In order to test the hypothesis that pregnant women are responsive to nutrition education aimed at altering dietary behaviour (irrespective of social or demographic consideration) four studies were conducted on women resident in Aberdeen. Valid and reliable methods of assessing nutrition knowledge, attitudes to healthier eating (based on the Theory of Reasoned Action model) and dietary intake were developed from a number of formative research and pilot studies carried out in the local population. The results from the major studies indicated that women change their diets during early pregnancy (i.e. before attending ante-natal clinics) and these changes are maintained throughout gestation, but are not related to nutrition knowledge. The response of pregnant women to nutrition education was to increase knowledge about nutrition but no effect was detected on attitudinal variables or dietary intake. Multiple Regression analysis of the socio-demographic characteristics, nutrition knowledge, attitude, and dietary intake of women who have not received formal nutrition education during pregnancy suggest that knowledge about nutrition has a limited impact on diet, whereas social class and smoking may have a greater effect. Attitudinal variables, including Subjective Norm (or social pressure), will also exert an effect on dietary intake. The implication of these studies is that future nutrition education programmes need to commence well before pregnancy in order to alter diet during pregnancy. Future programmes could usefully assess ways of influencing Attitude and Subjective Norm and evaluate the impact of targeting these variables as a means to changing dietary behaviour.

Background: High serum phosphorus (hPhos) is common in chronic kidney disease (CKD) and increases the risk of metastatic calcification. Guidelines advise patients with hPhos to restrict dietary phoshorus intake to 800-1000mg/day, and compliance with this diet can be challenging. Innovative education may improve compliance. Hypothesis: Intensive dietary education using the Phosphorus Point System Tool© (PPS) will result in lower serum phosphorus levels compared to standard education (SE). Methods: This study compared the effectiveness of the PPS to SE on 1) serum phosphorus, 2) dietary phosphate intake, knowledge and satisfaction in pre-dialysis CKD. Results: The PPS reduced 12 week serum phosphorus by 0.16 mmol/L (95% CI 0.37 to -0.05, p=0.130) when controlling for baseline. Dietary phosphorus and protein intake decreased significantly at week 6 on PPS compared to SE (p= 0.026, p=0.050; respectively). Summary: Although there was a trend indicating the tool may reduce serum phosphorus levels, further research is needed.

Background: High serum phosphorus (hPhos) is common in chronic kidney disease (CKD) and increases the risk of metastatic calcification. Guidelines advise patients with hPhos to restrict dietary phoshorus intake to 800-1000mg/day, and compliance with this diet can be challenging. Innovative education may improve compliance. Hypothesis: Intensive dietary education using the Phosphorus Point System Tool© (PPS) will result in lower serum phosphorus levels compared to standard education (SE). Methods: This study compared the effectiveness of the PPS to SE on 1) serum phosphorus, 2) dietary phosphate intake, knowledge and satisfaction in pre-dialysis CKD. Results: The PPS reduced 12 week serum phosphorus by 0.16 mmol/L (95% CI 0.37 to -0.05, p=0.130) when controlling for baseline. Dietary phosphorus and protein intake decreased significantly at week 6 on PPS compared to SE (p= 0.026, p=0.050; respectively). Summary: Although there was a trend indicating the tool may reduce serum phosphorus levels, further research is needed.