{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:54:11Z","timestamp":1776315251305,"version":"3.50.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The diet and physical activity of pregnant women are crucial for maternal and fetal health. Many countries have developed guidelines. Research shows higher adherence to dietary guidelines is associated with reduced risks of complications. However, pregnant women\u2019s adherence to these guidelines remains low. Accurate assessment of current adherence levels is essential to characterize behavioral patterns, identify high-risk groups, and provide evidence for the development of targeted interventions aimed at supporting maternal\u2013fetal health. The aim of this study was to investigate the adherence of pregnant women to dietary and physical activity guidelines and analyze factors associated with adherence, thereby providing a foundation for developing intervention strategies in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pregnant women who received routine prenatal care at the Department of Obstetrics, Women and Children\u2019s Hospital, School of Medicine, Xiamen University, from January to June 2025 were enrolled as study participants. A cross-sectional survey was conducted using general information, Pregnant Women\u2019s Dietary Guideline Compliance Index questionnaire, and physical activity guideline recommendations to analyze influencing factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 327 valid questionnaires were returned. The mean dietary and physical activity adherence score was 59.78 (SD = 16.04). Univariate analysis showed significant differences in adherence by ethnicity, stage of gestation, exercise habits during pregnancy, education level, occupation, personal monthly income, and family monthly income (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Multiple linear regression analysis showed that stage of gestation and exercise habits during pregnancy remained significantly associated with adherence to guideline recommendations for diet and physical activity after adjusting for confounders (both\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pregnant women exhibited a moderate level of adherence to dietary and physical activity guidelines. These findings suggest that healthcare providers may consider developing personalized guidance plans based on individual profiles, though longitudinal intervention studies are needed to determine their impact on pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1775351","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:20:38Z","timestamp":1776313238000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adherence to dietary and physical activity guidelines and influencing factors among pregnant women: a cross-sectional study in China"],"prefix":"10.3389","volume":"13","author":[{"given":"Wanling","family":"Hou","sequence":"first","affiliation":[{"name":"Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lun","family":"Wang","sequence":"additional","affiliation":[{"name":"Zhongshan Hospital, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinying","family":"Huang","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumin","family":"Lin","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yalan","family":"Chen","sequence":"additional","affiliation":[{"name":"Fujian Health College","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyu","family":"He","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Zhao","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Hospital, School of Medicine, Xiamen University","place":["Xiamen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1001\/jamainternmed","article-title":"Association of antenatal diet and physical activity-based interventions with gestational weight gain and pregnancy outcomes: a systematic review and meta-analysis.","volume":"182","author":"Teede","year":"2022","journal-title":"JAMA Intern Med."},{"key":"B2","unstructured":"Chinese Dietary Guidelines for Pregnant and Lactating Women.\n          \n          2022"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/S0954422424000283","article-title":"Dietary guidelines for pregnant and lactating women, adherence levels and associated factors: a scoping review.","volume":"21","author":"Rahmannia","year":"2024","journal-title":"Nutr Res Rev."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1016\/j.jand.2023.05.015","article-title":"Healthy eating index-2020: review and update process to reflect the dietary guidelines for americans, 2020-2025.","volume":"123","author":"Shams-White","year":"2023","journal-title":"J Acad Nutr Die."},{"key":"B5","doi-asserted-by":"publisher","first-page":"829","DOI":"10.3390\/nu13030829","article-title":"Association between Chinese dietary guidelines compliance index for pregnant women and risks of pregnancy complications in the Tongji maternal and child health cohort.","volume":"3","author":"Ding","year":"2021","journal-title":"Nutrients."},{"key":"B6","doi-asserted-by":"publisher","first-page":"121.e1","DOI":"10.1016\/j.ajog.2020.01.042","article-title":"Quality of periconceptional dietary intake and maternal and neonatal outcomes.","volume":"223","author":"Yee","year":"2020","journal-title":"Am J Obstet Gynecol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1017\/S0007114523000107","article-title":"Association of diet quality during pregnancy with maternal glucose metabolism in Chinese women.","volume":"130","author":"Pan","year":"2023","journal-title":"Br J Nutr."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1093\/ajcn\/nqac206","article-title":"Maternal diet during pregnancy and child neurodevelopment up to age 3.5 years: the nationwide \u00c9tude Longitudinale Fran\u00e7aise depuis l\u2019Enfance (ELFE) birth cohort.","volume":"116","author":"de Lauzon-Guillain","year":"2022","journal-title":"Am J Clin Nutr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/mcn.13068","article-title":"Be healthy in pregnancy: exploring factors that impact pregnant women\u2019s nutrition and exercise behaviours.","volume":"17","author":"Grenier","year":"2021","journal-title":"Matern Child Nutr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2809","DOI":"10.3390\/nu15122809","article-title":"Maternal diet quality and prenatal depressive symptoms: the moderating role of economic well-being.","volume":"15","author":"Wang","year":"2023","journal-title":"Nutrients."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2369","DOI":"10.1016\/j.tjnut.2023.05.028","article-title":"Experiences of racial discrimination and periconceptional diet quality.","volume":"153","author":"Bodnar","year":"2023","journal-title":"J Nutr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e000356","DOI":"10.3945\/cdn.116.000356","article-title":"Adherence to Canada\u2019s food guide recommendations during pregnancy: nutritional epidemiology and public health.","volume":"1","year":"2017","journal-title":"Curr Dev Nutr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.wombi","article-title":"Falling short of dietary guidelines- What do Australian pregnant women really know? A cross sectional study.","volume":"30","author":"Bookari","year":"2017","journal-title":"Women Birth."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1002\/hpja.853","article-title":"Physical activity and associated factors in Australian women during pregnancy: a cross-sectional study.","volume":"35","author":"Ceprnja","year":"2024","journal-title":"Health Promot J Austr."},{"key":"B15","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1080\/03630242.2020.1828231","article-title":"Objectively measured sedentary time and physical activity levels in Spanish pregnant women: factors affecting the compliance with physical activity guidelines.","volume":"61","author":"Baena-Garc\u00eda","year":"2021","journal-title":"Women Health."},{"key":"B16","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1093\/eurpub\/ckab165523","article-title":"Pregnant women and midwives\u2019 perception regarding physical activity recommendation during pregnancy.","volume":"313","author":"Scognamiglio","year":"2021","journal-title":"Eur J Public Health."},{"key":"B17","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1136\/bjsports-2022-105777","article-title":"Public health guidelines for physical activity during pregnancy from around the world: a scoping review.","volume":"57","author":"Hayman","year":"2023","journal-title":"Brit J Sport Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1123\/jpah.2016-0563","article-title":"Reasons, motivational factors, and perceived personal barriers to engagement in physical activity during pregnancy vary within the BMI classes: the prenatal prevention project germany.","volume":"15","author":"Bauer","year":"2018","journal-title":"J Phys Act Health."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-019-42473-7","article-title":"Effects of physical activity during pregnancy on neonatal birth weight.","volume":"9","author":"Pathirathna","year":"2019","journal-title":"Sci Rep."},{"key":"B20","doi-asserted-by":"publisher","first-page":"384","DOI":"10.16462\/j.cnki.zhjbkz.2020.04.003","article-title":"Association between physical activity and glucose metabolism in pregnant women.","volume":"24","author":"Wu","year":"2020","journal-title":"Chin J Dis Control Pre."},{"key":"B21","doi-asserted-by":"publisher","first-page":"223","DOI":"10.13325\/j.cnki.acta.nutr.sin.20210414.001","article-title":"Establishment and application of the chinese dietary guidelines compliance index for pregnant women.","volume":"43","author":"Xu","year":"2021","journal-title":"Acta Nutrimenta Sinica."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e178","DOI":"10.1097\/AOG.0000000000003772","article-title":"Physical activity and exercise during pregnancy and the postpartum period: ACOG committee opinion, number 804.","volume":"135","year":"2020","journal-title":"Obstet Gynecol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"3634","DOI":"10.3760\/cma.j.cn112137-20250616-01467","article-title":"Expert consensus on exercise for pregnant and postpartum women (2025 edition).","volume":"105","year":"2025","journal-title":"Natl Med J China."},{"key":"B24","doi-asserted-by":"publisher","first-page":"689","DOI":"10.4103\/jfmpc.jfmpc_338_18","article-title":"Questionnaire to assess adherence to diet and exercise advices for weight management in lifestyle-related diseases.","volume":"8","author":"Dubasi","year":"2019","journal-title":"J Family Med Prim Care."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e12916","DOI":"10.1111\/mcn.1291626","article-title":"Dietary guideline adherence during preconception and pregnancy: a systematic review.","volume":"16","author":"Caut","year":"2020","journal-title":"Matern Child Nutr."},{"key":"B26","doi-asserted-by":"publisher","first-page":"101198","DOI":"10.1016\/j.tjnut.2025.10.011","article-title":"2020-2025 dietary guidelines for Americans in pregnancy: adherence shortfalls and associations with gestational weight gain.","volume":"156","author":"Notario-Barandiaran","year":"2026","journal-title":"J Nutr."},{"key":"B27","doi-asserted-by":"publisher","first-page":"2821","DOI":"10.3390\/nu13082821","article-title":"The impact of lifestyle, diet and physical activity on epigenetic changes in the offspring-a systematic review.","volume":"13","author":"Rasmussen","year":"2021","journal-title":"Nutrients."},{"key":"B28","doi-asserted-by":"publisher","first-page":"E343","DOI":"10.1017\/S0029665120002918","article-title":"Improving health of the next generation: dietary intake and physical activity during pregnancy in an austrian cohort.","volume":"79","author":"Rust","year":"2020","journal-title":"P Nutr Soc."},{"key":"B29","doi-asserted-by":"publisher","first-page":"104841","DOI":"10.1016\/j.ijnurstu.2024.104841","article-title":"Physical activity levels and influencing factors among pregnant women in China: a systematic review and meta-analysis.","volume":"158","author":"Zhang","year":"2024","journal-title":"Int J Nurs Stud."},{"key":"B30","volume-title":"Investigation on the Nutritional Status and Aerobic Exercise of Pregnant Women in Lanzhou City.","author":"Meng","year":"2018"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e00232020","DOI":"10.1590\/0102-311X00010320","article-title":"Effectiveness of an intervention focusing on diet and walking during pregnancy in the primary health care service.","volume":"37","author":"Malta","year":"2021","journal-title":"Cad Saude Publica."},{"key":"B32","doi-asserted-by":"publisher","first-page":"2042","DOI":"10.3390\/healthcare12202042","article-title":"Compliance with 24 h movement behavior guidelines for pregnant women in Saudi Arabia: the role of trimester and maternal characteristics.","volume":"12","author":"Alghamdi","year":"2024","journal-title":"Healthcare."},{"key":"B33","doi-asserted-by":"publisher","first-page":"2541","DOI":"10.1096\/fj.201500018R","article-title":"Maternal exercise during pregnancy promotes physical activity in adult offspring.","volume":"30","author":"Eclarinal","year":"2016","journal-title":"FASEB J."},{"key":"B34","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s12966-020-01051-1","article-title":"Invest in physical activity to protect and promote health: the 2020 WHO guidelines on physical activity and sedentary behaviour.","volume":"17","author":"van der Ploeg","year":"2020","journal-title":"Int J Behav Nutr Phys Act."},{"key":"B35","doi-asserted-by":"publisher","first-page":"723","DOI":"10.3390\/jcm13030723","article-title":"Physical activity in work and leisure time during pregnancy, and its influence on maternal health and perinatal outcomes.","volume":"13","author":"Gonz\u00e1lez-Cazorla","year":"2024","journal-title":"J Clin Med."},{"key":"B36","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.ejogrb.2024.06.021","article-title":"Impact of pregnancy on women\u2019s health-related lifestyle habits: diet, physical activity, alcohol consumption, and smoking.","volume":"299","author":"Del Campo Gim\u00e9nez","year":"2024","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1080\/13548506.2022.2029502","article-title":"Meeting physical activity guidelines and its association with health-related quality of life throughout pregnancy: the PregnActive project.","volume":"28","author":"Oviedo-Caro","year":"2023","journal-title":"Psychol Health Med."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1186\/s12913-024-11861-9","article-title":"Rural versus urban healthcare through the lens of health behaviors and access to primary care: a post-hoc analysis of the Romanian health evaluation survey.","volume":"24","author":"Br\u00eendu\u015fe","year":"2024","journal-title":"BMC Health Serv Res."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1775351\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:20:42Z","timestamp":1776313242000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1775351\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":38,"alternative-id":["10.3389\/fnut.2026.1775351"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1775351","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]},"article-number":"1775351"}}