted access s#ch as hospitals% prisons% military $1ann 2 % 2...& Another good practical #sage is that researchers may /oin a gro#p which comes together with a special interest in mind% s#ch as chat rooms% mailing lists and conferences $2omley - % 133=& As 1ann states% one of the most powerf#l advantages of !nternet #se for '#alitative research is that the costs are red#ced to minim#m With traditional face-to-face interviewing% both researchers and participants have to cover time and travel costs The participation of the respondents often depends on the travel and time costs 0 the less they are% the bigger the participation A traditional research b#dgets #s#ally cannot cover the e:penses for trans-c#lt#ral participation and cross-c#lt#ral comparisons 2ond#cting online s#rvey eliminates the costs for travel

21

Significant advantage of the web-page-based and email s#rveys is their increased reach as they cross borders of time and space $6achmann et all% 133=; 1ehta 8 and Sivadas ) % 133(& Another ma/or advantage in the #se of email is its increased speed and this was showed in 2omleys $133=& st#dy directly comparing email% postal mail and Web s#rvey options Schaefer and 7illmans $1334& st#dy also affirmed that the ret#rning of email '#estionnaires is faster than their paper analogo#s @ % 2...& According to 1ann $2...& a problem that can occ#r is with finding e-mail addresses of respondents The easiest way to cope with that is to as" people directly for contact% since there is not yet a +f#lly developed global directory of e-mail addresses, $1ann 2 % 2...& A f#rther problem% which might arise% is with the correctness of the electronic address !t can be misspelled or incomplete% which prevents from delivery of the message And even if the contact list and the technology are available and acc#rate% individ#als might not respond to the e-mail s#rvey S#ch problems occ#r as lac" of enth#siasm from the s#b/ects #nder st#dy; they might be b#sy and lac" the time to respond or /#st people might not chec" their e-mails reg#larly This might s#bstantially affect the response rates and slow down the research process $1ann 2 % 2...& The design of the '#alitative st#dy is another challenge in front of the researcher De sho#ld be able to find the balance between interview methods% caref#lly considering the p#rpose of the st#dy !n str#ct#red interviews the researcher is trying more to control the interview De #ses standardized '#estions and the techni'#e of contrasting the responses $1ann 2 % 2...& +!t is in non-standardized interviews that the foc#s moves from the preform#lated ideas of the researcher to the meanings and interpretations that individ#als attrib#te to events and relationships, $1ay T % 133*& 6oth methods differ by level of '#alitative depth that they offer 7epending on% which interview form is chosen by the researcher% participants have more or less freedom when answering the '#estions $1ay T % 133*& +Wor"ing online% less str#ct#red interviews with individ#als are #s#ally cond#cted by e-mail% or by +chatting, one-to-one #sing real-time software, $1ann% 2...& @#rthermore% email offers considerable savings% as it e:cl#des paper and it is cheap to send $1ann 2 and Stewart

22

1. $esign of the study

As the p#rpose of the following st#dy is to gather information abo#t the daily ro#tine and eating habits of women and how motherhood affects their diet and lifestyle% less str#ct#red e-mail interviews were chosen as a method This '#alitative approach enabled fast and detailed data gathering from respondents% sit#ated in )astern )#rope The whole process too" appro:imately 2. days% which can be considered as relatively short time% considering the st#dy gro#p 0 mothers with small children All participants were as"ed in advance to participate in the st#dy and the e-mail '#estionnaire was sent only if their agreement was received The contact list incl#des mothers and pregnant women% gathered thro#gh personal connections% as well as by #sing the participants own friendships with other mothers The age of the respondents is between 2. and *( They are all married and live with their h#sbands Two of the mothers are still pregnant% si: of them have small babies #nder one year old% one is with twins at the age of one year and a half and the other si: mothers have children older than two years ):cl#ding the woman with the twins% three others indicated the presence of a second child in the family @o#r of the participating parents are wor"ing and the other eleven are on a maternity leave at the moment 1ost of them ta"e care of the child by themselves and dont #se child care services All of the respondents are ed#cated 0 college or #niversity and are c#rrently employed e:cept one The information is s#mmarized in Table 1 7#ring the process of gathering the e-mails the respondents reported to feel more comfortable with their mother lang#age Therefore the '#estionnaire was made in two forms 0 )nglish and 6#lgarian versions% as the respondents were mostly with 6#lgarian nationality They were as"ed to choose and fill in one% according to their preferences At first the '#estionnaires were send for pretesting to five women They answered in few days and no significant problems with the '#estions were determined Therefore the original forms were "ept and the '#estionnaires were sent to the others s#b/ects #nder st#dy from the contact list Those five women were incl#ded in the research All the data was gathered for appro:imately twenty days Two mothers were contacted again with 2*

additional '#estions abo#t their diet d#ring the pregnancy period 9nly one from all 1( mothers answered the )nglish version and the data was more incomplete and #nsystematic The data gathered from the other '#estionnaires was f#ll% representative and systematic The overall information helped for the elaboration of a complete descriptive analysis Since the change of the eating habits with the transition to motherhood were of interest% we as"ed '#estions in the areasK 1& way of eating before% d#ring% after pregnancy and in the c#rrent moment; 2& lifestyle behavior; *& weight gain d#ring pregnancy% recovery after giving birth% body image and satisfaction with their own diet and weight; ?& fastfood cons#mption% healthy eating and the effect of the advertisements over the mothers diets All the gathered data was analyzed thro#gh comparison The analytic proced#res incl#dedK 1& reading each participants e-mail interview and s#mmarizing the data; 2& reviewing each participants data to identify change in eating habits over time and finding "ey points in the areas of interest of #s; *& comparing s#mmarized cases- describe variations in the data and note relationships among the cases; ?& identifying emerging themes; (& describing the cases $7evine 2 et all% 2...& 7rawbac"s of the method are the c#lt#ral specificity of the respondents and the s#b/ective assessment of healthiness of their dietary behavior

Table &: 5articipants

Age in yearsK

2*

2C

2=

2=

*.

*2

*1

*?

2?

Age of each child in yearsK

Twins 1%(

3 months

Aot born yet

1%( months

*%( Osecon d child C.K*.

Assessment of distrib#tion of ho#sehold tas"s between yo#rself and partner $if& in percentageK Do#rs or wor" per wee"% yo#K

(.K(.

((K?(

34K2

(.K(.

C.K*.

4.K2.

(.K(.

?.

1=4

Do#rs or wor" per wee"% partnerK Do#rs of child-care per child $all reg#lar arrangements% s#ch as instit#tional child-care% babysitter and grandparents&K )d#cational level% yo#K

?.

((

12.

?.

?.

(.

?.-(.

1=4

12 per day

?.

4 ho#rs per day

bachelor

1aster

2ollege

6achelor

6achel or

6achelor !nternational )conomic 8elations 6achelors )ngineer

2 masters

6achel or

)d#cational level% partnerK

2ollege

2ollege

2ollege

2ollege

6achel or

6achelor

6achel or

9cc#pation $or last position&% yo#K

waitress

acco#nta nt

life ins#rance agent

8eporter

#nempl oyed

!nvestor 8elation 7irector

):pert mar"etin g manager N#ality control ):pert

9perat or in a firm

9cc#pation $or last position&% partnerK

1ilitary man

proc#rato r

driver

driver

engine er

>#ard

Eabor inspect or

Age in yearsK

2*

23

*?

*.

2*

*.

2(

2(

Age of each child in yearsK

Assessment of distrib#tion of ho#sehold tas"s between yo#rself and partner $if& in percentageK Do#rs or wor" per wee"% yo#K

(.K(.

1. monthsO second child = years C.K*.

( monthsO second child C.K*.

Lnborn

( months

2%( years

( months

=.K?.

=.K?.

(.K(.

=.K?.

2.

*.

Do#rs or wor" per wee"% partnerK Do#rs of child-care per child $all reg#lar arrangements% s#ch as instit#tional child-care% babysitter and grandparents&K

?.

?.

?.

=.

(.

?.-(.

?.

?.

)d#cational level% yo#K

college

bachelor

bachelor

6achelor

2olleg e

6achelor

bachelor

)d#cational level% partnerK

2ollege

2ollege

bachelor

6achelor

2olleg e

6achelor

2ollege

9cc#pation $or last position&% yo#K

waitress

6an" 1anager

6#siness 2ons#lta nt

9perator in 2all 2enter

Shop assista nt

School Teacher

-rod#cts demonstrator

9cc#pation $or last position&% partnerK

1ilitary man

7river

-rivate 6#siness

Eawyer

7istrib #tor

2onstr#ctor

7istrib#tor

2=

3( ,esults

The '#alitative analysis of the mothers responses led to the concl#sion that the life event of becoming a parent brings a change into womens eating habits and their body image All of them disting#ish different phases thro#gh which they have passed and ma"e a comparison between their dieting d#ring the periods !n the following analysis the phases are named and thoro#ghly described% as well as all the factors that infl#enced the respondents and their satisfaction with body shape and eating

&( 5re-pregnancy period 1any mothers from the st#dy gro#p describe the way they were eating before they got pregnant or got married They had concerns abo#t their body weight and #sed to watch closely the type of the food they ateK Before the pregnancy I used to eat low caloric foods lots of salads yoghurt and muesli less fruits meat and eggs in order to !eep my "ody in shape. 9ne saysK I ate healthy "efore the pregnancy# I loo!ed so good at that time. 9ther women too" the advantage of some coping strategies in order to loo" and feel goodK I used to sport a lot# I had a time for that in contrast to now. I didn$t eat "rea!fast "efore as I didn$t feel the need of eating so much food#.%ust a fruit and a coffee in the morning was enough. &ater in the day some light meals#not that much food A few respondents stress on the fact that the b#sy life of a wor"ing woman before and the daily ro#tine didnt act#ally let them thin" so m#ch abo#t food They dont define their

2C

diet before pregnancy as healthy% b#t as satisfying according to their body image and selfconfidenceK Before the pregnancy I used to s!ip so many feedings my eating was irregular' I was smo!ing a lot and all that "ecause of the wor!. (f course I !new it was unhealthy "ut I$ve never "een "othered a"out excess weight. I was satisfied with my diet. )ow I loo! in the mirror and I see all that weight that I gained#."ut still there is a good reason# 7#ring the pre-pregnancy period womens attit#de shows concern abo#t body shape and weight and each of the interviewees fo#nd her own strategy to cope with the problem% according to her own case The eating habits of most of the mothers cannot be defined as healthy d#ring the period

2. Pregnancy period

The pregnancy period is connected with positive change in eating habits by most of the women 6ecoming a parent might be triggering some feelings of concern and responsibility for the child and its growth and mothers adopt new eating behaviors They start eating more fr#its and vegetables% stop the coffee and dizzy drin"s% no alcohol and cigarettes d#ring the period% tho#gh some of them report to be e:tensive smo"ers and '#itting was really hard They started drin"ing more fresh /#ice and water and red#ced the cons#mption of sweetsK Before the pregnancy I didn$t eat oatmeal I used to have my dinner late and practically all !inds of food "ut !nowing that I$m expecting a "a"y changed everything* "it "y "it I was getting interested in the healthiness of the foods li!e preservatives and sta"ili+ers' I started eating more fruits and vegeta"les mostly organic and increased the consumption of water tea and %uice.

24

1any of the respondents indicate a positive change in their regimen of diet The e:pectancy of a baby provo"es a reg#lar eating in most of the mothers #nder st#dy All of them% who didnt have brea"fast before% start incl#ding it in their daily men# They dont s"ip any of the obligatory feedings% tho#gh it was a practice before the pregnancy Their perceptions abo#t n#trition are totally infl#enced with the occ#rrence of the life changing event- the baby ,y eating was so irregular in the period "efore pregnancy - my first consumption of some food during the day was around .*/ pm in the afternoon and it was some unhealthy staff. 0he "a"y changed my perception for nutrition and lifestyle. I don$t remem"er to have ever had any "rea!fast' I was smo!ing a lot and dran! lots of coffee. )ot anymore# 9ther mothers reported that their daily diet didnt change significantly They "ept eating the same way as before the pregnancy and increased only the amo#nt of the cons#med fr#its d#ring the day The reasons might be that they considered their way of eating as healthy and didnt see the need to #nderta"e any changeK I have always "een eating three times per day' my food includes plenty of meat rise vegeta"les and pasta. I have also "een avoiding all !inds of di++y drin!s' I %ust started eating more fruits "etween the main feedings. Another reason might be that they didnt want to give #p their daily ro#tine and have been afraid of gaining weight d#ring the pregnancy The stress of losing their body shape might have affected the mothers and their way of eating d#ring the pregnancyK I didn$t change a lot#no "rea!fast lots of coffee during the whole day. I only included lots of fruits and vegeta"les "ecause it$s healthy for the "a"y. 1till I consider my diet "etter than "efore the pregnancy. Some of the women reviewed that the pregnancy has t#rned to be a liberating period for them according to eating and diets They significantly increased the amo#nt of the cons#med food and the n#mbers of feedings d#ring the day 9ne reason might be that

23

they didnt act#ally eat reg#larly and eno#gh before the pregnancy and the transition to parenthood made them more responsible abo#t their regime and n#tritionK I$ve never "een eating a lot' %ust enough to satisfy my needs#."ut when I understood that I$m expecting the little precious I started to eat regularly and as healthier as I could. Still other reason might be that the mothers /#st felt liberated from all restrictions abo#t weight and body image and saw the period of pregnancy as a moment to let themselves to their cravings and needs of food The tho#ght that its good for the baby and thats eno#gh a reason to eat whatever they want has been the leading for those mothers They didnt have to worry or feel the press#re of maintaining their weight anymoreK At the "eginning I was trying to maintain my regular diet and to eat healthy "ut the more the months were passing the more food I was eating. I couldn$t resist - I was consuming everything my "ody was craving#fast food sweets chips. I gained /2 !ilos and I still cannot get "ac! in shape. It was awful' I simply couldn$t stop eating#. Still% e:cept these cases of #ncontrolled eating by some of the respondents% most of the interviewees see the phase of the pregnancy as a period when they passed to a healthier eating )ven those mothers who didnt ma"e any radical changes in their diet% say it became more n#tritio#s in a way% beca#se they were watching closely what was good for the baby and e:cl#ded the inappropriate food As a whole the transition to parenthood had a positive effect over the women d#ring this partic#lar phase% maybe beca#se they felt responsibility not only for themselves b#t also for a second life The symptoms of na#sea and vomiting affected significantly the eating habits of most of the women in the st#dy gro#p Tho#gh some of them didnt really change their diet with the occ#rrence of the life changing event% the months thro#gh which they felt the na#sea provo"ed the appetite for foods% not normal for the mothers daily ro#tineK

*.

I had nausea the fist months of the pregnancy and I could hardly stand strong smells of food. I had a craving for very sweet and sour things li!e ca!es and pic!les. I perceived the principle3 Eat whenever and whatever I can as much as possi"le. I$ve never "een eating fast food "efore "ut during the period it was o"ligatory for me to include in my daily diet pi++a duner !e"a" ca!e lemons. And these are foods I couldn$t eat "efore. 1others /#st left themselves on their cravings and cons#med everything they li"ed 9thers were /#st loo"ing for some "inds of food that their body was accepting and they co#ld eat d#ring this period That in a way made their diet #nhealthy both for them and the babyK I couldn$t stand any coo!ed dishes only fast food and "read#that was all I was eating for the first three*four months. 9ne mother sharesK I couldn$t eat normally at all#only sandwiches with cheese. 0he vomiting was so strong that I$ve lost / !ilos during the first months. &ater on during the sixth month of the pregnancy I got heart*"urns which again distur"ed my regular diet#I was eating mostly mandarins and yoghurt. All these restrictions didn$t let me gain a lot or eat healthy during the pregnancy. Th#s the symptoms of na#sea and vomiting led to a change in the eating habits of the mothers who were affected and practically made their n#trition #nhealthier Those women who didnt s#ffer the symptoms report having a healthy and wonderf#l pregnancy They felt fit and cons#med all the recommended foods% which were good for the baby% th#s trying to ass#re it properly growing They report to have increased the amo#nt of the daily meals% which might have been more than the child act#ally needed% b#t this led to a calm and easy pregnancy I was eating good and that led to healthy and slowly gaining of 45 !ilos during the pregnancy. I was feeling wonderful.

*1

I didn$t have any symptoms of nausea# I had a "ig appetite for different !inds of food#I$m still pregnant and I really feel good with my diet.

". First months after gi!ing %irth# %reastfeeding

1ost of the interviewees changed slightly their diet d#ring the period of breastfeeding compared to the time of pregnancy They report to have e:cl#ded foods of their daily men# li"e spices% cabbage% chocolate% coffee and dizzy drin"s beca#se all these were provo"ing colic for the baby They were loo"ing for sol#tions so the baby wo#ldnt feel any discomfort 6#t these cannot be defined as significant changes for them They "ept the healthy diet ac'#ired d#ring the pregnancy period ,y doctor advised me to !eep the same rules of eating as during the pregnancy and I was doing it #...I %ust limited the consumption of eggs and cheese#"ut nothing so special. Those who didnt have a healthy or reg#lar diet d#ring the pregnancy share to have tried to eat that way d#ring the breastfeeding% th#s to ass#re everything needed for the baby They ac'#ired completely new n#trition habits Some noted their own diet was directly related to the n#trition demands of their baby thro#gh breastfeeding and they preferred to postpone their own body needs for their child I was eating more often on small portions#.drin!ing more water and %uice. I tried to maintain good nutritional levels and eat healthily. I$ve missed the coffee so much during the period "ut I was trying to eat nourishing food#.everything was worthy for my little precious "a"y. Some mothers report a significant change in their lifestyle and diet only d#ring the period of breastfeeding They didnt eat differently d#ring the pregnancy comparing with the time before that% b#t the first months after the baby was born affected their ro#tineK

*2

I actually increased the amount of the consumed food only during the ten months of the "reastfeeding. 0hat$s the only period when I was eating fast food sweets li!e croissants and waffles' I was drin!ing lots of water and %uice. After that I got "ac! to my normal regimen' I didn$t feel the need for so much food any more. With the end of the breastfeeding the mothers share to have ret#rned bac" to their bad habits abo#t eating While the period of feeding the baby with mil" stim#lated them to eat healthy and to ta"e care of the cons#med foods% its end gave them the liberty to start eating whatever they wanted again They might have been feeling restricted in their choices d#ring the period% which to have ca#sed the opposite effect afterwards After I stopped the "reastfeeding I was eating everything I can# I had a healthy diet during the "reastfeeding "ut after that#.. As a whole it can be concl#ded that the biggest part of the mothers had a healthy diet d#ring the breastfeeding period They report that they "new the baby was absorbing everything they were cons#ming and therefore were e:tremely ca#tio#s abo#t the food they were eating Their instinct of mothers might have developed even more% as women who didnt #nderta"e any changes d#ring pregnancy started a healthier diet now

". After %reastfeeding#%ac& to routine

Women report that after the breastfeeding period a complete t#rn-down in their diet occ#rred They completely gave #p the healthy and reg#lar eating of the previo#s period They started s"ipping some meals and led themselves to the cravings for all "inds of food This is the period when mothers report to be the least satisfied with their diet Some of them started wor"ing again% which led to the cons#mption of more fast food% more stress while eating and less time for body shape care Women share that with the ret#rn bac" to the ro#tine% their diet became #nhealthier

**

'. (eight management

2oncerns abo#t weight have ta"en a ma/or part in the interviewees answers With the appearance of the life changing event 0 the pregnancy% most of the mothers report a transition to a healthier and reg#lar diet They incl#de more vegetables and fr#its% mil" and meat They start cons#ming more food% in a bigger variety% watch o#t for the n#trition of the prod#cts% all in the name of the baby Still other women leave themselves to their cravings and appetite for #nhealthy n#trition The ma:im#m +)ating for two, has been perceived by not so small part of them Some say that they were /#st h#ngry too often% others shareK I don$t li!e this maximum "ut practically that was my way of eating during the pregnancy. ,y doctor was scolding me "ecause of that way of diet#I gained too much weight "ut I li!ed to eat. 9ne mother says that she doesnt want to admit it% b#t its tr#e that her eating habits became according to that ma:im That led to dissatisfaction with their n#trition and body weight While d#ring the pregnancy mothers didnt feel almost any worries% beca#se they ate in the name of the baby% after the birth% the feelings changedK #now I feel so worried "ecause of this excessive weight I still cannot get "ac! in shape. I didn$t feel worried "y the fact that I was gaining weight. It was such a pleasure to see how my tummy was growing. 0he depression and unhappiness came when the child turned one year and a half. The comparison between their body shape before and after the pregnancy brings the biggest dissatisfaction Women cannot accept the change that occ#rred with the transition to parenthoodK

*?

I$m still trying to loose /*6 !ilos "ut it$s so hard. I$m not so satisfied with my "ody now. )o "ecause I have always "een s!inny and good loo!ing and now this is too much - all this weight. Apart from those women who feel dissatisfied with their weight d#ring and after the pregnancy% half of the mothers report to feel very happy with their body I !new that I was gaining within the normal limits and I didn$t feel any stress a"out that. And now I$m happy with my appearance too. I didn$t feel happy a"out the 4. !ilos more "ut neither had I felt worried. )ow I$m even s!innier than "efore. The tho#gh abo#t the babys health and n#trition preocc#pies the womens concerns abo#t their body They accepted the new role of mother% which is m#ch more important than the body shape I have excessive weight "ut I cannot thin! a"out that now#the "a"y is more important#I$ll thin! a"out my "ody later#..may"e some sport. As a res#lt the st#dy showed that the transition to parenthood bro#ght weight concerns and dissatisfaction to half of the women d#ring the phase of the pregnancy They co#ldnt accept the change in their body The other part of them was either satisfied% or /#st accepted the sit#ation as normal for the period The tho#ght abo#t the baby and its health and n#trition /#stified everything 1aybe some women realized the effect of the life changing event over their bodies on a later stage of the pregnancy and started loo"ing for different ways to fight the problem

*(

). *oping strategies Women always find some strategies to fight with e:cessive weight% no matter how b#sy they are 6#t with the occ#rrence of the baby they may not have the same time% energy or freedom to #tilize previo#s strategies for weight control beca#se of the demands of the infant The following st#dy showed that some mothers didnt have the need to do anything to cope with the gained weight d#ring the pregnancy !t was a matter of good metabolism or body str#ct#re that they ret#rned their previo#s shape very fastK ,y "a"y is 42 months old and I$ve already lost 47 !ilos without any restrictions or dieting. ,y structure and meta"olism help a lot for that result. I don$t have pro"lems with my weight. It helps me a lot that I$m always running after the children. 0hey ta!e all my energy. ,ay"e I need to do some sports "ut not to lose weight. 1any mothers regret of not having the time to do some sports They see the need for themselves to ta"e more care for their appearance% b#t the motherhood is a lot of time cons#ming and p#ts some limits in front of them The mothers shareK ,otherhood is a hold"ac! for me#I don$t have even a second free time for myself# "efore I was going to fitness ta!ing care of myself "ut now I cannot find time for anything. I find time for fitness only once a wee! "ecause the children ma!e me really "usy. But what is "ad for my diet is that I always eat the !ids$ leftovers. I$m still "reastfeeding and I cannot find time for sports or !eep any diets. When the baby comes into parents lives it becomes the first priority for them and mothers are #nable to spend the same amo#nt of time for themselves as before Their daily ro#tine totally changes and the care for the body shape and appearance steps aside Some women might not be happy with the new circ#mstances and they loo" for other ways to cope with the problem They rely on restrictions in food li"e no sweets and fast

*=

food% more fr#its and vegetables to ret#rn their previo#s weight Still others cannot fight with their cravings and appetite for food They report being dissatisfied with their weight b#t the wea"ness to resist to all the temptations that #nhealthy diet can offer is stronger They shareK ,otherhood is not a hold*"ac!' I %ust miss a strong will. 1taying at home is really "ad for me "ecause I$m always going around the fridge. ,y la+iness and wea! will prevent me from achieving good results. !n order to retain their weight in normal borders% some interviewees report that their eating d#ring the pregnancy wasnt m#ch- /#st eno#gh to satisfy their and the babys need of food I wasn$t on a diet "ut I was watching closely what I$m eating* It was %ust enough to satisfy my hunger. Th#s mothers were trying to find different coping strategies d#ring different periods of the motherhood to fight their dissatisfaction with weight or were /#st accepting the weight gain as something normal Some were planning to start e:ercising or dieting on a later stage of their life% b#t it seems that they have accepted their new role of mothers% way of eating and appearance as they were @rom the interviews can be concl#ded that the women ad/#st themselves to the new daily ro#tine that the motherhood bro#ght and are happy with it

+. Influence factors Women mentioned many factors that infl#enced their diet d#ring the different phases% which were both internal and e:ternal S#ch a prominent factor is the partner @or some mothers he plays a significant role in the change of their eating habits with the transition to parenthood The h#sband directs the wife to a healthier diet in the name of the baby

*C

8e has always "een eating healthy in contradiction to me#and after I got pregnant he led me to this "etter !ind of eating. 8e is so interested in the 9uality of the products that I consume gives me advises and coo!s for me. :e spend lots of time together during the day and may"e that affects also#I$m positively surprised. The h#sband e:erts a positive infl#ence on the mothers eating habits% according to what choices of food she sho#ld ma"e% what is n#tritional and not% b#t also predisposes her to eat bigger meals 8e wor!s a lot and when he comes "ac! at home he insists to have plenty of nutritional food on the ta"le - always something with meat#.!ind of heavy dinner. While there are h#sbands who affect their wives daily eating habits% most of the men are staying inactive and dont e:ert any infl#ence over the family food choices Women report of being alone most of the time and that pres#pposes the preparation and eating of food depending on own preferencesK ,y hus"and is not at home most of the time and doesn$t affect my diet in any way. 8e is wor!ing a lot and that actually contri"utes for our high standard of living and the plenty of food that we consume. But therefore he doesn$t spend so much time at home and affect my eating. I coo! whatever I li!e. 9ne mother reports that her h#sbands eating habits has changed according to hers after the birth of the baby :e are so "usy around the small precious. I$ve always "een eating something light whenever I had time and that regimen is not new for me.#except during the pregnancy#...now I conform my meals according to the "a"y "ut I didn$t expect my hus"and to do that#and he is helping me a lot. 8e is eating when the "a"y lets us and "ecause I don$t li!e coo!ed food he eats whatever I do#some salad or a soup.

*4

A final concl#sion can be maid that the biggest part of the h#sbands doesnt affect the eating behavior of their wives The reasons might be that the co#ples do not spend so m#ch time together or /#st beca#se the women are the more active part in the family With the birth of the baby% it becomes another factor that often infl#ences the mothers eating behavior As this woman reported both her and hers h#sband diets became irreg#lar and #nhealthy with the transition to parenthood The care for child is so time cons#ming for them% that they almost forget their own needs And if she is familiar to that regimen and way of eating% for her h#sband thats a complete change of the lifestyle Another mother reports that her reg#lar eating depends on the mood of her child If he is calm and let me I can sit down and eat a regular meal as I$m used to "ut if he$s not#.I %ust s!ip it. Still another shares that what affects her diet is the habit to finish the leftovers of her children after they are done with the meal 9r when mothers b#y some fast food for the children% the temptation to eat becomes stronger and they /#st cannot resist Another interviewer reports to conform the coo"ing for the family to the taste of her child I don$t watch on the healthiness of the food if she li!es it. 1ore than a half of the women being #nder st#dy are on a maternity leave and still ta"e advantage of the free childs "itchen that the >overnment ass#res The food is prepared according to the standards for the childrens healthy eating Th#s in most of the cases the mothers coo" only for themselves and the h#sbands and they report to conform that mostly to their own taste The other relatives or members of the family do not e:ert almost any infl#ence over the co#ples eating habits 1ost of the interviewers report to be living alone and they have only some irreg#lar visits% which doesnt significantly affect their diets 9ne woman sharesK

*3

:hen my mother comes at home she stays for couples of days and then we definitely have to eat healthy and regularly. But after she leaves#. Women also mention that meeting with friends affects their healthy diet An afternoon coffee is always accompanied with a ca"e% an ice-cream or coo"ies and being with somebody else increases the temptation for s#ch "ind of food Also mothers report that they often b#y themselves fast food when they are with a friend This does not happen if they go o#t alone or with their h#sbands Th#s friends infl#ence negatively the healthy eating of the mothers and pres#ppose the cons#mption of more fast food and sweets% which leads to weight gain and dissatisfaction with womens own diet Still social connections have also a positive impact over mothers They gain lots of "nowledge and e:change information abo#t what is healthy and #nhealthy for the baby and themselves thro#gh the participation in some online and personal social gro#ps They ed#cate each other% e:change advices when having problems d#ring the pregnancy or with the baby and find coping strategies for the different phases By sharing our own experiences to each other we find solutions of many pro"lems. I didn$t have any"ody to as! at the "eginning and the other mothers were giving me so many advices a"out the "a"y. :hen I don$t !now something I as! my pregnant friends#how they cope with the pro"lem what effect does some product have over their "ody and weight#it is really helpful. Social connections% no matter personal or in a gro#p% infl#ence to a high degree mothers decisions abo#t choice of food or prod#cts They help them to ma"e discrimination between healthy and #nhealthy either for the baby% or for themselves The women share to have their eating habits affected by the contacts with the others in the gro#p% beca#se they often e:change recipes and coo"ing advises too Still face-to-face meetings are characterized by eating more ca"es and coo"ies% some fast-food which they #s#ally try to avoid

?.

Women report to ac'#ire #nhealthy habits of eating also on their wor"ing place The stress of the wor"ing environment and the b#sy daily grind pres#ppose irreg#lar feeding% snac"ing and the cons#mption of more sweets and fast-food% either alone or in the company of colleag#es I always have fast food for lunch "ecause I$m "usy and in a hurry#.we %ust go and gra" with the colleagues. I$m never calm often interrupted "y something#I don$t li!e it' I !now I$m eating unhealthy. I$m always in the run while having my lunch I don$t have time to sit down and relax#.it$s some sandwiches easy to carry. 0his wor! is %ust so much' it$s good if I have five minutes for some fruit or chocolate "ar. I drin! coffee all day long' I wouldn$t stand it without it. Some of the wor"places offer a l#nch that is already prepared with a wide variety of meals% where women can have a salad or a so#p Still some of the interviewees connect the canteen with fatty food and too big portions that they cannot handle I prefer to "ring food prepared at home it$s not that fatty and it$s healthier. The wor"ing environment is a great indicator for womens lifestyle and affects their eating habits The b#sier the mothers are at the office% with the child and with the ho#sewor"% the less healthy they eat and coo" They start relying on frozen food% something% which can be prepared fast and easy% neglecting the content and no#rishment of the meal S#ch diets and eating habits can easily lead to diseases and obesity% either for the parents or for the children ,. -atisfaction with diet The c#rrent diet of most of the interviewees incl#de lots of meat% rise% potatoes% pasta% fr#its and vegetables% dar" bread% m#esli% cheese% yogh#rt% mil" They try to prepare their

?1

meals on their own and to bring as m#ch variety as possible The c#lt#re of the respondents imposes some beliefs abo#t healthiness 9ne mother saysK :e always start with a soup then a salad the main course which is a meat with potatoes or rise and vegeta"les and at the end a dessert. I consider this an appropriate and healthy meal for the grown ups as well as for the children. 1ost of the women li"e that they cons#me lots of fr#its and vegetables d#ring the day and disli"e the e:cessive cons#mption of sweets and chocolate They report they have the wish to change that fact in the f#t#re% as eating so m#ch ca"e and s#gar is seen #nhealthy I love sweets and the children eat lots of candies "ecause we always have at home. :e should change that. What is also li"ed by the women #nder st#dy is the fact that they dont restrict themselves abo#t food Aone of them admits to be on a real diet for loosing weight and they all say to be satisfied by that fact 9nly one mother shares that once per month she doesnt eat anything for 2? ho#rs and relies on that way of dieting to maintain her body shape I don$t li!e it# all the restrictions#no food during the whole day is !ind of heavy. As a whole the mothers are satisfied with the way they are eating at the moment% no matter if they are still pregnant or they gave birth Those who already have children admit that the period of pregnancy was the one when they ate the healthiest diet and attained bad eating habits after that ,y regimen now "ecame irregular and unhealthy' it wasn$t li!e that during the pregnancy.

?2

Still this fact doesnt affect the feeling of satisfaction with the own diet 1aybe that is d#e to the fact most women cons#me the prod#cts they li"e% eat according to their taste and cravings and do not report of having obsessions for weight loss and restrictions

.. Fast food consumption Another topic that was #nder interest of the following st#dy was the cons#mption of fast food from the mothers and the infl#ence that advertisements or some other factors have over them To introd#ce the women into the topic% '#estions abo#t their behavior and choice of prod#cts were as"ed 1ost of the women reported to have no affection to any partic#lar prod#ct and that advertisements do not infl#ence their cons#mer behavior I never pay attention on an ad showing food products. I don$t really crave any food or try new products even if I see them on the 0V. Still there were some interviewees who reported their cons#mer choice was affected by advertisements I often choose what to "uy according to what was seen on the 0V "ut I$m also usually disappointed. I thin! ads always affect our consumer "ehavior even if we sometimes don$t reali+e that. Then the mothers were directly as"ed abo#t their fast food craving and if it increased with the occ#rrence of the life changing event Almost half of the women reported that with the transition to parenthood they had bigger appetite for fast food and chocolate% especially d#ring the phase of pregnancy They also report to have tried to avoid this type of food% being aware of its #nhealthiness and bad effect over the body ;es a lot# I always li!ed these "ut I used to avoid them

?*

I used to avoid the "ig shopping centers where it$s really easy get pi++a or ham"urger. ;es the craving definitely increased especially during the first months of the pregnancy. I started to eat lots of chocolate and ca!es during the pregnancy some sandwiches# !nterviewees shared that the appetite for fast food appeared especially when they were on the street among other people% which were cons#ming s#ch type of food Sometimes even the smell can trigger the craving and ma"e mothers b#y for themselves :hen I$m out for a wal! and see some"ody eating pi++a I really cannot resist I should have one piece. :hen I$m out I usually eat them on my own. @riends and wor" are also a strong infl#ential factor according to women 6eing in the company of someone else or /#st the b#sy daily ro#tine pres#pposes eating of fast food and #nhealthy dieting :henever I go out with friends we visit such type of restaurant and it happens !ind of often. :henever I$m in a hurry or at lunch time with a colleague#that$s the "est food we can gra". A sit#ation when mothers were #nable to resist the temptation was when they were o#t with their children Women share that "ids often want fast food or some ca"e and #s#ally the re'#ests are being satisfied 6#t being aro#nd% the mothers appetite for the same "ind of food increases and they b#y for themselves too Th#s sometimes the infl#ence of the children might affect parents healthy eating The inability of the mothers to ref#se "ids re'#ests leads to bad in n#trition diets for the whole family 9ther factors that the women pointed as being infl#ential over their cons#mption of fast food were the period of pregnancy and their cravings

??

0his type of food is tasty for me' there are no any particular factors. #.the need to eat something really unhealthy Right now pregnancy does mostly Some mothers report that the mar"eting campaigns have a strong effect over their b#ying behavior of fast food 9ne of them reported on an earlier '#estion that ads are affecting also her choice of any type of food That is not the case with the other interviewees Tho#gh they might b#y some type of fast food as a res#lt of a good mar"eting campaign% that doesnt mean this is a typical cons#mer behavior for them abo#t all "inds of prod#cts A general concl#sion can be maid that almost all women cons#me fast food infl#enced by different factors and in different sit#ations @amily% children% friends and wor" are from the most common given reasons that the interviewees report to affect their craving for this type of food 1ar"eting campaigns and advertising cannot be considered as a significant infl#ential factor over mothers cons#mer behavior They report to rely mostly on their taste and cravings

/. $iscussion

@rom the res#lts can be concl#ded that eating habits change to great e:tend with the transition to parenthood Women passed thro#gh different phases which were disting#ished from them as the pre-pregnancy period% pregnancy% breastfeeding and the period after breastfeeding 1otherhood triggered both healthy and #nhealthy changes The period of pregnancy was disting#ished as the one% when women were eating the healthiest A possible reason might have been that mothers felt responsible not only for themselves% b#t also for the life of the baby A common tendency was an increase of the cons#med food% more fr#its and vegetables between the main feedings and reg#lation of the regimen of eating of mothers Ao matter if and what changes the women #ndertoo"% they almost all see the period of pregnancy as a transition to a healthier diet ):cl#sion ma"es the period when mothers had the symptoms of na#sea and vomiting% as this is the

?(

time when most of them report eating lots of fast food% chocolate% #nvaried and #nhealthy meals !n comparison with the pregnancy period the pre-pregnancy period is characterized with ta"ing more care abo#t the weight and personal appearance Women #se different coping strategies to "eep their body shape as it is Some describe their eating behavior as irreg#lar% cons#ming less food; others rely on a healthy diet and sport As a whole the period cannot be characterized with a healthy eating behavior by the women The biggest part of the mothers had a healthy diet d#ring the breastfeeding period They report that they "new the baby was absorbing everything they were cons#ming and therefore were e:tremely ca#tio#s abo#t the food they were eating With some e:ceptions where women gave themselves to their cravings for inn#tritio#s eating% the period can be described as healthy in food habits Still mothers see the pregnancy period as the one when they maintained the best diet The period after breastfeeding is characterized as the #nhealthiest according to eating habits period Women ret#rn bac" to their normal life and eating or report to stop the healthy diet from the previo#s period% which has a negative infl#ence over their body Some of the mothers ret#rn to their daily ro#tine% start wor"ing again% which brings irreg#lar feedings% lots of fast food and sweets Thats the period d#ring which interviewees are the least satisfied with their diet The transition to parenthood bro#ght lots of weight concerns to mothers Dalf of them had serio#s worries abo#t their body and the "ilos they gained d#ring the phase of pregnancy Therefore they too" advantage of different coping strategies in order to prevail themselves from weight gain above the standard or too" steps to loose it afterwards The other half were either happy or /#st accepted the change that occ#rred They loo"ed more on the reason than on the effect that it ca#sed 1aybe some body concerns act#ally occ#rred among these mothers on some later stages% b#t d#ring the nine months of pregnancy the satisfaction with weight prevailed Womens eating behavior was affected by some infl#ence factors As s#ch were mentioned the h#sband and the child% friends% family and the wor" atmosphere With some e:ceptions% most of the mothers reported that their h#sbands didnt affect their eating behavior and they were the one who too" the decisions abo#t food choices in the

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family The child was a significant infl#ential factor for the mothers The transition to motherhood bro#ght the feeling of responsibility for the second life and aim for healthier eating With its birth it "ind of r#ined the regimen of eating of some mothers% as they were having their meals according to the mood and regimen of the child Still more than half of the mothers "ept preparing the food for the family according to their own taste and needs !nterviewees didnt thin" the family affects in any way their eating habits @riend e:erted more infl#ence over them by visiting different resta#rants and coffee shops and th#s increasing the cons#mption of #nhealthy food The other way friends infl#enced the mothers was thro#gh social gro#ps% by giving advises and directing each other to healthier eating The wor"ing environment e:ercise negative infl#ence over the eating habits of the women The stress of the wor"ing environment and the b#sy daily grind pres#ppose irreg#lar feeding% snac"ing and the cons#mption of more sweets and fast-food% either alone or in the company of colleag#es Women also report that the role of wor"ing mothers p#ts the coo"ing on a bac" position and they start relying more on fast and frozen food also at home Th#s children are affected as well and ac'#ire the #nhealthy diet of the parents 1others dont consider the income as a significant factor% affecting their eating behavior 7#ring the pregnancy most of the women report having a healthy and n#tritional diet% despite the fact that some of them are #nemployed and others are on a maternity leave% which considering the sit#ation in the co#ntry is relatively low The iss#e re'#ires additional% deeper research% which wasnt the aim of the following st#dy The research of the fast food cons#mption among the mothers showed that the biggest part of them are eating this type of food and th#s affect the diet of the children too Jids also affect their parents eating habits by re'#esting pizza or hamb#rgers and women report being #nable to repress their appetite and b#y for themselves @actors as friends and wor" are also with a ma/or significance 1ar"eting campaigns and advertising have a minor infl#ence over the mothers 9nly a few of them reported to have ever been affected by s#ch "ind of factor They report to rely mostly on their taste and cravings

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3'( 6onclusion A '#alitative method was chosen in cond#cting the following st#dy to gain deep insight into parents eating habits and their change of lifestyle with transition to parenthood The method was a combination of e-mail interviews and new media $@aceboo"& Eimitations might have been that the interviews were cond#cted only with 1( mothers from )astern )#rope Th#s the small n#mber of the respondents does not allow generalizing the concl#sions% especially on some topics !n addition women were from the same geographical area% which restricted the concl#sions to one c#lt#ral gro#p Dowever% e:tensive information was gathered abo#t mothers attit#des with the occ#rrence of the life changing event +Transitions are periods of change where there are shifts in lifestyles from one stage to another, $-rice et al 2...& The concept of transitions cannot be disc#ssed separately witho#t that of tra/ectories in the life co#rse perspective $7evine 2 1 % 2..(& A life co#rse perspective can be #sed to observe peoples food and eating choices% how they constr#ct and change them and what factors in the food and eating environment affect those choices $8ozin - % 133.& -eople often report that when some normal life transitions occ#r% they are ma"ing small ad/#stments in their food choice tra/ectories to adapt to new food choice settings $7evine 2 and 9lson 2 % 1331& !n congr#ence with the theories% the following st#dy showed that parenthood has a ma/or effect over the lifestyle of mothers -regnancy affected womens daily and eating habits% diet '#ality; concerns for n#trition and motivation for food choices% as well as body weight concerns and satisfaction As proved in other st#dies mothers pass to a healthier diet d#ring the phase of pregnancy They change their eating habits d#ring the period as they start to cons#me foods they consider +better to eat%, s#ch as fr#its and vegetables% and limit salty snac"s $@owles 5 >abrielson% 2..(; @owles et all% 2..(; 8ifas-Shiman S et all% 2..=& @actors% which facilitate their healthy eating habits% are family s#pport% "nowledge of healthy foods% willingness to prepare separate meals for themselves% and eating meals at home $@owles et al % 2..(& The biggest infl#ence over them e:erts the awareness that the baby absorbs everything the mothers ta"e with the food -regnancy mar"s the beginning of a life stage ?4

in which women thin" not only for their personal n#tritional needs and weight goals% b#t also for the needs of their child $7evine and 9lson% 1332; >ordon and Tobias% 134?& Dowever% cravings% demands on time% and na#sea are barriers to healthy eating $@owles et al % 2..(& The weight management has a great implication for the mothers The st#dy proved the res#lts of other researches that pregnancy brings concerns for weight gain and half of the women e:perience body dissatisfaction After giving birth women might not li"e the changes that occ#rred in their bodies and might find that distressing $Wal"er% 1334& + 8et#rning to their old body shape and weight is diffic#lt and not always achievable, $Jen"in 5 Tiggemann% 133C& 1any of the mothers #sed to ta"e e:tensive care for their appearance in the pre-pregnancy period and the tho#ght that theyll never loo" as before is very stressf#l The postpart#m period is hard for womenK they are happy to give birth and have a child and meanwhile #nhappy with the losses that this event brings to their lives $Aicholson% 1333& 1others rely on different coping strategies to fight the e:cessive weight Some of them do sports% others #se dieting% and still others learn to accept their new body loo" and feel satisfied with their eating habits The postpregnancy period is connected with a down t#rn in dietary behaviors 1others transit from n#tritio#s and reg#lar eating to totally #nhealthy diet The main factors are wor"% friends% b#t mostly the child As -atel $2..(& also concl#des from his research% it might be diffic#lt for mothers to establish reg#lar eating habits as pregnancy brings disr#ption to ro#tine% sleep and mealtimes 6eca#se of the demands of the infant they may not have the same time as before% energy or freedom to #tilize previo#s strategies for weight control $-atel - 2..(& This leads to irreg#lar eating and #nhealthy diet for most of the mothers #nder st#dy Eow income is a social factor% which is commonly associated with #nhealthy eating $@inch% 2..*& The limited financial reso#rces of women may prevent them from providing healthy n#tritional diet for the period of pregnancy $6er"owitz 5 -apierni"% 133*& St#dies cond#cted by 8ogers $1334& and Wynn $133?& show that low-income pregnant women often cons#me less fr#its and vegetables and have a lower inta"e of lean so#rces of protein and whole grainsMall comparatively high-cost foods !n o#r st#dy%

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women report to have cons#med lots of fresh fr#its and vegetables% meat and rise d#ring the pregnancy 1ost of them are on a maternity leave and ta"e advantage of the offered from the >overnment 2hild Jitchen @rom the data can be seen that some of the families are with low income% b#t they dont report it as factor% which affects their eating Ao significant relationship was fo#nd between the income of the respondents and their #nhealthy diet at certain phases of the pregnancy +The conditions in which foods are chosen% the lives of the parents ma"ing the choices% and the foods available to be chosen are constantly changing, $7evine 2 2..(& Significant social and economic trends% which affect the food choices incl#de changes in the conditions related with maternal employment and parental ho#rs of employment $-resser D 6 % 1333; 6#rea# of Eabor Statistics % 2..(& and time spent preparing and eating meals at home $6lisard A et all 2..2; 7evine 2 1 et all 2..*; Jacobs J A et all 2..1& The following st#dy showed that after giving birth mothers are enormo#sly b#sy with children% wor" and ho#sehold that they increase the cons#mption of #nhealthy food and meals% easy to prepare Their diet becomes irreg#lar They also adopt habits to b#y ta"e away and fast food for themselves% as well as for their children Th#s% the b#sier the daily ro#tine of the parents% the #nhealthier is the diet of the whole family 2hildren were also affecting the eating behavior of the mothers thro#gh the foods they were re'#esting 6#ying #nhealthy prod#cts for their "ids increased the cravings of the women for that "ind of food !n congr#ence with many researches% which show that mar"eting infl#ences parents eating habits% the following st#dy co#ldnt find a significant relationship between it and the cons#mption of any "ind of food The changes that occ#rred into mothers lives and were reported into the st#dy can be synthesized into the followingK Women differentiate separate phases d#ring the pregnancy as each one is characterized by different eating habits and diet '#ality 6efore pregnancy the biggest part of the women are highly ca#tio#s abo#t the food they are cons#ming and care a lot abo#t their body shape and weight Still their eating habits cannot be defined as healthy and n#tritio#s

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The nine months of pregnancy are connected with transition to healthy eating The phase is considered the healthiest in diet and n#trition from the biggest part of the mothers

The symptoms of na#sea and vomiting provo"e drastic change in womens diet Those who e:perience them pass to #nhealthy and #nvaried eating 7#ring the breastfeeding period most of the mothers maintain a healthy diet considering the fact that the baby is absorbing everything they are cons#ming The e:amination of the daily ro#tine of the mothers after the breastfeeding phase shows that a total t#rn down occ#rs into their eating habits !ts reported a transition to #nhealthy diet from most of the women @actors% infl#encing these choices of food are the child and the family% friends and wor" environment

The pregnancy bro#ght both satisfaction and dissatisfaction with gained weight Dalf of the women #nder st#dy% who didnt accept the change in their body too" advantage of some coping strategies to fight the problem

@ast food is cons#med by almost all of the women 7ifferent factors affect their choice for s#ch "ind of food Among the most common are friends% children% family% going o#t Advertising is not considered an important factor% which can infl#ence womens cons#mer behavior

3''( 'mplications for research and practice

Additional research that draws on a life co#rse perspective sho#ld be cond#cted !t sho#ld e:amine the eating behavior and changes in diets in the long r#n The transition to motherhood is an important event and the o#tcomes of the change in the eating habits sho#ld be seen 2hronic diseases% obesity% and other problems which arise with the mother or the child in the long r#n sho#ld be st#died $9lson 2 % 2..(& A factor% which was only mentioned% b#t has a significant impact over womens eating habits and sho#ld be a s#b/ect of another research% is low income (1

Weight management is of a great importance for women Therefore the topic sho#ld be st#died in depth )ating disorders% obsessions for weight control and habit#al overeating d#ring pregnancy might be of interest as s#ch attit#des endanger the health of the baby The res#lts of the following st#dy have also implications for the practice Transition to motherhood is a sensitive event% which demands lots of "nowledge abo#t health and n#trition -regnancy is a time% when mothers are closely connected with different instit#tions and organizations% wor"ing in the partic#lar sphere $9lson 2 % 2..(& Th#s% it might be easier to advise women abo#t healthy eating and proper weight gain d#ring the period 1others might need advises how to maintain reg#lar and healthy diet in the postpregnancy period or on the wor" place% as these were reported as factors e:tremely affecting their healthy eating and body shape The res#lts have also implications abo#t weight management Women are preocc#pied with child% wor"% ho#sehold% which might lessen the time spend for body shape care and sports They might need more advises how to gain weight according to the recommendations d#ring pregnancy and how to lose properly in the postpregnancy period @ood mar"eting can also contrib#te for that by offering healthy and low caloric prod#cts% which are tasty for the mothers

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3'''( ,eferences:

1 2 * ? ( = C 4

Aaronson E % and 1acnee 2 $1343& The relationship between weight gain and n#trition in pregnancy )ursing Research% p 2*022C Abrams 6% Doggatt JJ% Jand 1S% Selvin S $2..1& Distory of weight cycling and weight changes d#ring and after pregnancy Am < Epidemiol.p.1(*K(*= Alderson T and 9gden J % $1333&% What do mothers feed their children and whyP% 8ealth Education Research% pp C1C-C2C Allen E D % $2..1&% -regnancy and lactation inK 6owman 6 A % 8#ssell 8 1 % eds =resent >nowledge of )utrition. p ?.*-?1( Anderson A S % $2..1&% -regnancy as a time for dietary change =roc )utr 1oc p ?3C0 (.? Aschemann-Witzel J % $2.1.&% -arents eating habits d#ring transition to parenthood Lnp#blished 1an#script% p 1-1? 6achmann 7 % )lfrin" J and <azzana > % $133=&% Trac"ing the progress of e-mail vs snail-mail ,ar!eting Research% p *.-*( 6ec"er D S % $133=&% +The epistemology of '#alitative research, in 8 Jessor% A 2olby and 8 A Shweder% Ethnography and 8uman ?evelopment% 2hicagoK Lniversity of 2hicago -ress% p (*-C2

6er"owitz > % 5 -apierni" ) % $133*&% )pidemiology of preterm birth Epidemiologic Reviews p. ?1?0??*

1. 6illson D % -ryor J 5 Aichols 8 % $1333&% <ariation in fr#it and vegetable cons#mption among ad#lts in 6ritain An analysis from the dietary and n#tritional s#rvey of 6ritish ad#lts European <ournal of @linical )utrition p. 3?=03(2 11 6irch E E % 5 @isher J A % $1334& 7evelopment of eating behaviors among children and adolescents =ediatrics p (*30?3 12 6lincoe A % $2..(&% A g#ide to healthy eating d#ring pregnancy% British <ournal of ,idwifery p. 4A.*4A7 (*

1* 6lisard A % Ein 6 D % 2romartie J % 6allenger A % $2..2&% AmericaFs changing appetiteK food cons#mption and spending to 2.2.% Bood Rev. p 2(K2-3 1? 6#rea# of Eabor Statistics% $2..(&% )mployment 2haracteristics of @amilies S#mmary% Available atK www b!s govQnews releaseQfamee nr9 htm 1( 2annella 6 % $2..=&% 1ediators of the relationship between social s#pport and positive health practices in pregnant women )ursing Research p. ?*C0??( 1= 2arson 7 % >ilmore A % -erry 2 and >ronha#g J % $2..1&% N#alitative mar"eting research 1age =u"lications3 &ondon 1C 2enter on D#nger and -overty% $2..2&% 0he conse9uences of hunger and food insecurity for children. 8etrieved from httpKQQwww accfb orgQpdfsQ2onse'#encesofD#nger pdf 14 2hanm#gam - % >#thrie J @ % 2ecelio S % 1orton J % 6asiotis - % Anand 8 % $2..*&% 7id fat inta"e in the Lnited States really decline between 1343-1331 and 133?-133=P <ournal of ?iet Association. p.4=C-4C2 13 2hristensen - % $2..?&% The health-promoting familyK a concept#al framewor" for f#t#re research% 1ocial 1cience and ,edicine% p *??-*4C 2. 2ohen J % $133=&% 2omp#ter mediated comm#nication and p#blication prod#ctivity among fac#lty Internet Research3 Electronic )etwor!ing Applications and policy p. 64*C/ 21 2ollins 1 ) % Stevens J W % 5 Eane T S % $2...&% Teenage parents and welfare reformK @indings from a s#rvey of teenagers affected by living arrangements 1ocial :or!% p. *2C0**4 22 2omley - % $133=&% The #se of the !nternet as a data collection method Available atK httpKQQwww sga co #"Qesomar html 2* 2onway 8% 8eddy S% 7avies J $1333& 7ietary restraint and weight gain d#ring pregnancy Eur < @lin )utr. p 4?304(* 2? 2oomber 8 % $133C&% Lsing the !nternet for s#rvey research 1ociological Research (nline 2( 2opper 8 E % 7#bard 1 6 % >oldenberg 8 % 9weis A ! % $133(&% The relationship of maternal attit#de toward weight gain to weight gain d#ring pregnancy and low birth weight ("stetrics and Dynecology p (3.-(3(

(?

2= 2owan 2 - and 2owan - A % $1333& When partners become parentsK the big life change for co#ples 1ahwah% AJK Eawrence )rlba#m Associates 2C 2owan 2 % 2owan - % Deming > % >arrett ) % 2oysh W % 2#rtis-6oles D 5 6oles A % $134(&% Transitions to parenthoodK his% hers% and theirs <ournal of Bamily Issues p ?(10?41 24 7avis-@loyd 8 ) % $133?&% 1ind over bodyK the pregnant professional =re* and perinatal =sychology <ournal% p 2.1022C 23 7eshm#"h-Tas"ar - % Aic"las T % Hang S 5 6erenson > % $2..C&% 7oes food gro#p cons#mption vary by differences in socioeconomic% demographic% and lifestyle factors in yo#ng ad#ltsP The 6ogal#sa Deart St#dy <ournal of the American ?ietetic Association p. 22*02*? *. 7evine 2 et all% $2...&% 2ontin#ity and change in womenFs weight orientations and lifestyle practices thro#gh pregnancy and the postpart#m periodK the infl#ence of life co#rse tra/ectories and transitional events 1ocial 1cience E ,edicine p. 7CA*75. *1 7evine 2 % 9lson 2 % $1331& WomenFs dietary prevention motivesK Eife stage infl#ences <ournal of )utrition Education p 2=3-2C? *2 7evine 2 % 9lson 2 % $1332&% WomenFs perceptions abo#t the ways social roles promote or constrain personal n#trition care :omen and 8ealth p C3-3( ** 7evine 2 1 % $2..(&% A life co#rse perspectiveK #nderstanding food choices in time% social location% and history. 7ivision of A#tritional Sciences% 2ornell Lniversity% !thaca% <ournal of )utrition Education E Behavior% p 121-1*. *? 7evine 2 1 % 2onnors 1 1 % Sobal J % 6isogni 2 A % $2..*&% Sandwiching it in spillover of wor" onto food choices and family roles in low- and moderate-income #rban ho#seholds Soc 1ci ,ed. p =1C-=*. *( @agerh 8 A and Wandel 1 % $1333& >ender differences in opinions and practices with regard to a Rhealthy diet F Appetite. p.1C1-13. *= @airb#rn 2 > 5 6eglin S % $133.&% St#dies of the epidemiology of b#limia nervosa American <ournal of =sychiatry% p ?.10?.4 *C @airb#rn 2 > and Welch S E % $133.&% The impact of pregnancy on eating habits and attit#des to shape and weight International <ournal of Eating ?isorders p 1(*-1=.

((

*4 @inch% 6 $2..*& Socioeconomic gradients and low birth-weightK )mpirical and policy considerations 8ealth 1ervices Research p.1413014?2 *3 @lic" L % $2..3&% An introd#ction to '#alitative research $? ed & SageK Eos Angeles ?. @owles ) % 5 >abrielson 1 % $2..(&% @irst trimester predictors of diet and infant birthweight in low-income pregnant women <ournal of @ommunity 8ealth )ursing p.11C01*. ?1 @owles ) % $2..2&% 2omparison of pregnant womens n#tritional "nowledge to act#al dietary inta"e ,@)3 0he American <ournal of ,aternal*@hild )ursing% p 1C101CC ?2 @owles ) % $2..4&% Dealthy eating d#ring pregnancyK determinants and s#pportive strategies% <ournal of @ommunity 8ealth )ursing p 1*401(2 ?* @owles ) % Dendric"s J 5 Wal"er E % $2..(&% !dentifying healthy eating strategies in low-income pregnant womenK Applying a positive deviance model 8ealth @are for :omen International p. 4.C042. ?? @owles ) % Dendric"s J % 5Wal"er E % $2..(&% !dentifying healthy eating strategies in low-income pregnant womenK Applying a positive deviance model 8ealth @are for :omen International p.4.C042. ?( @rench A % Darnac" E % and Jeffery 8 % $2...&% @ast food resta#rant #se among women in the po#nd of prevention st#dyK dietary% behavioral and demographic correlates% International <ournal of ("esity E Related ,eta"olic ?isorders p. 1*(*0(3 ?= >adsby 8 % 6arnie-Adshead A 1 et al% $133*&% A prospective st#dy of na#sea and vomiting d#ring pregnancy% <ournal of Deneral =ractice p 2?(-4 ?C >arner 7 1 % >arfin"el - ) % Schwartz 7 5 Thompson 1 % $134.&% 2#lt#ral e:pectations of thinness in women =sychological Reports% p ?4*0?31 ?4 >enevie E % 1argolies ) % $134C&% The 1otherhood 8eportK Dow Women @eel abo#t 6eing 1others ,acmillan =u"lishing @ompany )ew ;or!. ?3 >eorge > % Danss-A#ss D % 1ilani T % 5 @reeland->raves J% $2..(&% @ood choices of low-income women d#ring pregnancy and postpart#m <ournal of the American ?ietetic Association p. 43303.C (. >ier S % 1ensinger J % D#ang S % J#manyi"a S % and Stettler A % $2..C&% @ast-@ood mar"eting and childrens fast food cons#mptionK e:ploring parents infl#ences in an ethnically diverse sample% p 22102*(

(=

(1 >lazer 6 > and Stra#ss A % $13=C&% The discovery of gro#nded theoryK strategies for '#alitative research Aew Hor"K Aldine (2 >oody J % 6eardsworth A % Jeil T et al% $133?&% 2hanging the nationFs dietK a st#dy of responses to c#rrent n#tritional messages 8ealth Educational <ournal p 24(M33 (* >ordon J 6 % Tobias A % $134?&% @at% female and the life co#rseK The developmental years ,arriage and Bamily Review p =(-32 (? >#nderson ) - % Abrams 6 % Selvin S % $2...&% The relative importance of gestational gain and maternal characteristics associated with the ris" of becoming overweight after pregnancy International <ournal of ("esity Related with ,eta"olic ?isorder p 1==.-4 (( >#thrie J @ % Ein 6 D % @razao ) % $2..2&% 8ole of food prepared away from home in the American diet% 13CC-C4 vers#s 133?-3=K changes and conse'#ences <ournal of )utritional Education. p.462*472. (= Dastings > % Stead 1 % 1c7ermott E % @orsyth A % 1acJintosh A 1 % 8ayner 1 % et al $2..*&% 8eview of research on the effects of food promotion to children% Dlasgow G>3 Bood 1tandards Agency. (C Delman 2 % $2...&% 2#lt#re% health and illness (xford3 Butterworth 8einemann (4 Doffmann-8iem% 2 $134.&% +7ie Sozialforsch#ng einer interpretativen SoziologieK 7er 7atengewinn,% >olner Heitschrift fur 1o+iologie und 1o+ialpsychologie % p **3*C2 (3 Doo"er A % $2.1.&% 2hildhood obesity and schoolsK evidence from the national s#rvey of childrens health% <ournal of 1chool 8ealth p. IC*427 =. !nstit#te of 1edicine% Aational Academy of Sciences% $133.&% A#trition d#ring pregnancy% weight gain% n#trient s#pplements . :ashington ?@3 )ational Academy =ress. =1 !nstit#te of 1edicine% $2..=b&% +-rogress in -reventing 2hildhood 9besityK @oc#s on 2omm#nitiesK 6rief S#mmary%, !nstit#te of 1edicine 8egional Symposi#m% -rogress in -reventing 2hildhood 9besityK @oc#s on 2omm#nities AtlantaK Dealthcare >eorgia @o#ndation and the 8obert Wood Johnson @o#ndation =2 Jacobs J A % >erson J % $2..1&% 9verwor"ed individ#als or overwor"ed familiesP ):plaining trends in wor"% leis#re and family time :or! and (ccupations. p ?.-=*

(C

=* Jen"in W 5 Tiggemann 1 % $133C&% -sychological effects of weight retained after pregnancy :omen and 8ealth% p 43034 =? Jewell 7 and Ho#ng > % $2..*&% !nterventions for na#sea and vomiting in early pregnancy 0he @ochrane ?ata"ase of 1ystematic Reviews =( Jalich J % 6a#er 7 % 5 1c-artlin 7 % $2..3&% )arly spro#tsK c#ltivating healthy food choices in yo#ng children. 1t. =aul ,)3 Redleaf =ress. == Eacroi: 8 % )ason ) % 5 1elzac" 8 % $2...&% Aa#sea and vomiting d#ring pregnancyK A prospective st#dy of its fre'#ency% intensity and patterns of change American <ournal of ("stetrics and Dynecology% p 3*103*C =C Eee 8 % $133*&% ?oing Research on 1ensitive 0opics Eondon and Aewb#ry -ar" =4 Eeifer 1 % $13CC&% -sychological changes accompanying pregnancy and motherhood Denetic =sychology ,onographs% p ((03= =3 1ann 2 and Stewart @ % $2...&% !nternet comm#nication and '#alitative research SageK Eondon C. 1ay T % $133*&% 1ocial Research3 Issues ,ethods and =rocesses. 6#c"inghamK 9pen Lniversity -ress C1 1ehta 8 and Sivadas ) % $133(&% 2omparing response rates and response content in mail vers#s electronic mail s#rveys <ournal of the ,ar!et Research 1ociety p ?23?*3 C2 1ela J % 8ogers - J % $1334&% Bood eating and o"esity. 0he psycho"iological "asis of appetite and weight control. EondonK 2hapman 5 Dall C* Aicholson - % $1333&% Eoss% happiness and postpart#m depressionK the #ltimate parado: @anadian =sychology% p 1=201C4 C? Aielsen S J % Siega-8iz A 1 % and -op"in 6 1 % $2..2&% Trends in energy inta"e in L S between 13CC and 133=K Similar shifts seen across age gro#ps% ("esity Research p. *C.-*C4 C( ABrgaard 1 % 6r#nsB J % 2hristensen - and 1i""elsen% 1 % $2..C&% 2hildrens infl#ence on and participation in the family decision process d#ring food b#ying% ;oung @onsumers% p 13C-21=

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C= Ati% 2 % Earweh - % $2..2&% @ood cons#mptionK patterns% dietary '#ality and health stat#s of e:pectant mothersK case st#dies in s#b#rban and r#ral comm#nities in >hana >yemf#a-Heboah% Haa. International <ournal of @onsumer 1tudies% pC-4 CC 9lson 2 % $2..(&% Trac"ing of food choices across the transition to motherhood% <ournal of )utritional Educational Behavior p 123-1*= C4 9sofs"y D J % 9sofs"y J 7 % 2#lp 8 % Jrantz J % Eitt J 5 Tobiasen J % $134(& % Transition to parenthoodK ris" factors for parents and infants =sychosomatic ("stetrics and Dynecology% p *.*0*1( C3 -atel - % Eee J % Wheatcroft 8 % 6arnes J % Stein A % $2..(&% 2oncerns abo#t body shape and weight in the postpart#m period and their relation to womens selfidentification% <ournal of Reproductive and Infant =sychology p *?C-*=? 4. -ereira A % Jartashov A % )bbeling 2 % Dilner J et al % $2..*&% @ast food meal fre'#ency and the incidence of obesity and abnormal gl#cose homeostasis in yo#ng blac" and white ad#ltsK The 2A87!A st#dy% @irculation% p *( 41 -ines 7 % $13C4&% 9n becoming a parent <ournal of @hild =sychotherapy% p 130*1 42 -olomeno < % $2..=&% Why is love so important in childbirth ed#cationP 0he International <ournal of @hild"irth Education p *(-? 4* -resser D 6 % $1333&% Toward a 2?-ho#r economy 1cience. p.1CC4-1CC3 4? -rice S % 1cJenry - 5 1#rphy 1 % $2...&% @amilies across timeK a life co#rse 8o:b#ry -#blishing 2ompany% Eos Angeles% 2alifornia 4( -riel 6 5 6esser A % $2..2&% -erceptions of early relationships d#ring the transition to motherhoodK the mediating role of social s#pport Infant ,ental 8ealth <ournal p *?*0*=. 4= 8ifas-Shiman S % 8ich-)dwards J % Willett W % Jleinman J % 9"en ) 5 >illman 1 % $2..=&% 2hanges in dietary inta"e from the first to the second trimester of pregnancy =ediatric and =erinatal Epidemiology p. *(0?2 4C 8ogers ! % )mmett - % 6a"er 7 5 >olding J % $1334&% @inancial diffic#lties% smo"ing habits% composition of the diet and low birthweight in a pop#lation of pregnant women in the So#th West of )nglandK AES-A2 St#dy TeamK Avon Eongit#dinal St#dy of -regnancy and 2hildhood European <ournal of @linical )utrition p. 2(10 2=. <ournal of

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44 8oos > % -rattaala 8 % Jos"i J % $2..1&% 1en% masc#linity and foodK interviews with @innish carpenters and engineers. Appetite p.?C-(= 43 8ozin - % $133.&% Ac'#isition of stable food preferences <ournal of )utritional Review% p 1.=-11* 3. 8ozin - % Trachtenberg S % 2ohen A % $2..1&% Stability of body image and body image dissatisfaction in American college st#dents over abo#t the last 1( years Appetite. p.2?(-2?4 31 Saltonstall 8 % $133*&% Dealthy bodies% social bodiesK menFs and womenFs concepts and practices of health in everyday life 1ocial 1cience ,edicine. p C-1? 32 Savage J % @isher J % 6irch E % $2..C&% -arental infl#ence on eating behaviorK conception to adolescence% <ournal of law medicine and ethics p. ..*/C 3* Schaefer 7 and 7illman 7 A % $1334&% 7evelopment of a standard e-mail methodologyK 8es#lts of an e:periment =u"lic (pinion Juarterly% p *C4-*3C 3? Schafer 8 6 and Schafer ) % $1343&% 8elationship between gender and food roles in the family <ournal for )utritional Education. p 113-12= 3( SBndergaard D and )delenbos 1 % $2..C&% What parents prefer and children li"e 0 !nvestigating choice of vegetable-based food for children% Bood Juality and =reference% pp 3?3-3=2 3= Stein A % @airb#rn 2 > % $133=&% )ating habits and attit#des in the postpart#m period =sychosomatic ,edicine p *21-*2( 3C Stern > 5 Jr#c"man E % $134*&% 1#ltidisciplinary perspectives on post-part#m depressionK an anthropological criti'#e 1ocial 1cience and ,edicine p 1.2C01.?1 34 Stevens 2 5 Tiggemann 1 $1334& Womens body fig#re preferences across the life span <ournal of Denetic =sychology% p 3?01.2 33 Stevens 2 % $2..?&% !mages and voicesK Adolescent mothers 1eattle. 1.. Stevens 2 % $2.1.&% ):ploring @ood !nsec#rity Among Ho#ng 1others% <ournal for 1pecialists in =ediatric )ursing p. 4C/*A/ 1.1 Stevens 2 A % $2..=&% 6eing healthyK <oices of adolescent women who are parenting <ournal for 1pecialists in =ediatric )ursing% p 240?. negotiating socioeconomic environments. Gnpu"lished ?issertation Gniversity of :ashington

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1.2 Striegel-1oore 8 D % Silberstein 2 8 5 8odin J % $134=&% Towards an #nderstanding of ris" factors for b#limia American =sychologist% p 2?=02=* 1.* Sweet 2 $1333&% ):panding the '#alitative research arenaK 9nline foc#s gro#ps 1.? Thorsdottir ! and 6irgisdottir 6 ) % $1334&% 7ifferent weight gain in women of normal weight before pregnancyK postpart#m weight and birth weight ("stetrical. Dynecology p *CC0*4* 1.( Tiran 7 % $2..=&% A#tritional approaches to na#sea and vomiting in pregnancy R@, ,idwifery p./72*7/ 1.= L S 7epartment of Dealth and D#man Services -hysical activity and healthK a report of the S#rgeon >eneral Atlanta% >AK L S 7epartment of Dealth and D#man Services% 2enters for 7isease 2ontrol and -revention% Aational 2enter for 2hronic 7isease -revention and Dealth -romotion; $133=& 1.C <an Tei/lingen ) % Wilson 6 % 6arry A et al $1334&% )ffectiveness of interventions to promote healthy eating in pregnant women and women of childbearing ageK a review Dealth )d#cation A#thority% Eondon 1.4 <olins"i J % $2..4&% @ood for tho#ght% R@, ,idwifery p *.-*2 1.3 Wal"er E 9 $1343& Stress process among mothers of infantsK -reliminary model testing )ursing Research% p 1.01= 11. Wal"er E 9 % 2ooney A T 5 8iggs 1 W % $1333&% -sychosocial and demographic factors related to health behavior in the 1st trimester <ournal of ("stetric Dynecologic and )eonatal )ursing% p. =.=0=1? 111 Wal"er E % $1334&% Weight-related distress in the early months after childbirth Western Jo#rnal of A#rsing 8esearch% p *.0?? 112 Wal"er E 9 % $133C&% Weight and weight-related distress after childbirth <ournal of 8olistic )ursing p *43-?.( 11* Ward S and Wac"man 7 % $13C2&% 2hildrenFs p#rchase infl#ence attempts and parental yielding% <ournal of ,ar!eting Research% p *1=-*13 11? Wardle J % $133(&% -arental infl#ences on childrens diets =roceedings of the )utrition 1ociety% p C??0C(4 11( Welch S E % 7oll D A % @airb#rn 2 > % $133C&% Eife events and the onset of b#limia nervosaK A controlled st#dy =sychological ,edicine p (1(-(22

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11= Wilson T - % $1342& N#antitative +oder, '#alitative 1ethoden in der Sozialforsch#ng% >olner Heitschrift fur 1o+iologie und 1o+ialpsychologie% p ?4C-(.4 11C Wynn S % Wynn A % 7oyle W 5 2rawford 1 % $133?&% The association of maternal social class with maternal diet and the dimensions of babies in a pop#lation of Eondon women )utrition and 8ealth p. *.*0*1(

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'8( Appendi9

1. 0uestionnaire Questionnaire for healthy parents

Thank you for taking the time to fill in the /uestionnaire( The aim of the study is to look at how parents change their eating habits in regard to eating healthier or less healthy than before in the different stages they go through during pregnancy and kindergarten( 'ts also looking to show what products and services do parents choose and what kinds of marketing communications affect their buying behaviour( The results might be used in the food marketing or help giving advice to future parents( 5lease answer the /uestions as honest as you feel comfortable to( :our answers will be treated with complete confidentially( The survey will take appro9imately one hour( 5lease return the filled in /uestionnaire on the same e-mail address(

Part 1 todays daily routine and food

&( ;ould you please shortly describe your daily routine- what you do at which time throughout the day on an average weekday< $!f there is no +average day,% describe the most common day at the momentP 9r e:plain why that is not possible Answer only the '#estions that are applicable to yo# & When do yo# get #pP What do yo# do thro#gho#t the morningP When do yo# leave the ho#seP Where do yo# go% and howP $2hild-careP Wor"P 6rea"sP ShoppingP AppointmentsP SportP )at-o#tP S& What else do yo# do thro#gho#t the dayP When do yo# come bac" homeP What do yo# do thro#gho#t the eveningP $2hildrenP Wor"P Eeis#re timeP S& When do yo# go to bedP $( ;ould you please describe the food that you eat on a typical weekday at the moment( ;hat kind of meals=snacks and drinks do you eat throughout the day( 5lease try to narrate it and give me a full picture of the situation ! when you eat> where you eat> with whom you eat> how and why you do that> and how you feel like in that situation(

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KDive circular picture of day with hours as an aidL Where% when% what% with whom and how yo# eat and drin" for S and why in that wayP - 6rea"fast - first and secondP thro#gho#t the morningK 6rea" and Snac"% - E#nch% thro#gho#t the afternoonK 6rea" and Snac"% maybe ca"e% fast food - 7inner 0 $first with children% second after bringing children to bed&P - 1aybe snac"ing% maybe drin"s in the evening - Dow do yo# feel li"e% in this eatingQdrin"ing sit#ations that yo# have describedP - 7oes the company of yo#r family affect yo#r eating habitsP $ in a way that ma"es yo# eat more% try different "ind of foods% eat less healthy foodsP
Part 2 pasts diet and eating behavior

)( ;ould you please try to recall your diet and eating habits of the last years< 5lease think of what you usually ate and drank throughout the day> in the time before ?your first@ pregnancy and in the different stages of becoming a parent( 'f you try to compare that ! what do you think has changed> and why< KDive time*line picture of "ecoming parent with phases and events as an aidL Answer only those '#estions which are applicable to yo# ;hat were your diet and eating habits like> when: Ho# did not have children $before pregnancy&P Ho# were pregnantP - at the first three months of pregnancyM during the symptoms of nausea and vomiting - later in pregnancy Ho#r $first& child was still a baby% drin"ing $breast-& mil"P Ho#r $first& child ate food b#t had its own food $p#ree% baby-food from glasses&P Ho#r $first& child ate the same food as yo#P Ho# had yo#r second childP *( ;hat else do you think has also led to changes in your own diet and eating habits in the last years<
(Give picture of a parents surrounding as an aid, use subquestions to explain)

Which influence has for example brought a change? How healthy and fit you are? Your partner (e.g. his work and contribution to family life, his eating habits) he support or influence of the extended family and friends! family "isits Your work (as e.g. working hours and working en"ironment)? he child#care (as e.g. hours of child#care, the facilities, the time#frame and how it is

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organi$ed) Your home and the area where you li"e (space and e%uipment in home, recreational facilities, shopping facilities and centers near home)?

Part 3 healthiness of changes and todays diet and eating habits

7( 'f you look at the different stages from when before you had a child and throughout all the stages of becoming a parent: when do you think that you have eaten in the healthiest> and when in the least healthy way<

Part 4 Satisfaction with todays diet and eating habits

-( 5lease think about the diet and eating habits that you have at the moment( Are there things that you are unhappy and dissatisfied with> and are there other things that you are happy and satisfied with< !s there something that yo# disli"e abo#t the diet that yo# eat at the moment% or the way yo# eat food at the momentP Are there things yo# wo#ld li"e to changeP !s there something that yo# li"e abo#t the diet that yo# eat at the moment% or the way that yo# eat food at the momentP Are there things that yo# are pleased withP What coping strategies do yo# #se to deal with some of the infl#ences that becoming a parent had on yo#r diet and eating habitsP

4( ;ould you please describe how your weight= body shape has changed during and after the pregnancy< Ao you feel satisfied with your body now< 'f not> what strategies do you apply to change that< Aoes the child prevent you from taking care for your own diet< What "inds of food do yo# tend to avoid now in order to "eep yo#r body shapeP What did yo# avoid d#ring the pregnancyP What "inds of food do yo# prefer now and d#ring the pregnancyP What do yo# thin" abo#t the ma:ima 0 +eating for two,P 7id yo# eat that way d#ring yo#r pregnancyP Part 5 fast food ar!eting

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1( ;ould you please describe what your attitude towards fast food is and do you regularly consume such kinds of food ?sandwiches> hamburgers> piBBa> chips> chocolate etc(@< Aoes your craving for such foods increased during the pregnancy< When% where% in what sit#ations% with whom do yo# cons#me s#ch "ind of foodP 2( ;ould you describe what kinds of factors affect your food choices< Aoes advertising affect your preferences or do children and family re/uests such kind of food( 5lease shortly describe some advertising or situations not connected with the daily routine that made you break your diet(

&&( 5ersonal /uestions Age in yearsK Age of each child in yearsK Do#sehold-members% apart from yo#rself and child$ren&K Assessment of distrib#tion of ho#sehold tas"s between yo#rself and partner $if& in percentageK Do#rs or wor" per wee"% yo#K Do#rs or wor" per wee"% partnerK Do#rs of child-care per child $all reg#lar arrangements% s#ch as instit#tional childcare% babysitter and grandparents&K )d#cational level% yo#K )d#cational level% partnerK

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9cc#pation $or last position&% yo#K 9cc#pation $or last position&% partnerK

Thank you very much for taking the time to complete the /uestionnaire( 5lease send it back to the following e-mail: svetoslavaCssDyahoo(com 'f you have any other comments> please add them below:

2. *ontact list

)vgenia Jovacheva 0 beboTsnUabv bg 2vetelina Lz#nova 0 cec"a#z#novaUmail bg )milia Hon"ova 0 eyon"ovaUyahoo com )milia 6oneva 0 emiTganevaUabv bg Stanislava 8adeva 0 cho"iTUabv bg <elina >eorgieva 0 velinaT134?Uabv bg 1arina Hordanova - mjstojanova435@gmail.com Hov"a 7imitrova - ilonessaUabv bg; Hana 6osh"ova 0 yanaTbosh"ovaUabv bg; >alena !vanova- galena 4.Uabv bg; 7aniela Stancheva - danielaTstanchevaUyahoo com; Tanya Slavova - tanya2*Uabv bg 1ariyana Stancheva - mariyanaT4(Umail bg; Aeli - neliT"zUmail bg Tsveti 6oicheva - tsvetiTboichevaUyahoo com;

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Sonia Sarab'n- soniaTsrUabv bg; Vori - zoriboriUgbg bg Tan' Jarabelova - taidiUabv bg Tania 7aneva - "reizitoTtaniaUabv bg )lena Joleva - elis "Uabv bg 1ilena 7imitrova 0 mimi"oser"ataUabv bg Snezh"a -opova-Joleva snezhka@gbg.bg

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