Associations of maternal diet quality with weight gain during pregnancy and obesity at three-year postpartum in Jakarta

Higher Diet Quality Observed in Pregnant Women Compared to Women Living with and without Children in the US: NHANES 2011-2016

BACKGROUND

Women of reproductive age are a critical part of the population because their dietary habits and nutritional status impact the nutritional trajectory of future generations. Various studies have assessed the diet quality among women of reproductive age, but few studies have compared the diet quality of these women across the different life stages.

OBJECTIVE

To compare the diet quality among pregnant women, women living with children and women living without children in the United States of America (USA) using the Healthy Eating Index (HEI).

METHODS

This cross-sectional study was a secondary data analysis of the National Health and Nutrition Survey (NHANES), 2011-2016. Study participants comprised a total of 7120 women, ages 20-44 years in one of three life stage categories, pregnant women, women living in households with and without children less than 18 years. The HEI 2015 was used to assess the overall diet quality score as well as 13 dietary component scores-whole fruit, total fruit, greens and beans, whole grains, total vegetables, total protein foods, fatty acids, seafood and plant proteins, dairy, saturated fat, sodium, refined grains, and added sugars. The differences in HEI scores by life stage was assessed using linear regression models, adjusting for marital status, age, race and ethnicity, poverty index ratio, and educational status.

RESULTS

The mean overall HEI score of participants was 52.0 out of 100 points. The overall HEI scores of pregnant women was significantly higher than women living with and without children respectively (β = 4.6 ± 1.42, p = 0.002; β = 3.7 ± 1.34, p = 0.009). Also, pregnant women had significantly higher scores for whole fruit (β = 0.99 ± 0.18, p < 0.001; β = 0.98 ± 0.17, p < 0.001), dairy (β = 0.63 ± 0.27, p = 0.02; β = 0.68 ± 0.29, p = 0.02) and whole grains (β = 1.05 ± 0.40, p = 0.01; β = 0.97 ± 0.39, p = 0.02) than women living with and without children respectively. On the other hand, women living without children had significantly higher scores for total vegetables (β = 0.18 ± 2.04, p = 0.002), refined grains (β = 0.22 ± 0.10, p = 0.03) and added sugars (β = 0.35 ± 0.16, p = 0.04) than women living with children.

CONCLUSION

Pregnant women had the highest diet quality while women living in households with children had the lowest diet quality among the studied population.

Associations of Diet Quality, Socioeconomic Factors, and Nutritional Status with Gestational Weight Gain among Pregnant Women in Dar es Salaam, Tanzania

Background

Gestational weight gain (GWG) is a modifiable factor associated with maternal and child health outcomes, but the relationship between diet quality and GWG has not been evaluated using metrics validated for low-income and middle-income countries (LMICs).

Objective

This study aimed to investigate relationships between diet quality, socioeconomic characteristics, and GWG adequacy using the novel Global Diet Quality Score (GDQS), the first diet quality indicator validated for use across LMIC.

Methods

Weights of pregnant women enrolled between 12 and 27 wk of gestation (N = 7577) were recorded in Dar es Salaam, Tanzania, from 2001 to 2005 during a prenatal micronutrient supplementation trial. GWG adequacy was the ratio of measured GWG to Institute of Medicine-recommended GWG, categorized into severely inadequate (<70%), inadequate (70 to <90%), adequate (90 to <125%), or excessive (≥125%). Dietary data were collected using 24-h recalls. Multinomial logit models were used to estimate relationships between GDQS tercile, macronutrient intake, nutritional status, and socioeconomic characteristics and GWG.

Results

GDQS scores in the second [relative risk (RR): 0.82; 95% confidence interval (CI): 0.70, 0.97] tercile were associated with lower risk of inadequate weight gain than those in the first tercile. Increased protein intake was associated with higher risk of severely inadequate GWG (RR: 1.06; 95% CI: 1.02, 1.09). Nutritional status and socioeconomic factors were associated with GWG: underweight prepregnancy BMI (in kg/m2) with a higher risk of severely inadequate GWG (RR: 1.49; 95% CI: 1.12, 1.99), overweight or obese BMI with a higher risk of excessive GWG (RR: 6.80; 95% CI: 5.34, 8.66), and a higher education (RR: 0.61; 95% CI: 0.42, 0.89), wealth (RR: 0.68; 95% CI: 0.48, 0.80), and height (RR: 0.96; 95% CI: 0.95, 0.98) with a lower risk of severely inadequate GWG.

Conclusions

Dietary indicators showed few associations with GWG. However, stronger relationships were revealed between GWG, nutritional status, and several socioeconomic factors.This trial was registered at clinicaltrials.gov as NCT00197548.

Energy Intake and Food Restriction as Determinant Factors of Chronic Energy Deficiency among Pregnant Women in Rural Area of Sungai Sembilan, Riau, Indonesia

BACKGROUND OF THE STUDY: Maternal malnutrition is a major public health problem in Indonesia which is shown by high prevalence of chronic energy deficiency (CED) among pregnant women. CED was expressed by the measurement of Mid Upper Arm Circumference (MUAC) showing value less than 23.5 cm. AIM OF THE STUDY: This study aimed to identify the factors associated with chronic energy deficiency among pregnant women in rural area, Riau Province. METHODOLOGY: A community- based cross sectional study was conducted among 130 samples of pregnant women in Sungai Sembilan Community Health Center in June 2020. Data was collected using structured and field-study questionnaires. Mid Upper Arm Circumference (MUAC) was measured by MUAC tape. Energy and protein intake were assessed using 24-hour food recall. Multiple logistic regression was employed to analyse factors associated with CED by using SPSS version 20. RESULTS: The prevalence of CED among pregnant women was 64.9%. Age of mothers, food restriction, infection disease status, protein and energy intake were associated significantly with CED. Furthermore, energy intake and food restriction in pregnancy were risk factors of CED (AOR = 3.04, 95% CI: 1.1 – 8.3 and AOR = 6.73, 95% CI: 1.33 – 33.9, respectively). We found that proportion of energy intake below 80% RDA and mothers with food restriction were higher among CED group. CONCLUSION: High prevalence of chronic energy deficiency (CED) was found among pregnant women. Hence, innovative intervention was required to overcome this problem.

Gestational obesity: An unconventional endocrine disruptor for the fetus

Obesity has reached pandemic proportions and is a growing concern throughout the world. A parallel trend has also been observed among women in reproductive age, leading to the increasing global prevalence of gestational obesity (GO). The well-known obesity-related health problems also extend to pregnancy, where they are responsible for giving rise to a variety of medical and obstetrical complications, resulting in an increased incidence of adverse maternal and fetal outcomes. In this context, several epidemiological and clinical studies have shown that nutritional changes through different stages of gestation can have a substantial impact on the future health and development of the child. Therefore, it is clear that GO is a modifiable endocrine disruptor that negatively influences the health of the fetus and the newborn, with long-term metabolic implications. This review aims to describe the impact of GO on maternal and fetal outcomes using the available scientific literature and highlighting the evidence-based nutritional approaches currently recommended for the management of GO.