Family meals for future health: A life-course approach to type 2 diabetes risk reduction after gestational diabetes.

Abstract

Aims: Gestational diabetes (GDM) more than doubles maternal and child risk of type 2 diabetes (T2D). Post-GDM, a life-course approach to T2D risk reduction includes family nutrition-focused health promotion. This study explores mothers' perceptions of the role of family meals in T2D risk reduction post-GDM, and brief messages to promote optimal nutrition-related behaviours during family meals.

Methods: Fourteen qualitative, semi-structured online interviews were conducted with mothers aged 18+ years, living in Australia, with prior GDM and at least one child aged <3 years, recruited via social media. Interviews explored perceptions of family meals and T2D risk and included cognitive debriefing and refinement of health-promoting family mealtime messages. Reflexive thematic analysis was applied to transcripts.

Results: Mothers indicated awareness of elevated T2D risk. Four themes included: Mothers place high value and expectations on family meals; Balancing individual and collective health and well-being needs post-GDM; an opportunity for family health beyond T2D risk reduction; and supports required to engage in family meals for future health. Mothers perceived the messages as relevant and mostly acceptable. Mothers liked how messages normalised mealtime challenges, though some suggested adaptations conflicted with best-practice guidelines. Mothers preferred online or physical message delivery (e.g. videos, posters), via credible sources (e.g. health professionals) and with practical resources (e.g. recipes).

Conclusions: Post-GDM, mealtimes appear feasible and acceptable for supporting T2D risk reduction in families. Acceptability and relevance of messages highlight their potential for supporting family health, although how to support best practice remains challenging. Implementation pathways and ways to action messages may require the inclusion of practical resources.