Table 2.

Summary table of intervention characteristics of included studies

Author, Year Country	Study design	Intervention type Number of participants randomised	Control	Intervention	Target behaviour	Duration (weeks)	Setting	Explicit theoretical model/theory/framework of behaviour change
Guelinckx, et al. 2010 [51] Belgium	RCT (three arm)	Mixed (PA + diet) n = 195	Standard Antenatal Care	3 × 1 hr F2F group Delivered by: Nutritionist (trained in counselling)	Limit intake energy-dense foods (e.g. fast food and sweets), increasing low-fat dairy products, increasing whole-wheat grains, and reducing saturated fatty acids	17	Clinical	NA
Jackson, et al. 2011 [54] HIP United States	RCT	Mixed (PA + diet) n = 321	Standard Antenatal Care	2 × 10–15 min Computer program Delivered by: Video doctor program	Improve women’s diet and PA behaviours during pregnancy	6	Clinical	NA
Hui, et al. 2012 [53] Canada	RCT	Mixed (PA + diet) n = 224	Standard Antenatal Care (including information on PA and nutrition in pregnancy from Health Canada)	2 × individualised F2F visits Delivered by: Dietitian	Improve dietary habit, increase PA and achieve recommended GWG	16	Community	NA
Wilkinson and McIntyre. 2012 [66] Australia	RCT	Mixed (PA + diet) n = 360	Standard Antenatal Care (including a booklet with behaviours influencing maternal and infant health outcomes)	1 × 60 min F2F group ± partners Delivered by: Dietitian	Improve dietary behaviours (change in meeting fruit and vegetable pregnancy guidelines), improve diet quality index, improve GWG guideline awareness	12	Clinical	Social Cognitive theory*
Kieffer, et al. 2014 [56] United States	RCT	Mixed: (PA, diet, stress management) n = 278	Other: minimal intervention group (3 group pregnancy education sessions)	2 × individualised F2F home visits, 9 × optional group activities such as healthy cooking demonstrations Delivered by: Community health workers	Decrease added sugars, total fat and saturated fat, increase fruit, vegetables and fibre	11	Community	NA
Kinnunen, et al. 2014 [69] Finland	Cluster RCT	Mixed (PA + diet) 14 sites n = 442	Standard Antenatal Care	1 × 20–30 min and 3 × 10–15 min individualised F2F visits Delivered by: Public health nurses	Achieve a diet with energy intake from < 10% saturated fat, 5–10% polyunsaturated fat, 25–30% total fat, and < 10% saccharose and 25–35 g fibre per day	29	Clinical	PRECEDE-PROCEED model and Transtheoretical Model of Health Behaviour Change*
Dodd, et al. 2014 [49] LIMIT Australia	Multicentre RCT	Mixed (PA + diet) n = 2212	Standard Antenatal Care	3 × individualised F2F visits and 3 × telephone calls Delivered by: Dietitian (F2F) or research assistants (calls)	Healthy eating as per ADG (maintain balance of CHO, fat, and protein, reduce high refined CHO and saturated fats, increase fibre, 2 serves of fruit and 5 serves of vegetables and 3 serves dairy daily)	26	Clinical	Stage Theories of Health Decision Making
Phelan, et al. 2014 [59] United States	RCT	Mixed (PA + diet) n = 401	Standard Antenatal Care, included standard nutrition counselling and F2F visit at study entry with the study interventionist, study newsletters at 2-mo intervals providing general information about pregnancy-related issues	1 × individualised F2F visit and 3 x (10–15 min) follow up telephone call, provided with scales, food records, pedometers and received weekly postcards Delivered by: Dietitian	Achieve recommended GWG, PA and healthy eating (decrease intake high fat foods)	NA	Academic and community	Social Learning Theory*
Pollak, et al. 2014 [37] United States	Pilot RCT	Mixed (PA + diet) n = 35	Text4Baby (free mobile information service, limited number of texts related to healthy eating or PA)	2 SMS three times a week Delivered by: NA	Achieve recommended GWG by walking 10,000 steps/day, avoid sweetened drinks, eat at least five fruit and vegetables per day, eliminate fast food intake	16	Community	Social Cognitive Theory*
Flynn, et al. 2015 [35] UPBEAT UK	Pilot RCT	Mixed (PA + diet) n = 183	Standard Antenatal Care	1 × Individualised F2F visit and 8 × group sessions Delivered by: Study health trainer	Reduce dietary glycaemic load, saturated fat intake and increase PA	8	Clinical and community	Control Theory and Social Cognitive Theory*
Jing, et al. 2015 [55] China	RCT	Mixed (PA + diet) n = 262	Standard Antenatal Care	3 × 20 min individualised F2F visits, optional feedback via telephone or smartphone app Delivered by: Graduate student	Improve pregnant women’s behaviour about dietary intake, PA to lower the frequency of excessive GWG and GDM	8	Clinical	Health Belief Model
Flynn, et al. 2016 [50] UPBEAT UK	RCT	Mixed (PA + diet) n = 1555	Standard Antenatal Care	1 × individualised F2F and 8 × group sessions Delivered by: Study health trainer	Reduce dietary glycaemic load and saturated fat and increase PA	8	Clinical	Control Theory and Social Cognitive Theory*
Asci and Rathfisch. 2016 [41] Turkey	RCT	Mixed (PA + diet) n = 102	Standard Antenatal Care	4 × 1 hr individualised F2F visit Delivered by: Researcher	Adapting to a healthy lifestyle, developing dietary habits, for recommended GWG	25	Family health centre	Pender’s health promotion model
Hillesund, et al. 2016 [52] NFFD Norway	RCT	Mixed (PA + diet) n = 606	Standard Antenatal Care	2 × 20 min telephone calls and option cooking class Delivered by: Clinical nutritionist or public health nutrition masters students	Meal regularity, fruit and vegetable intake, consumption of water (over sugar sweetened beverages, awareness of frequency and portion size of discretionary foods)	12	Clinical	NA
Mauriello, et al. 2016 [57] United States	RCT	Lifestyle (PA, diet, smoking cessation, stress management) n = 335	Standard Antenatal Care	3 × iPad sessions Delivered by: Healthy pregnancy: step by step iPad delivered intervention	Smoking cessation and relapse prevention, effective stress management, and consumption of fruits and vegetables	24	Clinical	Transtheoretical Model of Behaviour Change*
Tussing-Humphreys, et al. 2016 [62] United States	Randomized, comparative impact trial	Mixed (PA + diet) n = 82	Parents as Teachers (PAT) control group	Monthly 90–120 min F2F home visits Delivered by: Community based parent educators	Not clear (achieve appropriate GWG, improve dietary intake and health behaviours)	72	Community	NA
Assaf-Balut, et al. 2017 [43] Spain	RCT	Mixed (PA + diet) n = 1000	Standard Antenatal Care (Included basic Med diet advice and instructions to restrict consumption of dietary fat provided by Midwives)	1 × 1 hr group session and 2 individualised F2F visits, provided with EVOO and pistachios Delivered by: Dietitian	Adherence to Mediterranean style diet including daily consumption of > 40 ml EVOO	24	Clinical	NA
Bruno, et al. 2017 [45] Italy	RCT	Mixed (PA + diet) n = 191	1 h counselling session and 4 follow ups with dietitian with general advice on diet and PA, and a nutritional booklet according to Italian Guidelines for healthy diet and PA in pregnancy	1 × 1 hr initial and 4 × follow up individualised F2F sessions Delivered by: Dietitian	Avoid high GI foods, reduce high saturated fat foods, increase low GI vegetable, and fruit consumption, total intake of 1500 kcal/day	25	Clinical	NA
Sewell, et al. 2017 [38] Scotland	Pilot RCT	Dietary n = 30	Standard Antenatal Care	1 × 15 min F2F and 3 follow up telephone calls, provided with shopping voucher to purchase EVOO Delivered by: Dietitian or researcher	Adherence to Mediterranean style diet	26	Clinical	NA
Simmons, et al. 2017 [64] DALI 9 European countries (UK, Ireland, Netherlands, Austria, Poland, Italy, Spain, Denmark, Belgium)	RCT (four arm)	Mixed (PA + diet) n = 436	Standard Antenatal Care	5 X 30–45 min individualised F2F visits, ≤ 4 x ≤ 20 min telephone calls Delivered by: Lifestyle coach	Improve diet quality (replace sugar sweetened beverages, eat more vegetables, increase fibre, watch portion size, eat protein, reduce fat intake, eat less CHO), increase PA	18	Clinical & community	Health Action process approach
Wilcox, et al. 2017 [39] txt4two Australia	Pilot RCT	Mixed (PA + diet) n = 100	Standard Antenatal Care (including brochure with diet and PA advice)	1 × individualised F2F visit, 4–5 tailored SMS per week, assess to study website with short videos and social media page Delivered by: SMS, videos by Dietitian/ obstetrician + researcher	Promote healthy diet (increase fruit and vegetable intake, decrease discretionary foods and sugar sweetened beverages), PA and GWG	26	Clinical and community	Social Cognitive Theory*
Asiabar, et al. 2018 [42] Iran	RCT (three arm)	Dietary n = 150	Standard Antenatal Care	2 × 90 min individualised F2F visit with partners and 3–5 × text messages Delivered by: Trained midwife	Improve diet quality: decrease intake of energy dense food and high fat foods by replacing with low fat and or sugar substitutes and increase fruit, vegetables, and dairy, improve fat quality, and recommended serving sizes	5	Clinical	NA
Rönö, et al. 2018 [60] Finland	RCT	Mixed (PA + diet) n = 293	Standard Antenatal Care (included leaflets on healthy diet and PA)	Individualised F2F visits every 3 months prior to and during pregnancy, and 4 × 1 hr F2F group (enrolment, 1st trimester pregnancy, 6 and 12 months PP) Delivered by: Dietitian and study nurse	Achieve total energy intake 1600–1800 kcal/day, with total energy intake coming from 40–50% carbohydrates, 30–40% fats and 20–25% protein. Increase intake of vegetables, legumes, fruits and berries, wholegrains and fibre, low-fat dairy and vegetable fats	22	Clinical	NA
Van Horn, et al. 2018 [63] MOMFIT United States	RCT	Mixed (PA + diet) n = 281	Standard Antenatal Care (including asses to MOMFIT website and biweekly e-newsletters)	3 individualised F2F visits, 6 × 30 min group sessions, 9 × coaching calls, emails, SMS, access to MOMFIT website, and access to LOSEIT Delivered by: Dietitian	Achieve recommended GWG through healthier diet (adherence to modified DASH diet), increased PA, and increased sleep	20	Clinical and community	NA
Günther, et al. 2019 [68] Gelis Germany	Cluster RCT	Mixed (PA + diet) n = 2102	Standard Antenatal Care	4 × 30–45 min individualised F2F (3 during pregnancy) Delivered by: Midwives, gynaecologists, or medical personnel	General healthy eating, according to the “Healthy Start-young family network” for recommended GWG	34	Clinical	NA
Buckingham-Schutt, et al. 2019 [46] United States	RCT	Mixed (PA + diet) n = 56	Standard Antenatal Care (received IOM chart of GWG)	Minimum 6 × 15–30 min individualised F2F visits, weekly emails and wearable fitness tracker Delivered by: Dietitian	Increasing PA and modifying carbohydrate intake, for recommended GWG (IOM guidelines)	26	Clinical	Self Determination Theory*
Rissel, et al. 2019 [70] Australia	Cluster RCT	Mixed (PA + diet) n = 326	1 × 20–30 min information only telephone call on GWG and provided with written resources on healthy eating, GWG and PA	Up to 10 health coaching calls (8 in pregnancy), journey booklet and written resources Delivered by: Dietitian or exercise physiologist	Achieve recommended GWG	24	Clinical, community (phone)	NA
Wattar, et al. 2019 [65] ESTEEM UK	RCT	Dietary n = 1252	Standard Antenatal Care (Including dietary advice as per UK national recommendations for antenatal care and weight management in pregnancy)	1 × individualised F2F visits, 2 × group sessions and 2 × telephone calls, provided with EVOO and mixed nuts Delivered by: Dietitian and researchers	Adherence to a Mediterranean style diet	14	Clinical	NA
Adam, et al. 2020 [40] Finland	RCT (three arm)	Mixed (PA + diet) n = 78	Standard Antenatal Care	2 individualised F2F visits and 2 × Supportive telephone calls Delivered by: Dietitian trained in healthy conversation skills	Adopt and maintain healthy behaviours, for recommended GWG	18	University	NA
Bianchi, et al 2020 [44] France	RCT	Dietary n = 80	1 × 30–45 min F2F appointment; 2 × 30 min telephone call, 3 × emails. Generic advice provided as per French Institute for Health Promotion and Health Education	1 × 30–45 min individualised F2F visit and 2 × telephone calls providing computer based tailored dietary counselling program, followed by 3 × email summaries and 3 × email reminders Delivered by: Dietitian	Improve nutrient adequacy (PANDiet)	12	Clinical	NA
Huang, et al 2020 [36] Australia	Pilot RCT	Mixed (PA + diet) n = 57	Standard Antenatal Care	Web based program, 1 × individualised F2F and weekly SMS Delivered by: Dietitian	Dietary education on low glycaemic index, low saturated fat, increased omega- 3 fatty acids, increased fibre, healthy portion sizes and take out options and snack substitution to achieve recommended GWG	12	Clinical	NA
Melero, et al. 2020 [58] St Carlos Spain	RCT (three arm)	Diet n = 285	2 × F2F visits (advised to restrict fat intake, limit EVOO to 40 ml/day, and < 3 day/week nuts)	1 × initial individualised F2F visit and 1 × 2 hr follow up F2F visit, provided with EVOO and pistachios Delivered by: Dietitian	Increase adherence to Med diet and increase EVOO consumption to ≥ 40 ml/day and handful of pistachios ≥ 3 days/week	28	Clinical	NA
Crovetto, et al. 2021 [47] IMPACT- BCN Spain	RCT (three arm)	Diet OR stress reduction program n = 1221	Standard Antenatal Care	1 hr monthly Individualised F2F visit, 1 hr monthly group session, monthly telephone calls and provided with EVOO and walnuts Delivered by: Dietitian	Adherence to a Mediterranean style diet	17	Clinical	NA
Dawson, et al. 2021 [48] Australia	RCT	Diet n = 45	Standard Antenatal Care	1 × half day F2F group and 2 × follow up telephone calls Delivered by: Nutritionist/ researcher	Eating for the gut microbiota (improve diet quality)	10	Academic (Food and Mood Centre)	Theory of Constructive Alignment
Sandborg, et al. 2021 [61] Sweden	RCT	Mixed (PA + diet) n = 305	Standard Antenatal Care (including optional lecture on a healthy lifestyle)	HealthyMoms App Delivered by: App	Healthy diet and PA in alignment with Nordic nutrition recommendations to achieve recommended GWG	26	Online (app)	Social Cognitive Theory*
Simpson, et al. 2021 [71], [72] HELP UK	Cluster RCT	Mixed (PA + diet) 20 sites n = 614	Standard Antenatal Care (including leaflets on healthy eating and PA)	Weekly 1.5 hr group (until 6 weeks PP) and 2 × telephone calls 3- and 6-weeks PP Delivered by: Midwife or slimming world consultant	Enhance motivation and equip women with knowledge and skills to make healthier choices and manage their weight during pregnancy and PP	36	Clinical	Control Theory and Social Cognitive Theory*
Zhao, et al. 2022 [67] China	RCT	Mixed (PA + diet) n = 560	3 × Individualised, with Mediterranean style diet but restrict dietary fats	3 × individualised F2F visits Delivered by: Dietitian	Adherence to Mediterranean style diet and consume ≥ 40 ml EVOO and 25–30 g pistachios daily	26	Clinical	NA

Where intervention includes three arms most active and least active groups are reported. Only dietary interventions have been extracted

RCT Randomised control trial, EVOO Extra Virgin Olive Oil, PA Physical activity, GI Glycemic Index, hr hour, SMS Short messaging Service, F2F Face to face, PP Postpartum