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Chinese immigrants living in Western countries are at increased risk for cardiometabolic diseases. Dietary acculturation has been implicated as a potential contributor, but little is known about why diets change post-migration. The purpose of this qualitative research study was to explore how and why diets change post-migration for Chinese immigrants living in Australia. Eleven participants undertook semi-structured interviews exploring and comparing their diets when they lived in China to their post-migration diets. Thematic analysis revealed that participants exhibited changed social structures of meal preparation, and made unacknowledged dietary changes, such as recipe modification, to maintain their traditional Chinese diet post-migration. Implications of both deliberate and unrecognized dietary changes post-migration include connections to increased risk for metabolic disease post-migration.

BACKGROUND: Approximately 50% of women gain weight in excess of gestational weight gain (GWG) recommendations during pregnancy leading to adverse maternal and foetal outcomes and the perpetuation of the cycle of obesity. Antenatal care provided by a general practitioner (GP) in the primary care setting is an important model of care, particularly for women in regional areas where rates of overweight and obesity are highest. The aim of this study is to explore GPs' perceptions and experiences of implementing GWG recommendations in GP-led antenatal care. METHODS: A qualitative exploratory approach recorded GPs' experiences and insights regarding the application of GWG recommendations in practice. Data were collected via semi-structured interviews informed by the revised Theoretical Domains Framework (TDF). Deductive thematic analysis grouped coded text into TDF domains from which main themes were generated. RESULTS: Twenty GPs (13 female, 7 male) from metropolitan and regional Victoria, Australia participated. Codes related to at least one of 11 TDF domains. Five main themes were apparent: 1) Despite low awareness of guidelines, GWG advice is provided; 2) 'I should do this more'; 3) Lack of everyday resources; 4) Working 'against the odds' at times; and 5) Optimism and reality. GPs were aware of the importance of optimal GWG however, other pregnancy-related issues are given precedence during consultations. Enablers for the implementation of GWG guidelines were practitioner-based and included GPs' strong sense of their professional role to provide advice, and ongoing and trusting relationships with women throughout pregnancy. Barriers were mostly health system-based with limited time, remuneration, and restrictive referral pathways being limiting factors. CONCLUSIONS: There is a need to support GPs to provide GWG advice in accordance with current national guidelines. Solutions potentially lie in strategies that promote the effective dissemination and uptake of guideline