DISCUSSION
overweight/obesity, overweight or obesity
REGRESSION, EARLY PREGNANCY
Use of the FIGO Nutrition Checklist has not been previously evaluated in an African setting. In the current study, in which 97.4% of participants reported at least one at‐risk dietary practice, use of the FIGO Nutrition Checklist was found to be acceptable and beneficial by both a dietitian and young women with overweight/obesity. Responses indicative of insufficient fruit and vegetable, whole grain, and dairy consumption were the most prevalent risks identified. In addition, we identified several context‐ and participant‐related factors that may impact implementation of the FIGO Nutrition Checklist in this setting.The prevalence of at‐risk dietary practices in this study of women with overweight/obesity is similar to or higher than findings from previous studies using the FIGO Nutrition Checklist in Ireland (80%) and Hong Kong (95%).The acceptability of the checklist within our study supports previous findings from implementation of the checklist in healthcare settings with women in early pregnancy.Factors such as social support and being pregnant were reported to facilitate changes in diet. At the same time, contextual factors such as food insecurity and social stressors, as well as cultural and participant‐related factors such as limited health literacy and perceptions around BMI classifications, were identified as potential barriers for the use of the FIGO Nutrition Checklist as a tool for advice. Interestingly, these results overlap with characteristics identified by quantitative regression analysis results as being associated with a high‐risk diet, such as lower education, food insecurity, and less time enrolled in the trial. These findings highlight that, if the FIGO Nutrition Checklist is to be employed not only to identify risk but also to provide advice for healthier behaviors in various global settings, it is important to consider the impact of relevant social, environmental, and structural factors on young women's ability to implement change on an individual level.The use of both quantitative and in‐depth qualitative data for evaluating the implementation of the checklist and exploring the implementation for both pregnant and nonpregnant young women are strengths of this study. A limitation is that the participants consisted mostly of women with overweight or obesity, which may impact the generalizability of our findings to all women of reproductive age. In addition, the extent to which these findings from a single‐center study translate to settings outside of Soweto requires further exploration.The simplicity and free availability of the FIGO Nutrition checklist underlie its potential for use in various global settings. The acceptability, reported benefits, and ease of implementation of the FIGO Nutrition Checklist emphasize this potential in a lower‐resource setting, when used within a dietary counselling session among women with raised BMI. In addition, the high prevalence of at‐risk dietary practices in our study emphasizes the need for efforts to improve nutrition in this population. Implementation of the FIGO Nutrition Checklist in various healthcare and community settings, for both preconception and pregnancy care, warrants further research and should consider context‐related structural, cultural, and social challenges, such as food insecurity and limited health literacy.