To identify determinants of diet in pregnancy, by detecting factors in our multiple-determinants life course framework that are associated with dietary patterns, quality or guideline adherence.

A systematic review of observational studies, published in English or German, was conducted. Sociodemographic, lifestyle, environmental and pregnancy-related determinants were considered. Four electronic databases were searched in January 2015 and updated in April 2016 and a total of 4368 articles identified. Risk of bias was assessed using adapted Newcastle–Ottawa Scales.

High- and upper-middle-income countries.

Pregnant or postpartum women reporting their dietary intake during pregnancy.

Seventeen publications of twelve studies were included and compared narratively due to heterogeneity. Diet in pregnancy was patterned along a social gradient and aligned with other health behaviours before and during pregnancy. Few studies investigated the influence of the social and built environment and their findings were inconsistent. Except for parity, pregnancy determinants were rarely assessed even though pregnancy is a physiologically and psychologically unique period. Various less well-researched factors such as the role of ethnicity, pregnancy intendedness, pregnancy ailments and macro-level environment were identified that need to be studied in more detail.

The framework was supported by the literature identified, but more research of sound methodology is needed in order to conclusively disentangle the interplay of the different determinants. Practitioners should be aware that pregnant women who are young, have a low education or do not follow general health advice appear to be at higher risk of inadequate dietary intake.

To identify the major perceived influences on food choice, to examine the use of and trust in information sources concerning healthy eating, and to assess attitudes towards and barriers to adopting healthy eating practices in a post-USSR country (Ukraine).

A survey of an urban adult population. The questions were adopted from the Pan-European Union (EU) Survey of Consumer Attitudes to Food, Nutrition and Health (1995–1996).

Lviv city, Ukraine.

The survey included 296 adults (84 males, 212 females) aged 18–55 years; they were primarily college students and subjects with tertiary education – the groups most likely to be both interested in healthy eating and affected by current socioeconomic downturns.

The major factors in food choice were: ‘quality/freshness’ (cited by 80%), ‘price’ (58%) and ‘taste’ (47%); only 34% cited ‘trying to eat healthily’. More older people cited ‘price’ than ‘quality/freshness’, and men were more likely than women to cite ‘taste’. Sources of healthy eating information included: ‘relatives/friends’ (cited by 65%, trusted by 85%) and health professionals (trusted by 92%, but used by only 35%); while advertising was the least trusted source (cited by 28%). Fifty-three per cent of respondents considered their diet to be healthy enough without further changes; 50% thought of the nutritional aspects of the food they ate; fewer women than men considered their diet healthy, and more women than men thought about nutrition. Barriers to healthy eating included: ‘cost’ (cited by 65%), ‘lack of time’ (55%), ‘self-control’ (54%), ‘selection influences’ (41%), ‘lack of knowledge’ (32%), ‘unpleasant foods’ and ‘resistance to change’ (both 30%).

Strategies to encourage healthy eating in this population should involve word-of-mouth nutrition education concerning low-cost healthy alternatives.