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Abdulai K, Torpey K, Kotoh AM, Laar A. Associated factors of diet quality among people living with HIV/AIDS in Ghana. BMC Nutr 2024; 10:90. [PMID: 38907324 PMCID: PMC11193199 DOI: 10.1186/s40795-024-00898-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 06/19/2024] [Indexed: 06/23/2024] Open
Abstract
INTRODUCTION Nutrition is a very important element of a comprehensive care for people living with HIV/AIDS (PLHIV), especially in resource-constrained settings where malnutrition and food insecurity are common. Dietary diversity is a useful indication of nutritional adequacy (diet quality) in people of all ages. An optimally diverse diet strengthens the body's immune system. OBJECTIVE This study aimed to assess diet quality and its associated factors among PLHIV. METHODS A facility-based cross-sectional study design was employed to select 440 PLHIV from two hospitals in the Eastern Region of Ghana. Dietary intakes were determined using 24-hour recall. A stadiometer and bioimpedance analysis machine were used to obtain anthropometric and body composition data. Diet quality was assessed using FAO's individual dietary diversity score (IDDS) as a proxy. SPSS version 20 was used for analysis. Odds ratios and ordinal logistic regression were used to identify factors associated with diet quality among the PLHIV. P-value was set at 0.05. RESULTS Most of the PLHIV (73%) consumed from 'Starchy staple" food group. Less than 20% of the study sample consumed 'Fruits' and 'Vegetables' (17% and 14% respectively) a day before the survey. The mean IDDS was 4.11 (SD = 1.29). Overall, most of the PLHIV (56%) had medium IDDS which is equivalent to "diet needing improvement', 14% had higher IDDS (good diet), whiles about 31% of the participants actually had poor diet (lower IDDS). Associated factors of diet quality were age (AOR = 0.966: 95%CI: 0.936-0.997: p = 0.031), married (AOR = 4.634: 95%CI: 1.329-16.157: p = 0.0016), separated (AOR = 0.0203: 95%CI: .036-0.994: p = 0.049), and daily meal frequency (AOR = 0.441: 95%CI: .478-1.948: p = 0.020). Overall, the model accounts for about 20% of the variation in diet quality of the participants (pseudo-R square = 0.196). CONCLUSION This study demonstrates that most of the PLHIV did not consume good diet which may have an implication on their immune system, which is already under attack by HIV, and probably emerging infections. Age, marital status, and meal frequency were the variables that predicted diet quality among the study participants.
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Affiliation(s)
- Kasim Abdulai
- Translational Nutrition Research Group, Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast, Ghana.
| | - Kwasi Torpey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Agnes Millicent Kotoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Aktaç Ş, İkiışık H, Sabuncular G, İçen H, Güneş FE. The effects of pregnancy-related changes in eating attitudes and behaviours on nutritional status. Fam Pract 2024:cmae026. [PMID: 38728410 DOI: 10.1093/fampra/cmae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND During pregnancy, the requirements of essential nutrients for the mother and foetus increase. The changes in pregnant women's eating behaviours may vary according to their sociodemographic characteristics. It is important to meet these increased requirements and understand the factors influencing eating habits during pregnancy. OBJECTIVES This study aimed to determine the effects of changes in pregnant women's eating attitudes and behaviours and their sociodemographic characteristics on their meeting status for nutrient recommendations. METHODS Sociodemographic information, eating behaviours, and attitudes of 656 pregnant women were obtained in face-to-face interviews between February and June 2020. Food consumption records were taken with a 24-hour recall method and evaluated according to the estimated average requirement value. RESULTS The average age of pregnant women was 29.0 ± 5.2 years, 28.0% were high school graduates, and 69.2% were non-working. The frequency of intakes below the estimated mean requirement value were iron, folic acid, vitamin B6, niacin, and calcium. It was demonstrated that there was a significant difference in snack consumption based on the working status and nutrition information obtained (P < .05). Getting nutrition information, age, education level, working status, and pre-pregnancy body mass index significantly increased food consumption (P < .05). CONCLUSION Inadequate nutrient intake is a common public health problem in pregnant women. It is necessary to identify the sociodemographic characteristics that negatively impact pregnant women's nutritional status and to develop nutrition and health education programs based on these features.
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Affiliation(s)
- Şule Aktaç
- Department of Nutrition and Dietetics, Marmara University, Recep Tayyip Erdogan Health Campus, Maltepe 34854, Istanbul, Turkey
| | - Hatice İkiışık
- Department of Health Sciences, Istanbul Medeniyet University, North Campus, Uskudar 34700, Istanbul, Turkey
| | - Güleren Sabuncular
- Department of Nutrition and Dietetics, Marmara University, Recep Tayyip Erdogan Health Campus, Maltepe 34854, Istanbul, Turkey
| | - Hayrunisa İçen
- Department of Nutrition and Dietetics, Marmara University, Recep Tayyip Erdogan Health Campus, Maltepe 34854, Istanbul, Turkey
| | - Fatma Esra Güneş
- Department of Nutrition and Dietetics, Istanbul Medeniyet University, Kartal Cevizli Campus, Kartal 34862, Istanbul, Turkey
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Mesfin S, Abebe D, Jiru HD, Sori SA. Only two in five pregnant women have adequate dietary diversity during antenatal care at Hiwot Fana Specialized University Hospital in Eastern Ethiopia. J Nutr Sci 2024; 13:e17. [PMID: 38572370 PMCID: PMC10988145 DOI: 10.1017/jns.2024.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/11/2024] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
Dietary diversification is a sustainable and appealing strategy for pregnant women to ensure a balanced dietary intake. In Ethiopia, despite the implementation of various nutritional initiatives, inadequate dietary diversity remains a significant factor contributing to adverse birth outcomes. Thus, this study aimed to assess the dietary diversity and associated characteristics among pregnant women attending antenatal care in Eastern Ethiopia. Institution-based cross-sectional study was conducted from April 28 to May 28, 2021. A total of 420 pregnant women were selected using a systematic random sampling technique. We used the adjusted odds ratio (AOR) and a 95% confidence interval to estimate the strength of the association. We used a p-value of 0.05 to declare statistical significance. Only 35.0% (95% CI: 30.5, 39.5) of the 420 pregnant women involved in this study received appropriate dietary diversity. Having an educational level of college and above (AOR 3.01, 95% CI: 1.19-7.5), being an urban dweller (AOR = 3.57, 95% CI: 1.68-7.52), eating three meals and above (AOR = 7.62, 95% CI: 2.88-9.03), and having ≤4 family sizes (AOR = 9.33, 95% CI: 4.06-10.4) were significantly associated with an adequate dietary diversity score among pregnant women. This study found that pregnant women had inadequate overall consumption of a diversified diet. Increasing meal frequency, enhancing women's education, raising awareness of dietary diversity among rural inhabitants, and offering counselling on family planning utilisation during ANC services are all beneficial in promoting dietary diversity among pregnant women.
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Affiliation(s)
- Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Abebe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Hirut Dinku Jiru
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Seboka Abebe Sori
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
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Tajima R, Matsumoto M, Fujiwara A, Yuan X, Shinsugi C, Okada E, Kurotani K, Yokoyama T, Takimoto H. Time Trends in Income-related Differences in Food Group Intakes: The National Health and Nutrition Survey, Japan in 2010, 2014, and 2018. J Epidemiol 2024; 34:76-86. [PMID: 36908117 PMCID: PMC10751188 DOI: 10.2188/jea.je20220220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/05/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND We aimed to clarify whether differences in food group intake according to household income have changed over the last decade in Japanese people aged 20 years or older. METHODS This cross-sectional study was based on the 2010, 2014, and 2018 National Health and Nutrition Surveys in Japan. Food intake was assessed using a 1-day semi-weighed household dietary record. The participants were categorized into three groups based on their income. The mean of each food intake according to the income group was estimated by adjusting for age, occupation, and number of participants from the same household. The significance of the interaction terms between income and survey year was evaluated to assess the change in income-related differences in food intake over time. RESULTS Cereal intake was lower in the middle- and the highest-income groups than in the lowest-income group, regardless of sex, and the interaction between income and year was nonsignificant for cereal intake. In the former two surveys, vegetable intake was higher among the highest-income women, while in the 2018 survey, the vegetable intake decreased in the women in the middle- and the highest-income groups. The interaction between income and year was significant for vegetable intake among the women. For other foods, the differences in intake among the income groups did not significantly change over time. CONCLUSION The tendency for lower cereal intake in the higher-income groups was consistent over time in both the sexes, and the tendency for higher vegetable intake in the highest income women disappeared over time.
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Affiliation(s)
- Ryoko Tajima
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Mai Matsumoto
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Xiaoyi Yuan
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Chisa Shinsugi
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Emiko Okada
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Kayo Kurotani
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
- Department of Health Sciences, Showa Women’s University, Tokyo, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Hidemi Takimoto
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
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Imai C, Takimoto H, Kurotani K, Fudono A, Tarui I, Aoyama T, Yago S, Okamitsu M, Miyasaka N, Sato N. Diet Quality and Its Relationship with Weight Characteristics in Pregnant Japanese Women: A Single-Center Birth Cohort Study. Nutrients 2023; 15:nu15081827. [PMID: 37111047 PMCID: PMC10142925 DOI: 10.3390/nu15081827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/28/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Maternal underweight and inadequate gestational weight gain (GWG) are problems in Japan. However, increases in food intake aimed at weight gain alone are not sufficient for mother-child health. This study assessed diet quality based on the 3-day dietary records of pregnant women in an urban area of Japan in order to show the importance of evaluating diet quality, using the Nutrient-Rich Food Index 9.3 (NRF9.3), which is one metric based on nutrition profiling, and the Japanese Food Guide Spinning Top (JFGST). After excluding misreporters of energy intake, we stratified women (n = 91) by pre-pregnancy body mass index (BMI) and determined energy intake, diet quality status, and their relationship with GWG. Intakes of carbohydrate-containing staple foods, vegetable dishes, and fruit were insufficient regardless of BMI. Most of the underweight women with inadequate GWG had insufficient energy intake but high diet quality, as assessed by NRF9.3. In contrast, most women who consumed energy within the recommended range had low diet quality and gained weight at inappropriate levels. These results highlight the importance for pregnant Japanese women to maintain diet quality through a nutrient-dense diet, while simultaneously increasing energy intake after evaluation of their individual diet quality.
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Affiliation(s)
- Chihiro Imai
- Faculty of Education, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 4-4-37 Takeda, Kofu 400-8510, Japan
| | - Hidemi Takimoto
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, NK Building, Kento Innovation Park, 3-17 Shinmachi, Senrioka, Settsu 566-0002, Japan
| | - Kayo Kurotani
- Faculty of Food and Health Sciences, Showa Women's University, 1-7-57 Taishido, Setagaya-ku, Tokyo 154-8533, Japan
| | - Ayako Fudono
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Iori Tarui
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, NK Building, Kento Innovation Park, 3-17 Shinmachi, Senrioka, Settsu 566-0002, Japan
| | - Tomoko Aoyama
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, NK Building, Kento Innovation Park, 3-17 Shinmachi, Senrioka, Settsu 566-0002, Japan
| | - Satoshi Yago
- Child and Family Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Motoko Okamitsu
- Child and Family Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Naoyuki Miyasaka
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Noriko Sato
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
- Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women's University, 2-8-1 Mejirodai, Bunkyo-ku, Tokyo 112-8681, Japan
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Montenegro JLZ, da Costa CA, da Rosa Righi R, Farias ER, Matté LB. Development and Validation of Conversational Agent to Pregnancy Safe-education. J Med Syst 2023; 47:7. [PMID: 36626106 DOI: 10.1007/s10916-022-01903-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/14/2022] [Indexed: 01/11/2023]
Abstract
Pregnant women constantly need some information to support nutritional decisions during pregnancy, and many do not receive such assistance at all. This study aims to present a conversational agent to provide reliable information to pregnant women, focusing on nutritional education and evaluating the perception of pregnant women and health professionals about the agent. As a scientific contribution, this article developed and implemented a conversational agent in a real environment capable of generating reliable responses on the basis of a set of health documents. We proposed an intervention study with 25 women and 10 healthcare providers through a survey to measure the perceptions of these groups towards conversational agents. The results show that the intended design could ensure positive support for pregnant women, clarify certain issues for the public, and remove some knowledge barriers. The results showed no significant difference between the groups (p-value = 0.713). Depending on the perception of the pregnant group, the conversational agent model can teach new knowledge during the prenatal period (Mean = 4.56). The model presented for health professionals could already be indicated as a support tool for pregnant women (Mean = 4.7).
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Affiliation(s)
- João Luis Zeni Montenegro
- Software Innovation Laboratory - SOFTWARELAB, Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos - Unisinos, Av. Unisinos 950, São Leopoldo, RS, 93022-000, Brazil
| | - Cristiano André da Costa
- Software Innovation Laboratory - SOFTWARELAB, Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos - Unisinos, Av. Unisinos 950, São Leopoldo, RS, 93022-000, Brazil.
| | - Rodrigo da Rosa Righi
- Software Innovation Laboratory - SOFTWARELAB, Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos - Unisinos, Av. Unisinos 950, São Leopoldo, RS, 93022-000, Brazil
| | - Elson Romeu Farias
- School of Public Health of the State Health Secretariat of RS, Universidade Luterana do Brasil - Ulbra, Canoas, Brazil
| | - Lara Balen Matté
- Software Innovation Laboratory - SOFTWARELAB, Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos - Unisinos, Av. Unisinos 950, São Leopoldo, RS, 93022-000, Brazil
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Wang L, Huang W, Zhao C, Hu Y, Cui S. Exploring the environment-nutrition-obesity effects associated with food consumption in different groups in China. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 317:115287. [PMID: 35642807 DOI: 10.1016/j.jenvman.2022.115287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/24/2022] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
Unsustainable diet is one of the main reasons for the nutrition-health-environment trilemma. However, information on environment-nutrition-obesity effects associated with food consumption is still limited. This study analyzes these diet-related impacts of different groups classified by various socio-economic attributes: location, gender, age, income, education, and occupation. We applied the samples in China Health and Nutrition Survey and divided them into advantaged group and dis-advantaged group according to the probability of access to more nutritious food. Results show that the advantaged groups had higher and more rapidly increasing dietary and nutrition quality than their counterpart during 1997-2011. On the contrary, the non-advantaged group' body mass index increased faster. Meanwhile, the high-income group as well as government and professional & technological workers have passed the criterion for overweight. The environmental footprints, i.e., nitrogen, phosphorus, carbon, and water footprints, of high-income group were higher 89%, 70%, 98%, and 41% than low-income group, respectively. Notably, food consumption sustainability of each group has declined, and the non-advantaged groups' is much more sustainable. We concluded that inequality existed and tends to expand in food consumption and its related impacts of different socio-economic groups. A reformed responsibility allocation system is needed during dietary transition for better environmental management. Strategies to improve dietary quality for advantaged group focus on improving the types of high-quality protein foods, such as milk and seafood, while the non-advantaged group can choose to increase the types of high-quality but relatively cheap foods like vegetables and fruits considering the availability and living cost.
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Affiliation(s)
- Lan Wang
- Key Research Institute of Yellow River Civilization and Sustainable Development & Collaborative Innovation Center on Yellow River Civilization jointly built by Henan Province and Ministry of Education, Henan University, Kaifeng, 475001, China; Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021, China; University of Chinese Academy of Sciences, No. 19(A) Yuquan Road, Beijing, 100049, China
| | - Wei Huang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021, China; University of Chinese Academy of Sciences, No. 19(A) Yuquan Road, Beijing, 100049, China; Xiamen Key Lab of Urban Metabolism, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021, China
| | - Chuan Zhao
- Graduate School of Environmental Studies, Tohoku University, Sendai, 980-8579, Japan
| | - Yuanchao Hu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, China.
| | - Shenghui Cui
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021, China; University of Chinese Academy of Sciences, No. 19(A) Yuquan Road, Beijing, 100049, China.
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Gokhale D, Rao S. Socio-economic and socio-demographic determinants of diet diversity among rural pregnant women from Pune, India. BMC Nutr 2022; 8:54. [PMID: 35787284 PMCID: PMC9254638 DOI: 10.1186/s40795-022-00547-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Diet diversity signifies the nutrient adequacy of an individual and thus has gained widespread significance in recent times. In developing countries achieving maximum diet diversity, especially among pregnant women from rural areas is challenging although of great importance. However, to do so understanding the primary factors associated with diet diversity is important. This paper, therefore, assessed the socio-demographic and socio-economic determinants of diet diversity among rural pregnant women in India. Methods The study consisted of a community-based prospective cohort of n = 204 pregnant women attending primary healthcare centers (PHC) across 14 villages in Mulshi Taluka, Pune, Maharashtra, India. The data was collected using a structured questionnaire through a one-to-one interview method. Results The prevalence of low, medium and high diet diversity was 56.4%, 33.3%, and 10.3% respectively. Minimum diversity in the diet was achieved among 73.5% of pregnant women. The mean diet diversity score (DDS) was 3.6 ± 1.3 with starchy staples being (100%) of commonly consumed foods. Young (< 20 years) women (OR = 5.2; CI:1.9- 13.8), housewives (OR = 3; CI:1.4–6.7), husbands working as skilled laborers (OR = 2.5; CI:1.2–5.5) were at significant risk of having low diet diversity scores. Whereas, those living in a joint family (OR = 0.3; CI:0.1–0.6), not owning a house (OR = 0.5; CI:0.2–0.9), and having a poor income (OR = 1.9; CI: 0.9- 3.7) were less likely to have low diet diversity. Conclusion Socio-economic and demographic factors (maternal age, mother's occupation, and husband's occupation) influenced the diet diversity among pregnant women. Monotonous diets are commonly seen in developing countries, especially in rural areas which can be a risk factor for poor nutrient adequacy and health of pregnant women. Policies and programs about these determinants of diet diversity should be enacted to replace the poor quality diets to ensure improved diet diversity and nutrient adequacy.
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Affiliation(s)
- Devaki Gokhale
- Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Maharashtra, 412115, India.
| | - Shobha Rao
- Society for Initiatives in Nutrition and Diseases, Pune Maharashtra, 411007, India
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Kuma MN, Tamiru D, Belachew T. Level and predictors of dietary diversity among pregnant women in rural South-West Ethiopia: a community-based cross-sectional study. BMJ Open 2021; 11:e055125. [PMID: 34697127 PMCID: PMC8547499 DOI: 10.1136/bmjopen-2021-055125] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the magnitude of dietary diversity and associated factors among pregnant women in the rural communities of Jimma Zone, south-west Ethiopia. DESIGN A community-based cross-sectional study was conducted from 1 June to 30 June 2020. SETTINGS The study was conducted in Seka Chekorsa and Mana districts. From a total of 63 listed kebeles, 21 were randomly selected. PARTICIPANTS Three hundred sixty first-trimester pregnant women have participated in this study. We used a systematic random sampling method to select the participants after a home-to-home census. PRIMARY AND SECONDARY OUTCOMES Dietary diversity was assessed using a 24 hours dietary recall method. Descriptive statistics were computed to describe the study subjects. Bivariate and multivariable logistic regression was run to control for all possible confounding effects and measure the strength of association between the outcome of interest and predictor. RESULTS The overall magnitude of adequate dietary diversity was found to be 186 (51.7%); 95% CI 46.1% to 56.4%). Having attended elementary education (adjusted OR (AOR)=2.45; 95% CI 1.33 to 4.51), completed grade 8 (AOR=6.05; 95% CI 2.65 to 13.80), attended high school (AOR=11.69; 95% CI 3.76 to 36.27), completed high school and above (AOR=2.92; 95% CI 1.16 to 7.32), husbands attended high school (AOR=2.92; 95% CI 1.15 to 7.47), family size of less than five (AOR=3.44; 95% CI to 1.77-6.66) were positively significantly associated with adequate dietary diversity. On the other hand, not had additional meal during pregnancy (AOR=0.42; 95% CI 0.21 to 0.83) was negatively associated with adequate dietary diversity. CONCLUSIONS We observed that the adequate dietary diversity score of pregnant women was low compared with the pooled proportion of dietary diversity conducted in Ethiopia. Therefore, strengthening and promoting female education through intersectoral collaborations and additional meal counselling during pregnancy is indispensable.
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Affiliation(s)
- Melesse Niguse Kuma
- Department of Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Oromia, Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Oromia, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Oromia, Ethiopia
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Oono F, Matsuura N, Saito A, Fujiwara A, Takahashi O, Sasaki S, Iida K. Association of Hours of Paid Work with Dietary Intake and Quality in Japanese Married Women: A Cross-Sectional Study. Nutrients 2021; 13:nu13093005. [PMID: 34578884 PMCID: PMC8466932 DOI: 10.3390/nu13093005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/21/2022] Open
Abstract
This study investigated the association of hours of paid work with dietary intake and diet quality among Japanese married women. This cross-sectional study was a secondary analysis of a nationwide population survey in 2013. The analytic sample included 644 married women aged 20–59 years. The participants were categorized into five groups according to hours of paid work per week: 0 (housewives), 1–14, 15–34, 35–42, and ≥43 h. Dietary intake was assessed by a self-administered diet history questionnaire. The Nutrient-Rich Food Index 9.3 (NRF9.3) was used to measure the dietary quality. The association of hours of paid work with dietary intake and NRF9.3 score was assessed using a multivariable general linear regression analysis with adjustments for confounders. Hours of paid work were associated with a higher intake of rice and lower intake of vegetables, potatoes, soy products, and seaweeds and nutrients including protein, dietary fiber, and most vitamins and minerals. Hours of paid work were negatively associated with the NRF9.3 score. This study showed that Japanese married women engaging in paid work, especially those who work long hours, have less healthy diets. Efforts to improve the dietary intake of married women with paid work might be needed.
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Affiliation(s)
- Fumi Oono
- Department of Nutrition and Food Science, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; (F.O.); (N.M.); (A.S.)
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;
| | - Nozomi Matsuura
- Department of Nutrition and Food Science, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; (F.O.); (N.M.); (A.S.)
| | - Aki Saito
- Department of Nutrition and Food Science, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; (F.O.); (N.M.); (A.S.)
| | - Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Osamu Takahashi
- Department of Epidemiology, Graduate School of Public Health, St. Luke’s International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;
- Department of General Internal Medicine, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kaoruko Iida
- Department of Nutrition and Food Science, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; (F.O.); (N.M.); (A.S.)
- Institute for Human Life Innovation, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan
- Correspondence: ; Tel.: +81-3-5978-5474
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Imai C, Takimoto H, Fudono A, Tarui I, Aoyama T, Yago S, Okamitsu M, Sasaki S, Mizutani S, Miyasaka N, Sato N. Application of the Nutrient-Rich Food Index 9.3 and the Dietary Inflammatory Index for Assessing Maternal Dietary Quality in Japan: A Single-Center Birth Cohort Study. Nutrients 2021; 13:nu13082854. [PMID: 34445014 PMCID: PMC8400739 DOI: 10.3390/nu13082854] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022] Open
Abstract
The maternal diet can potentially influence the life-course health of the child. A poor-quality maternal diet creates nutrient deficiencies and affects immune–metabolic regulation during pregnancy. The nutrient-based overall dietary quality can be assessed using the Nutrient-Rich Food Index 9.3 (NRF9.3), which measures adherence to the national reference daily values of nutrient intake. Pro- and anti-inflammatory nutrient intake can be assessed using the energy-adjusted dietary inflammatory index (E-DII), a comprehensive index of diet-derived inflammatory capacity. Using these indices, we assessed the overall dietary quality and inflammatory potential of pregnant women during mid-gestation in an urban area of Japan (n = 108) and found that there was a strong inverse correlation between the NRF9.3 and E-DII scores. Comparison of the scores among the tertiles of NRF9.3 or E-DII indicated that dietary fiber, vitamin C, vitamin A, and magnesium mainly contributed to the variability of both indices. Intake of vegetables and fruits was positively associated with high NRF9.3 scores and negatively associated with high E-DII scores, after adjustment for maternal age, pre-pregnancy body mass index, and educational level. Consistent with the previous studies that used dietary pattern analysis, this study also demonstrated that vegetables and fruits were the food groups chiefly associated with high dietary quality and low inflammatory potential among pregnant Japanese women.
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Affiliation(s)
- Chihiro Imai
- Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Hidemi Takimoto
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; (H.T.); (I.T.); (T.A.)
| | - Ayako Fudono
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (A.F.); (N.M.)
| | - Iori Tarui
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; (H.T.); (I.T.); (T.A.)
| | - Tomoko Aoyama
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; (H.T.); (I.T.); (T.A.)
| | - Satoshi Yago
- Child and Family Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (S.Y.); (M.O.)
| | - Motoko Okamitsu
- Child and Family Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (S.Y.); (M.O.)
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Shuki Mizutani
- Institute of Advanced Biomedical Engineering and Science, The Public Health Research Foundation, Tokyo 169-0051, Japan;
| | - Naoyuki Miyasaka
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (A.F.); (N.M.)
| | - Noriko Sato
- Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
- Institute of Advanced Biomedical Engineering and Science, The Public Health Research Foundation, Tokyo 169-0051, Japan;
- Correspondence: ; Tel.: +81-3-5803-4595
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Maternal psychological distress, education, household income, and congenital heart defects: a prospective cohort study from the Japan environment and children's study. BMC Pregnancy Childbirth 2021; 21:544. [PMID: 34364381 PMCID: PMC8348993 DOI: 10.1186/s12884-021-04001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/10/2021] [Indexed: 11/30/2022] Open
Abstract
Background The influence of maternal psychological distress on infant congenital heart defects (CHDs) has not been thoroughly investigated. Furthermore, there have been no reports on the combined effect of maternal psychological distress and socioeconomic status on infant CHDs. This study aimed to examine whether maternal psychological distress, socioeconomic status, and their combinations were associated with CHD. Methods We conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant women between 2011 and 2014. Maternal psychological distress was evaluated using the Kessler Psychological Distress Scale in the first trimester, while maternal education and household income were evaluated in the second and third trimesters. The outcome of infant CHD was determined using the medical records at 1 month of age and/or at birth. Crude- and confounder-adjusted logistic regression analyses were performed to evaluate the association between maternal psychological distress and education and household income on infant CHD. Results A total of 93,643 pairs of mothers and infants were analyzed, with 1.1% of infants having CHDs. Maternal psychological distress had a significantly higher odds ratio in the crude analysis but not in the adjusted analysis, while maternal education and household income were statistically insignificant. In the analysis of the combination variable of lowest education and psychological distress, the P for trend was statistically significant in the crude and multivariate model excluding anti-depressant medication, but the significance disappeared in the full model (P = 0.050). Conclusions The combination of maternal psychological distress and lower education may be a possible indicator of infant CHD. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04001-2.
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Kundu S, Jharna DE, Banna MHA, Khan MSI. Factors associated with dietary diversity and physical activity of pregnant women in Bangladesh: A cross‐sectional study at an antenatal care setting. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Satyajit Kundu
- Department of Biochemistry and Food Analysis Patuakhali Science and Technology University Patuakhali Bangladesh
| | - Dilruba Easmin Jharna
- Department of Biochemistry and Food Analysis Patuakhali Science and Technology University Patuakhali Bangladesh
| | - Md. Hasan Al Banna
- Department of Food Microbiology Patuakhali Science and Technology University Patuakhali Bangladesh
| | - Md Shafiqul Islam Khan
- Department of Food Microbiology Patuakhali Science and Technology University Patuakhali Bangladesh
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Do food taboo and dietary diversity associated with risk of chronic energy deficiency among pregnant women living in rural setting of Southeast Sulawesi, Indonesia? Proc Nutr Soc 2021. [DOI: 10.1017/s0029665121000847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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15
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Hashimoto A, Murakami K, Kobayashi S, Suga H, Sasaki S. Associations of Education With Overall Diet Quality Are Explained by Different Food Groups in Middle-aged and Old Japanese Women. J Epidemiol 2020; 31:280-286. [PMID: 32418938 PMCID: PMC7940974 DOI: 10.2188/jea.je20200030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The disparity of overall diet quality by personal educational attainment has been a public issue. However, it remains unknown which food groups contribute to the disparity. This cross-sectional study assesses which food groups explain associations between education and overall diet quality in Japanese women. Methods A total of 3,788 middle-aged (mean age, 47.7 years) and 2,188 older women (mean age, 74.4 years), who lived in 47 prefectures in Japan, provided data on their education (low, middle, and high) and dietary intakes from a diet history questionnaire. A diet quality score (possible score 0–70) was calculated based on seven food components. Mean diet quality scores, with adjustment for lifestyle and neighborhood variables, were estimated by education using a general linear model, and Dunnett’s multiple comparison was conducted. Additionally, mean scores of each food component were estimated by education and compared using the same manner. Results After adjustment for lifestyle and neighborhood variables, mean diet quality score of high or middle education was higher than low education for both generations. Middle-aged women with high and middle education had higher scores of ‘milk’, ‘snacks, confection, and beverages’, ‘fruits’, and ‘vegetable dishes’ than those with low education. Older women with high and middle education had higher scores of ‘sodium from seasonings’ and ‘fruits’ than those with low education. Conclusions This study suggests that positive associations between education and diet quality are explained by different food groups in middle-aged and older Japanese women, which are independent of lifestyle and neighborhood variables.
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Affiliation(s)
- Ayumi Hashimoto
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
| | - Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
| | - Satomi Kobayashi
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
| | - Hitomi Suga
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
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Differences in pre-pregnancy diet quality by occupation among employed women. Public Health Nutr 2020; 23:1974-1981. [PMID: 32100672 DOI: 10.1017/s1368980019003926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Maternal risk factors for pregnancy outcomes are known to vary by employment status. We evaluated whether pre-pregnancy diet quality varies by occupation in a population-based sample. DESIGN We analysed interview data from 7341 mothers in a national case-control study of pregnancy outcomes. Self-reported job(s) held during the 3 months before pregnancy were classified using Standard Occupational Classification (SOC) codes. Usual diet in the year before conception was assessed with a semi-quantitative FFQ and evaluated using the Diet Quality Index for Pregnancy (DQI-P). Using logistic regression, we calculated adjusted OR and 95 % CI to estimate associations between low diet quality (defined as the lowest quartile of DQI-P scores) and occupation types. SETTING The National Birth Defects Prevention Study: Arkansas, California, Georgia, Iowa, Massachusetts, North Carolina, New Jersey, New York, Texas, Utah. PARTICIPANTS Employed mothers of infants born between 1997 and 2011. RESULTS No occupation was strongly associated with low diet quality. Moderate but relatively imprecise associations were observed for women employed in management (OR: 1·3; 95 % CI: 1·1, 1·7); arts, design, entertainment, sports and media (OR: 1·4; 95 % CI: 0·9, 2·1); protective service (OR 1·3; 95 % CI: 0·7, 2·5) and farming, fishing, and forestry occupations (OR: 0·5; 95 % CI: 0·2, 1·1). CONCLUSIONS Our analyses suggest that women in certain occupations may have lower diet quality in the months before pregnancy. Further research is needed to determine whether certain occupations could benefit from interventions to improve diet quality in the workplace for women of reproductive age.
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Minimum Dietary Diversity Score and Associated Factors among Pregnant Women at Alamata General Hospital, Raya Azebo Zone, Tigray Region, Ethiopia. J Nutr Metab 2019; 2019:8314359. [PMID: 31192011 PMCID: PMC6525861 DOI: 10.1155/2019/8314359] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/26/2019] [Accepted: 03/26/2019] [Indexed: 12/14/2022] Open
Abstract
Background Consumption of diversified food during pregnancy found very important and critical to determine healthy pregnancy outcome. Low dietary diversity has a major adverse effect on mothers, fetus, and life of new born. Dietary diversity is still low in low-resourced countries. Therefore, this study aims to determine prevalence of minimum dietary diversity score (MDDS) and associated factors among pregnant women. Methods Facility-based cross-sectional study was conducted from April to May, 2017, in Alamata General Hospital (AGH). Data were collected using a pretested and structured self-interview questionnaire. A systematic sampling technique was used to select study participants. Binary logistic regression and odds ratio with 95% confidence interval (CI) were carried out to see the association between variables and the outcomes. Results From a survey of 412 participants, 61.2% had high MDDS and 38.8% had low MDDS. Multivariate analysis revealed that being government employees (AOR = 4.87, CI: 1.70–13.95), merchant (AOR = 4.67, CI: 1.81–12.05), secured food (AOR = 3.85, CI: 2.12–6.97), and eating three meals and above (AOR = 2.66, CI: 1.47–4.82) were significantly associated with high MDDS among pregnant women. Conclusions In our study, minimum dietary diversity shows small increment from previous study. Screening and special emphases should be given by a health-care provider on women diet during antenatal follow-up at health-care settings.
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Rho CR, Kim H, Kim MS, Kim EC. Income and Education are Independently Associated with Visual Impairment: The Korean National Health and Nutrition Examination Survey 2010-2012. Semin Ophthalmol 2019; 34:131-136. [PMID: 30920316 DOI: 10.1080/08820538.2019.1597133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To investigate the association of visual impairment (VI) with socioeconomic status, including the highest educational level and household income when other confounding variables were adjusted. Methods: The Korean National Health and Nutrition Examination Survey 2010-2012 data were analyzed. The final analyses included a total of 16,905 subjects with their demographic, socioeconomic, and health data. The socioeconomic data included the household income and the highest educational level. Household income was categorized into quartiles. The educational attainment was categorized as ≤ elementary school, middle school, high school, and ≥ university. VI was defined when the distance-corrected VA was worse than 0.32 (20/63 Snellen) in the better-seeing eye according to the definition of the World Health Organization. Four multiple logistic regression models were used to determine the odds ratio (OR) and 95% confidence interval (CI) between VI and household income or between VI and the highest educational level, by adjusting for several confounding variables. Results: The prevalence of VI was 5.0% (844 subjects). Multiple logistic regression analyses indicated that the adjusted OR was 1.729 (95% CI: 1.108-2.697) for developing VI in subjects with ≤ elementary school as their highest education level compared to those with ≥ university education. Also, the adjusted OR of subjects in the first quartile of household income was 1.502 (95% CI: 1.061-2.127) for developing VI compared to those in the fourth quartile of household income. Conclusions: The present study showed that household income and education were independently associated with VI even after adjusting for significant confounding variables.
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Affiliation(s)
- Chang Rae Rho
- a Department of Ophthalmology and Visual Science, Daejeon St. Mary's Hospital, College of Medicine , Catholic University of Korea , Daejeon , South Korea
| | - HyunSeung Kim
- b Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine , Catholic University of Korea , Seoul , South Korea
| | - Man Soo Kim
- b Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine , Catholic University of Korea , Seoul , South Korea
| | - Eun Chul Kim
- c Department of Ophthalmology and Visual Science, Bucheon St. Mary's Hospital, College of Medicine , Catholic University of Korea , Bucheon , Gyeonggido , South Korea
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Takei H, Shiraishi M, Matsuzaki M, Haruna M. Factors related to vegetable intake among pregnant Japanese women: A cross-sectional study. Appetite 2018; 132:175-181. [PMID: 30102942 DOI: 10.1016/j.appet.2018.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/31/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Vegetable intake (VI) is important for both fetal and maternal health. However, VI is insufficient among many pregnant Japanese women. This study aimed to identify the factors related to VI during pregnancy. METHODS A cross-sectional study was conducted in 2014, at a university hospital in Tokyo, Japan. Dietary intake was assessed using a brief-type self-administered diet history questionnaire. Demographic, physical, and psychological characteristics, dietary habits, and health-related behaviors were investigated using another questionnaire. Multiple linear regression analysis was used to identify factors related to VI. RESULTS Data of 273 healthy pregnant women was analyzed. The median value of energy-adjusted VI was 140.4 g/1000 kcal. Severe pregnancy-associated nausea (β = -0.148), a habit of eating out (β = -0.174), a habit of eating confectioneries (β = -0.158), and perceived barriers to obtaining vegetables (β = -0.149) were negatively associated with the energy-adjusted VI. In contrast, exercise habits (β = 0.193), knowledge of the recommended VI amounts for non-pregnant adults (β = 0.105), and the Vegetable Intake Self-Efficacy scale scores (β = 0.193) were positively associated with the energy-adjusted VI. CONCLUSIONS Pregnant women with severe pregnancy-associated nausea, or those who habitually eat out or eat confectioneries, may be a potential high-risk population for low VI. Enhancing knowledge and self-efficacy regarding VI would be effective in increasing VI during pregnancy.
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Affiliation(s)
- Haruka Takei
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mie Shiraishi
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Masayo Matsuzaki
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Megumi Haruna
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Nguyen CL, Hoang DV, Nguyen PTH, Ha AVV, Chu TK, Pham NM, Lee AH, Duong DV, Binns CW. Low Dietary Intakes of Essential Nutrients during Pregnancy in Vietnam. Nutrients 2018; 10:nu10081025. [PMID: 30082626 PMCID: PMC6116189 DOI: 10.3390/nu10081025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 01/05/2023] Open
Abstract
Inadequate intake of nutrients during pregnancy has been associated with poor pregnancy and infant outcomes; however, evidence remains limited in low-resource settings in Asia. This paper assessed food, macronutrient, and micronutrient intakes among 1944 Vietnamese pregnant women. Dietary information was collected via an interviewer-administered food frequency questionnaire, and nutrient intakes were estimated using the Vietnamese food composition tables. The levels of nutrient intakes were evaluated against the Vietnamese recommended nutrient intakes (RNI) for pregnancy. The diet profiles were reported as means and percentages. The average daily food intakes across socio-demographic factors were compared using ANOVA, with adjustment for multiple comparisons by the Tukey–Kramer test. Rice, fruits, and vegetables were the main food sources consumed. The mean energy intake was 2004 kcal/day with 15.9%, 31.8%, and 52.2% of energy deriving from proteins, fats, and carbohydrates, respectively. Just over half of the women did not meet the RNI for total energy intake. The intakes of essential micronutrients including folate, calcium, iron, and zinc were below the RNI, and almost all pregnant women failed to meet the recommendations for these micronutrients. The associations of maternal age, education, and pre-pregnancy body mass index with nutrient intakes varied across the nutrient subgroups. Targeted programs are needed to improve nutrient intakes in Vietnamese pregnant women.
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Affiliation(s)
- Cong Luat Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam.
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
| | - Dong Van Hoang
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam.
| | - Phung Thi Hoang Nguyen
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Nutrition and Food, Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam.
| | - Anh Vo Van Ha
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Environmental and Occupational Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam.
| | - Tan Khac Chu
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Epidemiology, Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam.
| | - Ngoc Minh Pham
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Epidemiology, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam.
| | - Andy H Lee
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
| | - Dat Van Duong
- Department of Sexual & Reproductive Health, United Nations Population Fund, Hanoi 100000, Vietnam.
| | - Colin W Binns
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
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Goodarzi-Khoigani M, Baghiani Moghadam MH, Nadjarzadeh A, Mardanian F, Fallahzadeh H, Mazloomy-Mahmoodabad S. Impact of Nutrition Education in Improving Dietary Pattern During Pregnancy Based on Pender's Health Promotion Model: A Randomized Clinical Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:18-25. [PMID: 29344041 PMCID: PMC5769180 DOI: 10.4103/ijnmr.ijnmr_198_16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Different types of nutrients in adequate amounts are required to meet the increased demands of the mother and the developing fetus. Therefore, we examined the impact of nutrition education on the number of food servings per day. Materials and Methods: Pregnant mothers were recruited to a prospective, randomized clinical trial from May to September, 2016. At 6–10 weeks of gestation, the participants were randomly divided into the intervention (n = 96) or the control group (n = 96), and were followed-up until the end of pregnancy. Each woman in the experimental group met the study nutritionist at the time of enrollment and an individualized nutrition plan was developed. In addition, the nutrition education based on Pender's Health Promotion Model (HPM) was designed, including three 45–60 min training sessions in 6–10, 18, and 26 weeks of pregnancy. The participants' usual food intake using a three-day dietary record was assessed at 6–10 weeks and 34–36 weeks of gestation. Results: The mean scores of the perceived benefits, self-efficacy, activity-related affect, interpersonal influences (husband support), and commitment to action increased while the competing demand scores decreased in the interventional group compared with the control group. The mean standard deviation (SD) of food portions from grain [10.40 (1.96) versus 12.70 (1.93) in the control group], vegetable [3.88 (1.33) versus 2.96 (0.91)], fruit [4.02 (0.05) versus 3.95 (0.91)], dairy [2.33 (0.68) versus 2.11 (0.45)], and meat [3.17 (0.68) versus 2.96 (0.67)] were improved in the experimental group. Conclusions: Pender's HPM for nutrition education is effective based on the compliance of pregnant women to the dietary guideline and the food guide pyramid.
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Affiliation(s)
- Masoomeh Goodarzi-Khoigani
- Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farahnaz Mardanian
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Fallahzadeh
- Department of Statistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - SeyedSaeed Mazloomy-Mahmoodabad
- Department of Health Education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Nagahata T, Nakamura M, Ojima T, Kondo I, Ninomiya T, Yoshita K, Arai Y, Ohkubo T, Murakami K, Nishi N, Murakami Y, Takashima N, Okuda N, Kadota A, Miyagawa N, Kondo K, Okamura T, Ueshima H, Okayama A, Miura K. Relationships among Food Group Intakes, Household Expenditure, and Education Attainment in a General Japanese Population: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S23-S28. [PMID: 29503382 PMCID: PMC5825688 DOI: 10.2188/jea.je20170248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A lower socioeconomic status (SES) may be related to the intake of unhealthy food; however, this relationship has not been examined in detail. This study was undertaken to examine relationships among food group intakes and SES in a representative Japanese population. METHODS This was a cross-sectional study using the baseline data of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey in Japan. A total of 2,898 participants were included in the baseline survey in 2010. The effects of age (<65 years and ≥65 years), equivalent household expenditure (EHE), and education attainment on food group intakes (gram per 1,000 kcal) were analyzed using a two-way analysis of variance. RESULTS When EHE was lower, cereal intake was higher in men and women. Among men, fish, milk, and alcohol intakes were reduced with lower EHE. Among women, vegetable intake was reduced with lower EHE. In men and women, cereal intake was higher with lower education attainment. In contrast, meat intake was reduced with lower education attainment. CONCLUSIONS Lower SES was associated with a higher cereal intake and lower vegetable, fish, meat, and milk intakes in a representative Japanese population. Socioeconomic discrepancies need to be considered in order to promote healthier dietary habits.
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Affiliation(s)
- Tomomi Nagahata
- Department of Nutrition, School of Health and Nutrition, Tokaigakuen University, Aichi, Japan
| | - Mieko Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Imako Kondo
- Department of Food and Nutritional Sciences, College of Bioscience and Biotechnology, Chubu University, Aichi, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Katsushi Yoshita
- Department of Food and Human Health Science, Osaka City University Graduate School of Human Life Science, Osaka, Japan
| | - Yusuke Arai
- Department of Nutrition, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Keiko Murakami
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, School of Medicine, Toho University, Tokyo, Japan
| | - Naoyuki Takashima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Keiko Kondo
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
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Tan MM, Chan CKY, Reidpath DD. Does the social gradient remain in the dietary habits of a health-conscious population? A study of Seventh-Day Adventists in West Malaysia. J Public Health (Oxf) 2017; 39:e179-e185. [PMID: 27738128 DOI: 10.1093/pubmed/fdw109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 08/30/2016] [Indexed: 11/14/2022] Open
Abstract
Background Socioeconomic status (SES) is a strong predictor of health, and individuals with higher SES generally have better health than those with lower SES. One of the pathways that SES influences health is through health behaviors, such as dietary intake, and a higher SES has been associated with a better diet. The purpose of this study was to determine whether there was a social gradient in dietary habits among the Seventh-Day Adventists, a group of conservative Christians, where healthy eating is part of the doctrinal teaching. Methods Data from a survey of 574 Adventists residing in West Malaysia, aged 18-80 years, were analyzed. Dietary habits were measured using the Nutrition subscale of Health Promoting Lifestyle Profile II. Results Education and income were significantly associated with dietary habits before and after controlling for demographics. There was a gradient of association; a higher level of education and higher income were associated with better dietary habits. However, only education remained significantly associated with dietary habits when the other two socioeconomic variables were included. Employment was not significantly associated with dietary habits before or after controlling for demographic variables and the other two sociodemographic variables. Conclusions This study showed that education is the strongest predictor of healthy diet, and a social gradient in dietary habits still exists even among health-conscious population.
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Affiliation(s)
- Min Min Tan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Jalan Lagoon Selatan, 46510 Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - Carina K Y Chan
- School of Psychology, Australian Catholic University, Banyo QLD 4014, Australia
| | - Daniel D Reidpath
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Jalan Lagoon Selatan, 46510 Bandar Sunway, Selangor Darul Ehsan, Malaysia
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Nachvak SM, Abdollahzad H, Mostafai R, Moradi S, Pasdar Y, Rezaei M, Esksndari S. Dietary Diversity Score and Its Related Factors among Employees of Kermanshah University of Medical Sciences. Clin Nutr Res 2017; 6:247-255. [PMID: 29124045 PMCID: PMC5665746 DOI: 10.7762/cnr.2017.6.4.247] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/31/2017] [Accepted: 10/18/2017] [Indexed: 11/26/2022] Open
Abstract
Dietary diversity score (DDS) is known as an indicator of food quality. Dietary diversity can promote health status. The aim of this study was determined DDS and its related factors in Kermanshah University of Medical Sciences (KUMS) employees. This cross-sectional study was conducted on 190 employees of KUMS in 2015. According to the population of KUMS centers which were selected randomly (Paramedical, Public Health faculties, Imam Reza Hospital and province health center), subjects were selected by convenience sampling method. Food frequency questionnaire (FFQ) was used to calculate DDS. Foods were divided into 5 main groups: grains, vegetables, fruits, meat, and dairy products. The main groups had 23 subgroups. Total DDS divided to 4 quartiles: less than 3.0, 3.0–5.5, 5.6–8.5, and more than 8.5. Anthropometric parameters including: weight, height, waist circumference (WC), and hip circumference were measured. Data were analyzed by Kolmogorov-Smirnov test, χ2 test, and analysis of variance (ANOVA) test with SPSS 20 software (IBM Corp., Chicago, IL, USA). The mean ± standard deviation of DDS and body mass index (BMI) were 5.68 ± 1.73 and 25.1 ± 3.42 kg/m2, respectively. The average of the waist-to-hip ratio (WHR) in men and women was 0.92 ± 0.04 and 0.86 ± 0.06, respectively. There was statistically significant difference between DDS and self-reported economic status (p < 0.022). No significant difference was observed between DDS and BMI or WC. However, significant negative correlation was observed between DDS and WHR in men (p < 0.019). This study showed that DDS had a negative correlation with the WHR. Therefore, dietary diversity may improve health status by effect on fat distribution in body.
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Affiliation(s)
- Seyed Mostafa Nachvak
- Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadi Abdollahzad
- Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roghayeh Mostafai
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shima Moradi
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Department of Biostatistics, Faculty of Health, Communing Developmental and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soudabeh Esksndari
- Research Center for Environmental Determinants of Health (RCEDH), School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Shiraishi M, Haruna M, Matsuzaki M, Murayama R, Sasaki S. Availability of two self-administered diet history questionnaires for pregnant Japanese women: A validation study using 24-hour urinary markers. J Epidemiol 2017; 27:172-179. [PMID: 28142045 PMCID: PMC5376307 DOI: 10.1016/j.je.2016.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 05/17/2016] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Accurate and easy dietary assessment methods that can be used during pregnancy are required in both epidemiological studies and clinical settings. To verify the utility of dietary assessment questionnaires in pregnancy, we examined the validity and reliability of a self-administered diet history questionnaire (DHQ) and a brief-type self-administered diet history questionnaire (BDHQ) to measure energy, protein, sodium, and potassium intake among pregnant Japanese women. METHODS The research was conducted at a university hospital in Tokyo, Japan, between 2010 and 2011. The urinary urea nitrogen, sodium, and potassium levels were used as reference values in the validation study. For the reliability assessment, participants completed the questionnaires twice within a 4-week interval. RESULTS For the DHQ (n = 115), the correlation coefficients between survey-assessed energy-adjusted intake and urinary protein, sodium, and potassium levels were 0.359, 0.341, and 0.368, respectively; for the BDHQ (n = 112), corresponding values were 0.302, 0.314, and 0.401, respectively. The DHQ-measured unadjusted protein and potassium intake levels were significantly correlated with the corresponding urinary levels (rs = 0.307 and rs = 0.342, respectively). The intra-class correlation coefficients for energy, protein, sodium, and potassium between the time 1 and time 2 DHQ (n = 58) and between the time 1 and time 2 BDHQ (n = 54) ranged from 0.505 to 0.796. CONCLUSIONS Both the DHQ and the BDHQ were valid and reliable questionnaires for assessing the energy-adjusted intake of protein, sodium, and potassium during pregnancy. In addition, given the observed validity of unadjusted protein and potassium intake measures, the DHQ can be a useful tool to estimate energy intake of pregnant Japanese women.
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Affiliation(s)
- Mie Shiraishi
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Children's and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
| | - Megumi Haruna
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masayo Matsuzaki
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryoko Murayama
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
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Monetary value of self-reported diets and associations with sociodemographic characteristics and dietary intake among Japanese adults: analysis of nationally representative surveys. Public Health Nutr 2016; 19:3306-3318. [PMID: 27357725 DOI: 10.1017/s1368980016001695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the relationships of monetary value of diets with sociodemographic and lifestyle characteristics and dietary intake among Japanese adults. DESIGN Cross-sectional study based on two nationally representative surveys: the Comprehensive Survey of Living Conditions and the National Health and Nutrition Survey, 2013. Dietary intake was assessed by a 1 d semi-weighed household dietary record with information on individual proportion of intakes. Diet cost was estimated by linking dietary data with retail food prices. A wide variety of sociodemographic and lifestyle variables were obtained from the two surveys. SETTING A random sample of nationally representative households in Japan. SUBJECTS Japanese adults aged 20 years or older (n 4658). RESULTS Lower energy-adjusted diet cost (Japanese yen/4184 kJ) was significantly associated with being younger, having a lower education, less equivalent monthly household expenditure, large household size, less physical activity and living in rented houses. Lower diet cost was associated with a lower intake of pulses, vegetables, fruits, fish, meat and dairy products, and a higher intake of grain, eggs, and fats and oils. At the nutrient level, lower diet cost was associated with a lower intake of protein, alcohol, dietary fibre, cholesterol and all vitamins and minerals examined, and a higher intake of carbohydrate. Diet cost was inversely associated with dietary energy density. CONCLUSION These data suggest that certain low socio-economic subgroups in Japan consume diets of lower monetary value, resulting in a lower quality of food and nutrient intake pattern except for lower sodium, cholesterol and alcohol consumption.
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Amugsi DA, Lartey A, Kimani E, Mberu BU. Women's participation in household decision-making and higher dietary diversity: findings from nationally representative data from Ghana. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2016; 35:16. [PMID: 27245827 PMCID: PMC5026004 DOI: 10.1186/s41043-016-0053-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 05/27/2016] [Indexed: 05/14/2023]
Abstract
BACKGROUND Low-quality monotonous diet is a major problem confronting resource-constrained settings across the world. Starchy staple foods dominate the diets in these settings. This places the population, especially women of reproductive age, at a risk of micronutrients deficiencies. This study seeks to examine the association between women's decision-making autonomy and women's achievement of higher dietary diversity (DD) and determine the socio-demographic factors that can independently predict women's attainment of higher DD. METHODS The study used data from the 2008 Ghana Demographic and Health Survey. The participants comprised of 2262 women aged 15-49 years and who have complete dietary data. The DD score was derived from a 24-h recall of intake of foods from nine groups. The score was dichotomized into lower DD (DD ≤4) and higher (DD ≥5). Logistic regression was used to assess the association between women decision-making autonomy (final say on how to spend money, making household purchases, own health care, opinions on wife-beating, and sexual intercourse with husband) and the achievement of higher DD. The logistic regression models were adjusted for covariates at the individual and household levels. RESULTS The analysis showed that women participation in decision-making regarding household purchases was significantly associated with higher DD, after adjusting for individual and household level covariates. The odds of achieving higher DD were higher among women who had a say in deciding household purchases, compared to women who did not have a say (OR = 1.74, 95 % CI = 1.24, 2.42). Women who had more than primary education were 1.6 times more likely to achieve higher DD, compared to those with no education (95 % CI = 1.12, 2.20). Compared to women who lived in polygamous households, those who lived in monogamous households had higher odds of achieving higher DD (OR = 1.42, 95 % CI = 1.04, 1.93). CONCLUSIONS Net other covariates, women who have a say in making household purchases are more likely to achieve higher DD compare to those who do not have a say. This may indicate autonomy to buy nutritious foods, suggesting that improving women decision-making autonomy could have a positive impact on women dietary intake.
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Affiliation(s)
- Dickson A Amugsi
- African Population and Health Research Centre, APHRC Campus, P.O. Box 10787-00100, Nairobi, Kenya.
| | - Anna Lartey
- Nutrition Division, Economic and Social Department, Food and Agriculture Organization, Rome, Italy
| | - Elizabeth Kimani
- African Population and Health Research Centre, APHRC Campus, P.O. Box 10787-00100, Nairobi, Kenya
| | - Blessing U Mberu
- African Population and Health Research Centre, APHRC Campus, P.O. Box 10787-00100, Nairobi, Kenya
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Liu FL, Zhang YM, Parés GV, Reidy KC, Zhao WZ, Zhao A, Chen C, Ning CY, Zheng YD, Wang PY. Nutrient Intakes of Pregnant Women and their Associated Factors in Eight Cities of China: A Cross-sectional Study. Chin Med J (Engl) 2016; 128:1778-86. [PMID: 26112720 PMCID: PMC4733713 DOI: 10.4103/0366-6999.159354] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: During the last 3 decades, China has dramatic changes of the dietary pattern among its citizens, particularly in urban cities. This study aimed to determine the nutrient intake status and factors associated with nutrient intakes of urban Chinese pregnant women now-a-day. Methods: The multistage stratified random sampling method was applied in the cross-sectional study. 479 women in three trimesters of pregnancy from eight cities of China were recruited. Nutrient intakes were evaluated with one 24 h dietary recall, and compared with the Chinese Dietary Reference Intakes (DRIs) 2013 for available nutrients. Results: Most pregnant women had imbalanced macronutrient distribution with excessive energy derived from fat. Intakes of Vitamin A, B6, calcium, magnesium, and selenium were below Chinese Recommended Nutrient Intake (RNI) and Estimated Average Requirements (EARs) in all trimesters. Most pregnant women took more folic acid in the first trimester with a significant decrease in the second and third trimester (P < 0.05). Shortfall in iron intake was found in the third trimester whereas some women may be at the risk of excessive iron intake. Intakes of thiamin met RNI in the first trimester but were below EAR in all trimesters. Trimester phasing was positively associated with most nutrients (P < 0.05). Prepregnancy body mass index was inversely associated with energy, fat, Vitamin C, and calcium intake (P < 0.05). Educational level and household income were positively associated with folic acid intake (P < 0.05). Conclusions: Current prenatal dietary choices of urban pregnant women in China are imbalanced in the nutrient intake when compared with national DRIs 2013, particularly in intakes of energy derived from fat and micronutrients. Appropriate dietary advice to pregnant women should promote a balanced diet with emphasis on avoidance of foods of high fat content and incorporation of foods that are good sources of the key micronutrients that are usually lacking in a regular pregnancy diet. Further research is needed to understand the eating habits and food patterns that contribute to this imbalanced diet in order to be able to effectively improve prenatal women's nutrient intake status.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Pei-Yu Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing 100191, China
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Nakamura S, Inayama T, Hata K, Matsushita M, Takahashi M, Harada K, Arao T. Association of household income and education with eating behaviors in Japanese adults: a cross-sectional study. BMC Public Health 2016; 16:61. [PMID: 26800891 PMCID: PMC4722662 DOI: 10.1186/s12889-016-2748-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 01/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities as social determinants of health are important issues in public health and health promotion. However, the association between socioeconomic status and eating behaviors has been investigated poorly in Japanese adults. To fill this gap, the present study examines the association of eating behaviors with household income and education. METHODS The sample comprised 3,137 Japanese adults (1,580 men and 1,557 women) aged 30 to 59 years who responded to an Internet-based cross-sectional survey in 2014. Data on the following eating behaviors were collected via self-report: "taking care of one's diet for health," "eating vegetables," "frequency of eating breakfast," "frequency of family breakfasts," "frequency of family dinners," "using the information on nutrition labels," and "conversations with family or friends during meals." Self-reported data on socioeconomic status (household income and education) and demographic variables (gender, age, district of residence, marital status, residence status, and employment status) were also collected. The associations between eating behaviors and household income or education were tested using binomial logistic regression analysis with eating behaviors as dependent variables and household income and education as independent variables. A trend P -value was calculated for three categories of household income (less than 3,000,000 JPY, 3,000,000-7,000,000 JPY, and over 7,000,000 JPY) and education (junior high/high school, 2-year college, and 4-year college/graduate school). RESULTS Higher household income and education were significantly associated with higher rates of eating vegetables, using the information on nutrition labels, and conversation with family or friends during meals in Japanese men and women. Higher household incomes were significantly associated with lower rates of frequency of family breakfasts in Japanese men and lower rates of frequency of family dinners in Japanese men and women. CONCLUSIONS Higher socioeconomic status as indicated by household income or education was associated with eating more vegetables and conversation with family or friends during meals in Japanese men and women. Socioeconomic status should be considered in health promotion and diet improvement.
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Affiliation(s)
- Saki Nakamura
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Hachioji, Tokyo, Japan
| | - Takayo Inayama
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Hachioji, Tokyo, Japan.
| | - Kikuko Hata
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Hachioji, Tokyo, Japan
| | | | - Masaki Takahashi
- Faculty of Science and Engineering, Waseda University, Shinjyuku, Tokyo, Japan
| | - Kazuhiro Harada
- Section of Motor Function Activation, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takashi Arao
- School of Sports Sciences, Waseda University, Tokorozawa, Saitama, Japan
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The Relationship Between Maternal Education and Child Health Outcomes in Urban Australian Children in the First 12 Months of Life. Matern Child Health J 2015; 19:2501-11. [DOI: 10.1007/s10995-015-1771-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Jing W, Huang Y, Liu X, Luo B, Yang Y, Liao S. The effect of a personalized intervention on weight gain and physical activity among pregnant women in China. Int J Gynaecol Obstet 2015; 129:138-41. [PMID: 25697965 DOI: 10.1016/j.ijgo.2014.11.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 11/07/2014] [Accepted: 01/14/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To examine whether personalized interventions could improve dietary intake and physical activity among pregnant women. METHODS A randomized controlled trial was conducted at a center in Chengdu, China, between September 2012 and February 2013. Women with a singleton pregnancy (aged ≥18years, could understand written Chinese, did not have pre-existing diabetes) were enrolled at approximately 12weeks of pregnancy. They were randomly assigned (1:1) to an intervention group (received personalized educational materials) or a control group (conventional interventions only). Data for dietary intake and physical activity were recorded via questionnaires. Only pregnant women who completed the study were included in the analysis. RESULTS Analyses included 106 women in the control group and 115 in the intervention group. After intervention, the intake of energy, protein, fruit, milk, seafood, and nuts differed significantly between groups (P<0.05), with intakes closer to the recommended amounts in the intervention group. Women in the intervention group spent significantly less time resting (P=0.033) and more time doing mild activity (P=0.016). Mean weight gain per week was significantly lower in the intervention group (P=0.023), and significantly fewer women in this group developed gestational diabetes (P=0.043). CONCLUSION Personalized educational interventions can improve dietary behavior and physical activity levels, and reduce prevalence of gestational diabetes among pregnant women in China. Chinese Clinical Trial Register: ChiCTR-IPR-15005809.
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Affiliation(s)
- Wenjuan Jing
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Huang
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xinghui Liu
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Biru Luo
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Yi Yang
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shujuan Liao
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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Mayén AL, Marques-Vidal P, Paccaud F, Bovet P, Stringhini S. Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review. Am J Clin Nutr 2014; 100:1520-31. [PMID: 25411287 DOI: 10.3945/ajcn.114.089029] [Citation(s) in RCA: 228] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In high-income countries, high socioeconomic status (SES) is generally associated with a healthier diet, but whether social differences in dietary intake are also present in low- and middle-income countries (LMICs) remains to be established. OBJECTIVE We performed a systematic review of studies that assessed the relation between SES and dietary intake in LMICs. DESIGN We carried out a systematic review of cohort and cross-sectional studies in adults in LMICs and published between 1996 and 2013. We assessed associations between markers of SES or urban and rural settings and dietary intake. RESULTS A total of 33 studies from 17 LMICs were included (5 low-income countries and 12 middle-income countries; 31 cross-sectional and 2 longitudinal studies). A majority of studies were conducted in Brazil (8), China (6), and Iran (4). High SES or living in urban areas was associated with higher intakes of calories; protein; total fat; cholesterol; polyunsaturated, saturated, and monounsaturated fatty acids; iron; and vitamins A and C and with lower intakes of carbohydrates and fiber. High SES was also associated with higher fruit and/or vegetable consumption, diet quality, and diversity. Although very few studies were performed in low-income countries, similar patterns were generally observed in both LMICs except for fruit intake, which was lower in urban than in rural areas in low-income countries. CONCLUSIONS In LMICs, high SES or living in urban areas is associated with overall healthier dietary patterns. However, it is also related to higher energy, cholesterol, and saturated fat intakes. Social inequalities in dietary intake should be considered in the prevention and control of noncommunicable diseases in LMICs.
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Affiliation(s)
- Ana-Lucia Mayén
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Fred Paccaud
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Pascal Bovet
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
| | - Silvia Stringhini
- From the Institute of Social and Preventive Medicine (A-LM, FP, PB, and SS) and the Department of Internal Medicine, Internal Medicine (PM-V), Lausanne University Hospital, Lausanne, Switzerland
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Fujiwara T. Socioeconomic status and the risk of suspected autism spectrum disorders among 18-month-old toddlers in Japan: a population-based study. J Autism Dev Disord 2014; 44:1323-31. [PMID: 24202730 DOI: 10.1007/s10803-013-1988-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The association between family socioeconomic status (SES) and the suspected autism spectrum disorder (ASD) status of 18-month-old toddlers was investigated using a population-based sample in Japan, which has a universal healthcare system and a mandatory health checkup system for toddlers. Questionnaires including SES measurements and modified checklist for autism in toddlers were mailed to all families with 18-month-old toddlers in Chiba, a city near Tokyo (N = 6,061; response rate: 64%). The results of logistic regression analysis (which were adjusted for potential confounders) indicated that low maternal education, but not paternal education or family income, were associated with having suspected ASD offspring. Lower maternal education was associated with an increased risk of autistic traits in Japan.
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Affiliation(s)
- Takeo Fujiwara
- Department of Social Medicine, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan,
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Larrañaga I, Santa-Marina L, Begiristain H, Machón M, Vrijheid M, Casas M, Tardón A, Fernández-Somoano A, Llop S, Rodriguez-Bernal CL, Fernandez MF. Socio-economic inequalities in health, habits and self-care during pregnancy in Spain. Matern Child Health J 2014; 17:1315-24. [PMID: 22983810 DOI: 10.1007/s10995-012-1134-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Socioeconomic disadvantage can be harmful for mother's health and can influence child's health long term. The aim of this study is to analyse social inequalities between pregnant women from four INMA (INfancia y Medio Ambiente) cohorts. The analysis included 2,607 pregnant women recruited between 2004 and 2008 from four INMA cohorts. Data on maternal characteristics were collected through two questionnaires completed in the first and third trimester of pregnancy. The relationship between socioeconomic status (SES) and maternal health, dietary intake, lifestyle habits and self-care related variables was modelled using logistic regression analysis. 33.5 % of women had a university level of education and 47 % had high occupational class. Women with higher SES reported healthier habits, fewer complications during pregnancy, better weight gain control and attended more prenatal appointments than women with lower SES. The risk of sedentary behaviour and passive smoking was higher among women with a lower level of education (OR = 1.7, 95 % CI 1.3-2.2 and OR = 1.6, 95 % CI 1.2-2.3, respectively) and with less skilled occupations (OR = 1.7, 95 % CI 1.4-2.0 and OR = 1.2, 95 % CI 1.0-1.5, respectively). Although both SES indicators-occupation and education-act as social determinants of diet, occupation was a more powerful determinant than education. For other lifestyle and self-caring variables, education was a more powerful predictor than occupation. Social inequalities were observed in health, habits and self-care during pregnancy. Proper care during pregnancy requires the control of common clinical variables and the knowledge of socioeconomic conditions of the pregnant women.
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Affiliation(s)
- Isabel Larrañaga
- Public Health Department of Gipuzkoa, Avenida Navarra no 4, San Sebastián, Gipuzkoa, Spain
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Finger JD, Tylleskär T, Lampert T, Mensink GBM. Dietary behaviour and socioeconomic position: the role of physical activity patterns. PLoS One 2013; 8:e78390. [PMID: 24223150 PMCID: PMC3819390 DOI: 10.1371/journal.pone.0078390] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 09/11/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The positive association between education level and health outcomes can be partly explained by dietary behaviour. We investigated the associations between education and several indices of food intake and potential influencing factors, placing special emphasis on physical-activity patterns, using a representative sample of the German adult population. METHODS The German National Health Interview and Examination Survey 1998 (GNHIES98) involved 7,124 participants aged between 18 and 79. Complete information on the exposure (education) and outcome (nutrition) variables was available for 6,767 persons. The associations between 'education' and indices of 'sugar-rich food', 'fat-rich food', 'fruit-and-vegetable' and 'alcohol' intake were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of education level on nutrition outcomes were calculated and adjusted for age, region (former East/West Germany), occupation, income and other influencing factors such as physical activity indicators. RESULTS Men and women with only a primary education had a more frequent intake of sugar-rich and fat-rich foods and a less frequent intake of fruit and vegetables and alcohol than people with a tertiary education. 'Physical work activity' partly explained the associations between education and sugar-rich food intake. The interference with physical work activity was stronger among men than women. No significant associations between education and energy-dense food intake were observed in the retirement-age group of persons aged 65+ and among persons with low energy expenditure. CONCLUSIONS In Germany, adults with a low level of education report that they consume energy-dense foods more frequently - and fruit and vegetables and alcohol less frequently - than adults with a high education level. High levels of physical work activity among adults with a low education level may partly explain why they consume more energy-dense foods.
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Affiliation(s)
- Jonas D. Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- * E-mail:
| | | | - Thomas Lampert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Gert B. M. Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Mudor H, Bunyarit F. A Prospective of Nutrition Intake for Pregnant Women in Pattani, Thailand. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.sbspro.2013.08.415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tanaka K, Miyake Y, Sasaki S, Hirota Y. Socioeconomic status and risk of dental caries in Japanese preschool children: the Osaka Maternal and child health study. J Public Health Dent 2013; 73:217-23. [PMID: 23560765 DOI: 10.1111/jphd.12016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 03/01/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Investigations concerning the relationship between socioeconomic status and dental caries have been conducted mainly in Western countries. The purpose of this longitudinal study was to examine the impact of socioeconomic factors, such as maternal occupation, household income, and parental educational levels, on the risk of dental caries in young Japanese children. METHODS A cohort of 315 preschool children was used. Information pertaining to exposure and potentially confounding factors was obtained by means of questionnaires administered to expectant mothers prior to delivery and subsequently when their children were in the ranges of 2-9, 16-24, 29-39, and 41-49 months of age. Outcome data were collected when the children were between 41 and 50 months old. Children were classified as having dental caries if one or more primary teeth had decayed or had been filled. RESULTS Compared with maternal or paternal education of less than 13 years, maternal or paternal education of 15 years or longer was significantly associated with a decreased risk of dental caries in children: the adjusted odds ratios for maternal and paternal education levels ≥ 15 years compared with <13 years of maternal and paternal education were 0.32 (95 percent confidence interval: 0.14-0.71) and 0.45 (95 percent confidence interval: 0.23-0.88), respectively. No relationship between maternal occupation or household income and the risk of children's dental caries was found. CONCLUSIONS Higher levels of parental education, in particular maternal education, may be associated with reduced risk of dental caries in preschool children.
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Affiliation(s)
- Keiko Tanaka
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Blumfield ML, Hure AJ, Macdonald-Wicks L, Smith R, Collins CE. A systematic review and meta-analysis of micronutrient intakes during pregnancy in developed countries. Nutr Rev 2013; 71:118-32. [PMID: 23356639 DOI: 10.1111/nure.12003] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Micronutrient status during pregnancy influences maternal and fetal health, birth outcomes, and the risk of chronic disease in offspring. Research reporting dietary intake during pregnancy in nationally representative population samples, however, is limited. This review summarizes the micronutrient intakes of pregnant women from developed countries and compares them with relevant national recommendations. A systematic search without date limits was conducted. All studies reporting the micronutrient intakes of pregnant women were considered, irrespective of design. Two authors independently identified studies for inclusion and assessed methodological quality. Nutritional adequacy was summarized, with confounding factors considered. Meta-analysis data are reported for developed countries collectively, by geographical region, and by dietary methodology. Pregnant women in developed countries are at risk of suboptimal micronutrient intakes. Folate, iron, and vitamin D intakes were consistently below nutrient recommendations in each geographical region, and calcium intakes in Japan were below the Japanese recommendations and the average intake levels in other developed countries. Research examining the implications of potential nutrient insufficiency on maternal and offspring health outcomes is needed along with improvements in the quality of dietary intake reporting.
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Affiliation(s)
- Michelle L Blumfield
- School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia
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Blumfield ML, Hure AJ, Macdonald-Wicks L, Smith R, Collins CE. Systematic review and meta-analysis of energy and macronutrient intakes during pregnancy in developed countries. Nutr Rev 2012; 70:322-36. [PMID: 22646126 DOI: 10.1111/j.1753-4887.2012.00481.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Research reporting diet during pregnancy in nationally representative samples is limited. This review summarizes the dietary intakes of pregnant women in developed countries and compares them with national recommendations. A systematic search without date limits was conducted. All studies reporting the macronutrient intakes of pregnant women were considered, irrespective of design. Two authors independently identified the studies to be included and assessed the methodological quality. Nutritional adequacy was summarized, with confounding factors considered. Meta-analysis data are reported for developed countries collectively, by geographical region, and by dietary methodology. Energy and macronutrient intakes of pregnant women do not match national recommendations. Energy and fiber intakes were consistently below recommendations, while total fat and saturated fat intakes were generally above recommendations and carbohydrate and polyunsaturated fat intakes were below to borderline low compared with recommendations. A mismatch between dietary practices and macronutrient recommendations in pregnant women is widespread and not well quantified. The implications of these practices are unknown until further research compares maternal diet with short-term and long-term maternal and offspring health outcomes.
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Affiliation(s)
- Michelle L Blumfield
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health, University of Newcastle, Australia
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Nishikitani M, Nakao M, Tsurugano S, Yano E. The possible absence of a healthy-worker effect: a cross-sectional survey among educated Japanese women. BMJ Open 2012; 2:bmjopen-2012-000958. [PMID: 22964114 PMCID: PMC3467618 DOI: 10.1136/bmjopen-2012-000958] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Despite being highly educated in comparison with women in other member countries of the Organisation for Economic Cooperation and Development, Japanese women are expected to assume traditional gender roles, and many dedicate themselves to full-time housewifery. Women working outside the home do so under poor conditions, and their health may not be better than that of housewives. This study compared the self-rated health status and health behaviours of housewives and working women in Japan. DESIGN Cross-sectional survey. SETTING A national university in Tokyo with 9864 alumnae. PARTICIPANTS A total 1344 women who graduated since 1985 and completed questionnaires in an anonymous mail-based survey. PRIMARY AND SECONDARY OUTCOME MEASURES Health anxiety and satisfaction, receipt of health check-ups, eating breakfast, smoking, and sleep problems according to job status and family demands: housewives (n=247) and working women with (n=624) and without (n=436) family demands. ORs were used for risk assessment, with housewives as a reference. RESULTS After adjustment for satisfaction with present employment status and other confounding factors, working women were more likely than housewives to feel health anxiety (with family demands, OR: 1.68, 95% CI1.10 to 2.57; without family demands, OR: 3.57, 95% CI 2.19 to 4.50) and health dissatisfaction (without family demands, OR: 3.50, 95% CI 2.35 to 5.21); they were also more likely than housewives to eat an insufficient breakfast (with family demands, OR: 1.91, 95% CI 1.22 to 3.00; without family demands, OR: 4.02, 95% CI 2.47 to 6.57) and to have sleep problems (ORs: 2.08 to 4.03). CONCLUSIONS No healthy-worker effect was found among Japanese women. Housewives, at least those who are well educated, appear to have better health status and health-related behaviours than do working women with the same level of education.
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Affiliation(s)
- Mariko Nishikitani
- Department of Environmental Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Mutsuhiro Nakao
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinobu Tsurugano
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Eiji Yano
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
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Abstract
A rising prevalence of CVD and diabetes has been observed in sub-Saharan Africa, particularly in cities. The aim of the present study conducted in Benin was to examine the mediating role of nutrition transition in the relationship of urbanisation level and socio-economic status (SES) to cardiometabolic risk markers. A total of 541 subjects in apparent good health were randomly selected from the main city of Cotonou, a small town and its surrounding rural areas. SES was assessed based on a proxy for income and on education. Dietary intake and physical activity were assessed with at least two non-consecutive 24 h recalls. Scores for micronutrient adequacy and preventive diet were used as indicators of diet quality. Cardiometabolic risk markers were BMI, waist circumference (WC), blood pressure, serum cholesterol and insulin resistance according to homeostasis model assessment. A more advanced stage of nutrition transition, which correlated with lower diet quality scores and less physical activity, was observed in the large city compared with less urbanised locations. More obesity and more adverse cholesterol profiles, but also lower blood pressure, were present in the large city. Urbanisation, income, sedentary lifestyle and alcohol consumption, but not diet quality, independently contributed to higher BMI and WC. Higher micronutrient adequacy was independently associated with a better cholesterol profile. The study confirmed the positive rural-urban gradient in nutrition transition and cardiometabolic risk, except for blood pressure. This risk could be mitigated by a more adequate diet, particularly micronutrient intake, and a more active lifestyle.
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Pu C, Huang N, Chou YJ. Do agreements between adolescent and parent reports on family socioeconomic status vary with household financial stress? BMC Med Res Methodol 2011; 11:50. [PMID: 21501531 PMCID: PMC3103482 DOI: 10.1186/1471-2288-11-50] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Accepted: 04/19/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many studies compared the degree of concordance between adolescents' and parents' reports on family socioeconomic status (SES). However, none of these studies analyzed whether the degree of concordance varies by different levels of household financial stress. This research examines whether the degree of concordance between adolescents' and parent reports for the three traditional SES measures (parental education, parental occupation and household income) varied with parent-reported household financial stress and relative standard of living. METHODS 2,593 adolescents with a mean age of 13 years, and one of their corresponding parents from the Taiwan Longitudinal Youth Project conducted in 2000 were analyzed. Consistency of adolescents' and parents' reports on parental educational attainment, parental occupation and household income were examined by parent-reported household financial stress and relative standard of living. RESULTS Parent-reported SES variables are closely associated with family financial stress. For all levels of household financial stress, the degree of concordance between adolescent's and parent's reports are highest for parental education (κ ranging from 0.87 to 0.71) followed by parental occupation (κ ranging from 0.50 to 0.34) and household income (κ ranging from 0.43 to 0.31). Concordance for father's education and parental occupation decreases with higher parent-reported financial stress. This phenomenon was less significant for parent-reported relative standard of living. CONCLUSIONS Though the agreement between adolescents' and parents' reports on the three SES measures is generally judged to be good in most cases, using adolescents reports for family SES may still be biased if analysis is not stratified by family financial stress.
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Affiliation(s)
- Christy Pu
- Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Jones LG, Zhang Y, Ahmed MI, Ekundayo OJ, Akhter S, Sawyer P, Aban I, Sims RV, Ahmed A. Understanding the reasons for the underuse of pneumococcal vaccination by community-dwelling older African Americans. J Am Geriatr Soc 2011; 58:2323-8. [PMID: 21143440 DOI: 10.1111/j.1532-5415.2010.03181.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To understand the potential roles of various patient and provider factors in the underuse of pneumococcal vaccination in Medicare-eligible older African Americans. DESIGN The Cardiovascular Health Study. SETTING Four U.S. states. PARTICIPANTS Seven hundred ninety-five pairs of community-dwelling Medicare-eligible African-American and white adults aged 65 and older, balanced according to age and sex. MEASUREMENTS Data on self-reported race, receipt of pneumococcal vaccination, and other important sociodemographic and clinical variables were collected at baseline. RESULTS Participants had a mean age ± standard deviation of 73 ± 6; 63% were female. Pneumococcal vaccination rates were 22% for African Americans and 28% for whites (unadjusted odds ratios (OR) for African Americans=0.75; 95% confidence interval (CI)=0.60-0.94; P=.01). This association remained significant despite adjustment for sociodemographic and clinical confounders, including education, income, chronic obstructive pulmonary disease, and prior pneumonia (OR=0.74, 95% CI=0.56-0.97; P=.03), but the association was no longer significant after additional adjustment for the receipt of influenza vaccination (OR=0.79, 95% CI=0.59-1.06; P=.12). Receipt of influenza vaccination was associated with higher odds of receiving pneumococcal vaccination (unadjusted OR=6.43, 95% CI=5.00-8.28; P<.001), and the association between race and pneumococcal vaccination lost significance when adjusted for influenza vaccination alone (OR=0.81, 95% CI=0.63-1.03; P=.09). CONCLUSION The strong association between receipt of influenza and pneumococcal vaccinations suggests that patient and provider attitudes toward vaccination, rather than traditional confounders such as education and income, may help explain the underuse of pneumococcal vaccination in older African Americans.
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Affiliation(s)
- Linda G Jones
- Section of Geriatrics and Extended Care, Veterans Affairs Medical Center, Birmingham, Alabama, USA
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Sukchan P, Liabsuetrakul T, Chongsuvivatwong V, Songwathana P, Sornsrivichai V, Kuning M. Inadequacy of nutrients intake among pregnant women in the deep south of Thailand. BMC Public Health 2010; 10:572. [PMID: 20863408 PMCID: PMC2958163 DOI: 10.1186/1471-2458-10-572] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 09/24/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The deep south of Thailand is an area which has been affected by violence since 2004, yet the concurrent coverage of antenatal care has remained at over 90%. Our study aimed to describe the prevalence of nutrient inadequacy among pregnant women who attended antenatal care clinics in hospitals in the study area and assess factors associated with nutrient inadequacy. METHODS Pregnant women from four participating hospitals located in lower southern Thailand were surveyed during January-December 2008. Nutrient intake was estimated based on information provided by the women on the amount, type and frequency of various foods eaten. Logistic regression was used to assess individual and community factors associated with inadequate nutrient intake, defined as less than two thirds of the recommended dietary allowance (RDA). RESULTS The prevalence of carbohydrate, protein, fat, calories, calcium, phosphorus, iron, thiamine, riboflavin, retinol, niacin, vitamin C, folic acid and iodine inadequacy was 86.8%, 59.2%, 78.0%, 83.5%, 55.0%, 29.5%, 45.2%, 85.0%, 19.2%, 3.8%, 43.2%, 0.8%, 0.0% and 0.8%, respectively. Maternal age, education level, gestational age at enrollment and pre-pregnancy body mass index and level of violence in the district were significantly associated with inadequacy of carbohydrate, protein, phosphorus, iron, thiamine and niacin intake. CONCLUSIONS Nutrient intake inadequacy among pregnant women was common in this area. Increasing levels of violence was associated with nutrient inadequacy in addition to individual factors.
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Affiliation(s)
- Phnom Sukchan
- Development of Health Strategy Unit, Narathiwat Provincial Public Health Office, Narathiwat 96000, Thailand.
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Bödecs T, Horváth B, Szilágyi E, Sándor J. The effects of demographic factors on the folate-supplementation and health-behavior in pregnant women. Orv Hetil 2010; 151:494-500. [DOI: 10.1556/oh.2010.28788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A szerzők a várandósok folsavszupplementációs és egyéb egészség-magatartási szokásait, illetve azok demográfiai tényezőkkel való összefüggéseit igyekeztek feltárni.
Módszer:
Szombathely város tíz védőnői körzetében populációs monitoringot hoztak létre, ahol 2008. február 1. és 2009. február 1. között minden terhességi nyilvántartásba kerülő nőről rendszeres adatgyűjtést folytattak.
Eredmények:
Az alacsonyabb életkor és iskolai végzettség a gyermekvállalásra való felkészülés esélyét csökkentette. A gyermekvállalásra tudatosan készülők közül több mint kétszer annyian vittek be folsavat, háromszor annyian vittek be vitaminokat és csaknem feleannyian dohányoztak. A folsavszupplementáció esélyét a magasabb életkor és szocioökonómiai státus, valamint a felsőfokú végzettség szignifikánsan növelte, míg a testvérek száma csökkentette. Az érettséginél alacsonyabb végzettségűek nagyobb eséllyel dohányoztak (EH = 4,72; 95% MT = 2,34–9,51), mint a felsőfokú végzettségűek, csakúgy, mint az élettársi kapcsolatban élők a házasságban élőkhöz képest (EH = 2,74; 95% MT = 1,54–4,89).
Következtetések:
A folsavszupplementációban nem részesülők főleg a fiatalok, az alacsony képzettséggel és jövedelemmel rendelkezők köréből kerülnek ki, ugyanők egyéb vonatkozásban is kedvezőtlen egészség-magatartást folytatnak.
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Affiliation(s)
- Tamás Bödecs
- 1 Pécsi Tudományegyetem, Egészségtudományi Kar Népegészségtani, Rekreációs és Egészségfejlesztési Intézet, Védőnői Tanszék Szombathely Jókai út 14. 9700
| | - Boldizsár Horváth
- 2 Pécsi Tudományegyetem, Egészségtudományi Kar Ápolás és Betegellátás Intézet, Szülésznői Tanszék Szombathely
| | - Enikő Szilágyi
- 3 Vas Megyei Markusovszky Kórház Pszichiátriai Osztály Szombathely
| | - János Sándor
- 4 Debreceni Egyetem, Népegészségügyi Kar Megelőző Orvosi Intézet, Biostatisztikai és Epidemiológiai Tanszék Debrecen
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