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Mazzuca G, Artusa S, Pietrobelli A, Di Cara G, Piacentini G, Pecoraro L. The Future for the Children of Tomorrow: Avoiding Salt in the First 1000 Days. CHILDREN (BASEL, SWITZERLAND) 2024; 11:98. [PMID: 38255411 PMCID: PMC10814202 DOI: 10.3390/children11010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024]
Abstract
It is widely known that optimal nutrition in the first 1000 days of life positively impacts the child's development throughout adulthood. In this setting, salt should not be added to complementary feeding. In developed countries, salt intake is generally higher than recommended for children. Excessive salt intake is the major determinant of hypertension and is associated with several cardiovascular outcomes. Therefore, pediatricians have a key role in raising awareness among parents to avoid salt consumption in the first 1000 days of life to ensure better health for their children. Starting from a review of the literature published in PubMed/MedLine regarding the short- and long-term consequences of salt consumption during the first 1000 days of life, our comprehensive review aims to analyze the beneficial effects of avoiding salt at such a vulnerable stage of life as the first 1000 days. Obesity, hypertension, increased salt sensitivity, high sweet drink consumption, increased mortality, and morbidity persisting in adult age represent the principal consequences of a higher salt intake during the first 1000 days of life.
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Affiliation(s)
- Giorgia Mazzuca
- Pediatric Clinic, Department of Surgical Sciences, Dentistry, Pediatrics and Gynecology, University of Verona, 37126 Verona, Italy; (G.M.)
| | - Silvia Artusa
- Pediatric Clinic, Department of Surgical Sciences, Dentistry, Pediatrics and Gynecology, University of Verona, 37126 Verona, Italy; (G.M.)
| | - Angelo Pietrobelli
- Pediatric Clinic, Department of Surgical Sciences, Dentistry, Pediatrics and Gynecology, University of Verona, 37126 Verona, Italy; (G.M.)
| | - Giuseppe Di Cara
- Department of Pediatrics, University of Perugia, 06129 Perugia, Italy
| | - Giorgio Piacentini
- Pediatric Clinic, Department of Surgical Sciences, Dentistry, Pediatrics and Gynecology, University of Verona, 37126 Verona, Italy; (G.M.)
| | - Luca Pecoraro
- Pediatric Clinic, Department of Surgical Sciences, Dentistry, Pediatrics and Gynecology, University of Verona, 37126 Verona, Italy; (G.M.)
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Debbag R, Torres JR, Falleiros-Arlant LH, Avila-Aguero ML, Brea-del Castillo J, Gentile A, Saez-Llorens X, Mascarenas A, Munoz FM, Torres JP, Vazquez L, Safadi MA, Espinal C, Ulloa-Gutierrez R, Pujadas M, Lopez P, López-Medina E, Ramilo O. Are the first 1,000 days of life a neglected vital period to prevent the impact on maternal and infant morbimortality of infectious diseases in Latin America? Proceedings of a workshop of experts from the Latin American Pediatric Infectious Diseases Society, SLIPE. Front Pediatr 2023; 11:1297177. [PMID: 38098643 PMCID: PMC10720332 DOI: 10.3389/fped.2023.1297177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023] Open
Abstract
While the first 1,000 days of life are a critical period in child's development, limited information on the main determinants affecting this period in the Latin America and the Caribbean (LAC) region is available. Therefore, the Latin American Pediatric Infectious Diseases Society (SLIPE) held an ad hoc workshop in May 2022 with an expert panel designed to analyze the main factors impacting the development of childhood in the region during this period and the main causes of maternal infant morbimortality. The aim was to identify priorities, generate recommendations, and advise practical actions to improve this situation. Considerations were made about the challenges involved in bridging the gap that separates the region from more developed countries regarding an optimal early childhood and maternal care. Extensive discussion was conducted to reach consensus recommendations on general strategies intended to reduce maternal and infant mortality associated with infections and immune-preventable diseases during the first 1,000 days of life in LAC.
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Affiliation(s)
- Roberto Debbag
- President of Sociedad Latinoamericana de Infectología Pediátrica, SLIPE, Buenos Aires, Argentina
| | - Jaime R. Torres
- Infectious Diseases Section, Tropical Medicine Institute, Universidad Central De Venezuela, Caracas, Venezuela
| | - Luiza H. Falleiros-Arlant
- Department of Children’s Health, Faculdade De Medicina, Universidade Metropolitana De Santos, Santos, Brazil
| | - Maria L. Avila-Aguero
- Infectious Diseases Service, Hospital Nacional De Niños “Dr. Carlos Sáenz Herrera”, Caja Costarricense De Seguro Social (CCSS), San José, Costa Rica
- Affiliated Researcher Center for Infectious Disease Modeling and Analysis (CIDMA) at Yale University, New Haven, CT, United States
| | - Jose Brea-del Castillo
- Associated Researcher, Investigador Asociado Hospital Dr. Hugo Mendoza, Santo Domingo, Republic Dominicana
| | - Angela Gentile
- Epidemiology Department, Hospital de Niños “Ricardo Gutiérrez”, Buenos Aires University, Buenos Aires, Argentina
| | - Xavier Saez-Llorens
- Head of Infectious Diseases and Director of Clinical Research, Hospital del Niño “Dr. José Renán Esquivel”, Panama City, Panama
| | - Abiel Mascarenas
- Department of Pediatric Infectious Diseases, Hospital Universitario “José E. Gonzalez”, Universidad Autónoma De Nuevo León, Nuevo Leon, México
| | - Flor M. Munoz
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Juan P. Torres
- Department of Pediatrics and Children Surgery, Universidad de Chile, Santiago, Chile
| | - Liliana Vazquez
- Pediatric Infectious Diseases, Clinica y Maternidad Suizo Argentina, Sanatorio Finochietto, Buenos Aires, Argentina
| | - Marco A. Safadi
- Department of Pediatrics, Faculda de de Ciências Médicas da Santa Casa de São Paulo, Sao Paulo, Brazil
| | - Carlos Espinal
- Global Health Consortium, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Rolando Ulloa-Gutierrez
- Infectious Diseases Service, Hospital Nacional De Niños “Dr. Carlos Sáenz Herrera”, Caja Costarricense De Seguro Social (CCSS), San José, Costa Rica
| | - Monica Pujadas
- Department of Epidemiology and Pediatric Infectious Diseases, Centro Hospitalario Pereira Rossell, Faculty of Medicine, Universidad de la República, Montevideo, Uruguay
| | - Pio Lopez
- Department of Pediatrics, Hospital Universitario del Valle, Cali, Colombia
| | - Eduardo López-Medina
- Centro de Estudios en Infectología Pediátrica CEIP, Department of Pediatrics, Universidad del Valle, Clinica Imbanaco Grupo Quironsalud, Cali, Colombia
| | - Octavio Ramilo
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, United States
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Delgado Ojeda J, Santamaría Orleans A. [Early life nutrition and immunity]. NUTR HOSP 2023; 40:16-19. [PMID: 37929892 DOI: 10.20960/nh.04948] [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] [Indexed: 11/07/2023] Open
Abstract
Introduction The first 1,000 days of life, from conception to two years of age, are a critical time window for human growth and development, since the interaction of different factors can generate relevant changes in different structures and functions of the organism, both at short and long term. Most of the studies in this area have been carried out in the prenatal and neonatal period. Some of the most relevant factors that can affect immune development at this time are smoking, maternal obesity and inadequate intake of micronutrients during pregnancy. In the case of the postnatal period, breastfeeding is primarily the most important factor related to the nutritional and immunological status of the newborn, also being associated with a protective effect against obesity. Subsequently, the proper introduction of complementary feeding will be essential to offer an adequate percentage of nutrients. Likewise, the intestinal microbiota also plays a key role during this period since it is part of different metabolic, protective, and immunological functions of the host. Fluctuations in homeostasis will condition the appearance of dysbiosis, which is associated with the development of different diseases in childhood, adolescence, and adulthood.
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Belesova K, Gasparrini A, Wilkinson P, Sié A, Sauerborn R. Child Survival and Annual Crop Yield Reductions in Rural Burkina Faso: Critical Windows of Vulnerability Around Early-Life Development. Am J Epidemiol 2023; 192:1116-1127. [PMID: 37116074 PMCID: PMC10326605 DOI: 10.1093/aje/kwad068] [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: 11/14/2021] [Revised: 10/02/2022] [Accepted: 03/21/2023] [Indexed: 04/30/2023] Open
Abstract
Populations that are reliant on subsistence farming are particularly vulnerable to climatic effects on crop yields. However, empirical evidence on the role of the timing of exposure to crop yield deficits in early-life development is limited. We examined the relationship between child survival and annual crop yield reductions at different stages of early-life development in a subsistence farming population in Burkina Faso. Using shared frailty Cox proportional hazards models adjusting for confounders, we analyzed 57,288 children under 5 years of age followed by the Nouna Health and Demographic Surveillance System (1994-2016) in relation to provincial food-crop yield levels experienced in 5 nonoverlapping time windows (12 months before conception, gestation, birth-age 5.9 months, ages 6.0 months-1.9 years, and ages 2.0-4.9 years) and their aggregates (birth-1.9 years, first 1,000 days from conception, and birth-4.9 years). Of the nonoverlapping windows, point estimates were largest for child survival related to food-crop yields for the time window of 6.0 months-1.9 years: The adjusted mortality hazard ratio was 1.10 (95% confidence interval: 1.03, 1.19) for a 90th-to-10th percentile yield reduction. These findings suggest that child survival in this setting is particularly vulnerable to cereal-crop yield reductions during the period of nonexclusive breastfeeding.
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Affiliation(s)
- Kristine Belesova
- Correspondence to Dr. Kristine Belesova, Department of Department of Primary Care and Public Health, Faculty of Medicine, Imperial College London, Reynolds Building, St. Dunstan's Road, London W6 8RP, United Kingdom (e-mail: )
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Gsoellpointner M, Eibensteiner F, Thanhaeuser M, Ristl R, Jilma B, Berger A, Haiden N. Effects of early introduction of solid foods on nutrient intake in preterm infants during their 1st year of life: a secondary outcome analysis of a prospective, randomized intervention study. Front Nutr 2023; 10:1124544. [PMID: 37275631 PMCID: PMC10232899 DOI: 10.3389/fnut.2023.1124544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/21/2023] [Indexed: 06/07/2023] Open
Abstract
Very low birth weight (VLBW) infants have higher nutritional needs even after hospital discharge. However, data concerning current nutrient intakes at different time points after the introduction of solid foods and whether dietary reference values are being met are scarce. To adress this issue, this secondary analysis of a prospective, two-arm interventional study in 177 VLBW infants 21 investigates dietary intake comparing early and late (early: 10-12 weeks corrected for gestational age, late: 16-18 weeks corrected for gestational age) introduction of standardized complementary food during the first year of life. Nutritional intake was assessed using self-reported monthly 3-day dietary records from 3 until 12 months, corrected for gestational age. The time point of the introduction of solid foods did not influence nutrient intake, but the early introduction of solids tended toward a higher proportional intake of protein and carbohydrates and a lower intake of fat as a percentage of total energy) during the 1st year of life, corrected for gestational age. The results of this study indicate that this standardized feeding concept was sufficient for zinc, calcium, and phosphorus intake. However, dietary iron and vitamin D intakes did not meet the recommendations. Thus, prolonged iron supplementation should be considered beyond the introduction of meat and vitamin D supplementation at least until 12 months, corrected for gestational age. Trial registration number ClinicalTrials.gov: NCT01809548.
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Affiliation(s)
| | - Fabian Eibensteiner
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Margarita Thanhaeuser
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Robin Ristl
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Angelika Berger
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Nadja Haiden
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Doggui R, McCormick BJ, Caulfield LE, Schulze KJ, Murray-Kolb LE. Adequacy of Iodine Status and Associations with Gut Health: A Prospective Cohort Study among Infants in 8 Low- and Middle-Income Countries. J Nutr 2023; 153:828-838. [PMID: 36797135 DOI: 10.1016/j.tjnut.2022.11.027] [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: 06/18/2022] [Revised: 10/25/2022] [Accepted: 11/15/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Environmental enteric dysfunction increases the likelihood of micronutrient deficiencies among infants, but few studies have assessed the potential impact of gut health on urinary iodine concentration (UIC) among this vulnerable group. OBJECTIVES We describe the trends of iodine status among infants from 6 to 24 mo old and examine the associations between intestinal permeability, inflammation, and UIC from 6 to 15 mo of age. METHODS Data from 1557 children enrolled in this birth cohort study conducted in 8 sites were included in these analyses. UIC was measured at 6, 15, and 24 mo of age by using the Sandell-Kolthoff technique. Gut inflammation and permeability were assessed using the concentrations of fecal neopterin (NEO), myeloperoxidase (MPO) and alpha-1-antitrypsin (AAT), and lactulose-mannitol ratio (LM). A multinomial regression analysis was used to assess the classified UIC (deficiency or excess). Linear mixed regression was used to test the effect of interactions among biomarkers on logUIC. RESULTS All studied populations had adequate (≥100 μg/L) to excess (≥371 μg/L) median UIC at 6 mo. Between 6 and 24 mo, 5 sites displayed a significant decline in the infant's median UIC. However, median UIC remained within the optimal range. An increase of NEO and MPO concentrations by +1 unit in ln scale reduced the risk of low UIC by 0.87 (95% CI: 0.78-0.97) and 0.86 (95% CI: 0.77-0.95), respectively. AAT moderated the association between NEO and UIC (P < 0.0001). The shape of this association appears to be asymmetric and in a reverse J-shape, with a higher UIC observed at both lower NEO and AAT concentrations. CONCLUSIONS Excess UIC was frequent at 6 mo and tended to normalize at 24 mo. Aspects of gut inflammation and increased permeability appear to reduce the prevalence of low UIC in children aged 6 to 15 mo. Programs addressing iodine-related health should consider the role of gut permeability in vulnerable individuals.
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Affiliation(s)
- Radhouene Doggui
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
| | | | - Laura E Caulfield
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kerry J Schulze
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA; Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
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Likhar A, Patil MS. Importance of Maternal Nutrition in the First 1,000 Days of Life and Its Effects on Child Development: A Narrative Review. Cureus 2022; 14:e30083. [DOI: 10.7759/cureus.30083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022] Open
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Breastfeeding, Complementary Feeding, Physical Activity, Screen Use, and Hours of Sleep in Children under 2 Years during Lockdown by the COVID-19 Pandemic in Chile. CHILDREN 2022; 9:children9060819. [PMID: 35740756 PMCID: PMC9221584 DOI: 10.3390/children9060819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022]
Abstract
Infants and children are a risk group in terms of developing healthy habits, an important aspect if we consider that many of them were born during the COVID-19 pandemic. Our objective was to evaluate compliance with lifestyle recommendations proposed at the national and international levels in children aged 0 to 23 months during confinement due to the COVID-19 pandemic in Chile. A cross-sectional study was conducted, and 211 online questionnaires were completed with sociodemographic and lifestyle information of children. Our results show high compliance with the recommendations on breastfeeding intake (78.3% and 69.5% in 0–5-month-old and 6–23-month-old children, respectively); age of starting complementary feeding (87.4%); non-consumption of salt and sugar (80.1%), non-caloric sweeteners (90.7%), and sweet and salty snacks (68.9%); and hours of physical activity (66.8%) and sleep (65.4%). However, we observed low compliance with the recommendations on the age of introduction of dinner (58.0%), eggs (23.0%), legumes (39.2%), and fish (35.1%); low consumption of legumes (43.4%) and fish (20.5%); and low compliance with the recommendations on screen use during meals (59.2%) and daily screen hours (41.2%). In conclusion, feeding behavior, physical activity, use of screens, and hours of sleep in children were altered by confinement during the pandemic, harming the development of healthy lifestyles.
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Perceived neighbourhood food access is associated with consumption of animal-flesh food, fruits and vegetables among mothers and young children in peri-urban Cambodia. Public Health Nutr 2022; 25:717-728. [PMID: 34593072 PMCID: PMC9991642 DOI: 10.1017/s1368980021004122] [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: 11/07/2022]
Abstract
OBJECTIVE To examine whether mothers' perceived neighbourhood food access is associated with their own and their young children's consumption of animal-flesh food, fruits and vegetables in peri-urban areas of Cambodia. DESIGN A cross-sectional survey measured food consumption frequency and perceived neighbourhood food access, the latter including six dimensions of food availability, affordability, convenience, quality, safety and desirability. Multivariate logistic regression was used to assess the association between perceived food access and food consumption. SETTING Peri-urban districts of Phnom Penh and Siem Reap, Cambodia. PARTICIPANTS 198 mothers of children between 6 and 24 months old. RESULTS Over 25 % of the mothers and 40 % of the children had low consumption (< once a day) of either animal-flesh food or fruits and vegetables. Compared with perceived high food access, perceived low food access was associated with an adjusted 5·6-fold and 4·3-fold greater odds of low animal-flesh food consumption among mothers (95 % CI 2·54, 12·46) and children (95 % CI 2·20, 8·60), respectively. Similarly, relative to perceived high food access, perceived low food access was associated with 7·6-times and 5·1-times higher adjusted odds of low fruits and vegetables consumption among mothers (95 % CI 3·22, 18·02) and children (95 % CI 2·69, 9·83), respectively. CONCLUSIONS Mothers' perceived neighbourhood food access was an important predictor of their own and their young children's nutrient-rich food consumption in peri-urban Cambodia. Future work is needed to confirm our findings in other urban settings and examine the role of neighbourhood food environment in the consumption of both nutrient-rich and nutrient-poor food.
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Abstract
The aim of this review is to summarise the common barriers and motivations for healthy food choice among adolescents, with a specific focus on the Irish context where available. It will also discuss other concerns adolescents have, which may influence their food choices and eating habits. Adolescence represents a period of rapid physical, mental and social development, and many health-related habits developed during adolescence tend to persist into adulthood, making the teenage years an optimal time to encourage healthy eating and health-promoting behaviours. Adolescents are concerned about the health impact of their diet, but their understanding of health is often seen in the context of their physical appearance or body image. Body image concerns are prevalent in adolescents, and this can affect their food choices. Taste, price and convenience are commonly noted factors influencing adolescents' food choices, and as they grow, their level of independence increases and spending more time with their peers means that social desirability and social norms about food become increasingly important factors in adolescent food choice. However, their limited autonomy means their supporting food environment also plays an important role. When developing more targeted interventions in adolescent populations, information on adolescent nutrition needs, their concerns for health and body image, and the barriers and motivations for healthy eating and food choice should be considered. Such a holistic approach should help support healthy eating and the prevention of overweight and obesity in the population, whilst also supporting a healthy relationship with food and their bodies.
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Dack K, Fell M, Taylor CM, Havdahl A, Lewis SJ. Prenatal Mercury Exposure and Neurodevelopment up to the Age of 5 Years: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041976. [PMID: 35206164 PMCID: PMC8871549 DOI: 10.3390/ijerph19041976] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/29/2022]
Abstract
Neurodevelopmental delays can interfere with children’s engagement with the world and further development, and may have negative consequences into adulthood. Mercury is highly toxic and may negatively influence neurodevelopment because it can freely cross the placenta and accumulate in the fetal brain. We searched four publication databases (Embase, PsycINFO, PubMed/MEDLINE, Scopus) for studies examining the relationship between early life mercury exposure and scores on neurodevelopmental performance measures in children aged 0 to 5 years old. Study quality was assessed using the National Institutes of Health (NIH) Quality Assessment Tool. Thirty-two prospective studies were included in the review. Neurodevelopmental performance was measured using 23 different scales, most commonly the Bayley Scales of Infant and Toddler Development (BSID). In most cases, the evidence for an association between mercury and neurodevelopment was weak. There did not appear to be exceptions for particular childhood ages, outcome scales, or mercury levels. The small number of results to the contrary were more likely to be studies which did not meet our high-quality criteria, and could be a consequence of multiple testing, selection bias, or incomplete confounder adjustment. Based on current evidence, dietary mercury exposure during pregnancy is unlikely to be a risk factor for low neurodevelopmental functioning in early childhood.
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Affiliation(s)
- Kyle Dack
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1TH, UK
- Correspondence:
| | - Matthew Fell
- Cleft Collective, University of Bristol, Bristol BS8 1TH, UK;
| | - Caroline M. Taylor
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK;
| | - Alexandra Havdahl
- Department of Mental Disorders, Norwegian Institute of Public Health, 0213 Oslo, Norway;
- Nic Waals Institute, Lovisenberg Diaconal Hospital, 0853 Oslo, Norway
| | - Sarah J. Lewis
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK;
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OUP accepted manuscript. Nutr Rev 2022; 80:2178-2197. [DOI: 10.1093/nutrit/nuac025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Garcia T, Duncanson K, Shrewsbury VA, Wolfson JA. A Qualitative Study of Motivators, Strategies, Barriers, and Learning Needs Related to Healthy Cooking during Pregnancy. Nutrients 2021; 13:nu13072395. [PMID: 34371903 PMCID: PMC8308614 DOI: 10.3390/nu13072395] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/01/2021] [Accepted: 07/07/2021] [Indexed: 02/04/2023] Open
Abstract
Nutrition during pregnancy has lifelong impacts on the health of mother and child. However, this life stage presents unique challenges to healthy cooking and eating. Cooking interventions show promising results, but often lack theoretical basis and rigorous evaluation. The objective of this formative, qualitative study was to explore motivators, strategies, and barriers related to healthy cooking during pregnancy. Pregnant individuals’ preferences for a cooking education program were also explored. We conducted five focus groups with pregnant individuals (n = 20) in Southeast Michigan in 2019. Focus groups were audio-recorded and transcribed verbatim, then double coded by two members of the research team. Mean gestational age was 18.3 ± 9.6 weeks. Common motivators included feeding other children, avoiding pregnancy complications, promoting fetal growth, and avoiding foodborne illness. Challenges included pregnancy symptoms, navigating nutrition recommendations, mental energy of meal planning, family preferences, and time constraints. Strategies employed were meal planning and including a variety of foods. Participants identified organizational strategies, recipes, nutrition information, and peer support as important components of a cooking intervention during pregnancy. This study characterized multiple challenges to healthy home cooking during pregnancy, providing novel insight to inform the development of cooking skills education programs during this important life stage.
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Affiliation(s)
- Travertine Garcia
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
- Department of Human Nutrition, Foods & Exercise, Virginia Tech, Blacksburg, VA 24061, USA
| | - Kerith Duncanson
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, Australia; (K.D.); (V.A.S.)
| | - Vanessa A. Shrewsbury
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, Australia; (K.D.); (V.A.S.)
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan 2308, Australia
| | - Julia A. Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
- Correspondence: ; Tel.: +410-955-3781
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