1. Introduction
Pregnancy nutrition is important for maternal and child health and may affect the development of the infant gut microbiome. Our objective was to assess the feasibility of implementing a food-based intervention designed to increase fiber intake among pregnant women in a rural setting. Participants were enrolled (Diet interventions designed to increase fiber intake have been shown to alter the gut microbiome in adults [The range of dietary intervention strategies that have been employed to promote healthy dietary intake during pregnancy has recently been reviewed [Rural regions have been characterized by limited access to quality healthcare, education, and transportation, contributing to inequities in healthcare outcomes compared with their urban counterparts [The overall goal of the Pregnancy EAting and POstpartum Diapers (PEAPOD) pilot study was to gather information to effectively refine an intervention so that it can be tested in a larger, longer study using a factorial design to assess the separate and combined effects of maternal diet during pregnancy and lactation on the establishment of the infant gut microbiome. The specific objectives were to test methods of randomization and outcome measurement and to assess the feasibility and acceptability of implementing the intervention and the study procedures, which included collecting survey data and multiple biospecimens (blood, urine, and stool) at multiple locations (prenatal clinic, telephone, and home), via multiple modes (interviewer-administered and self-collection). We present results indicating that this type of pragmatic food-based diet intervention is a feasible approach to use during pregnancy.