Women lacking pre-pregnancy nutritional education, warns study

The study​, ​published in the Journal of the Academy of Nutrition and Dietetics​, looked at data from more than 7,5000 women without children from 2010 to 2013 - finding that those who were non-Hispanic black, Hispanic or those less educated than a college degree had a diet which was sub-optimal before conception.

In those measured, on average, the main sources of iron, folate and Vitamin C were from juice and enriched bread.

The team behind the study said the problem could be remedied by adding more seafood, legumes, vegetables and whole grains into the diets of peri-conceptional women.

‘Below Average Scores’

The study ultimately found that the top sources of energy for women three months surrounding conception were sofa, pasta, cookies, cakes, refined bread, beer, wine and spirits.

Pizza was a common source of fat and iron.

By using food Frequency Questionnaires (FFQs) the women were given scores on the Healthy Eating Index 2010 (HEI-2010).

The HEI-2010 assesses 12 key aspects of diet quality, nine of which focus on adequacy and three focus on moderation.

The average score for all participants was 63, with a standard deviation of ± 13 points, out of a possible 100.

Non-Hispanic white women were found to have the highest scores, followed by Hispanic women and then non-Hispanic black women.

Almost half of the non-Hispanic black women had an HEI-2010 score in the lowest quintile, of which the median score was 46.

Less than 10% of all participants met the guidelines for whole grains, fatty acids, sodium, and empty calories categories, with most participants consuming nutrients through cheese, juices and ready-to-eat cereals.

Women in the study who had at least a college degree were found to have a higher Vitamin C intake on average.

Speaking in the report, Dr. Lisa Bodnar et al.​ said: “The diet quality gap among non-pregnant individuals is thought to be a consequence of many factors, including the access to and price of healthy foods, knowledge of a healthy diet, and pressing needs that may take priority over a healthful diet”.​

Maternal nutrition has been shown to have an influence on offspring’s health and weight in later life.

Poor periconception nutrition could also lead to postpartum weight retention in mothers.

“Structural interventions that promote an environment conducive to making healthy dietary choices should be considered,”​ added lead author, Bodnar, “Such collective actions may be more likely to influence low socioeconomic populations, thereby reducing health disparities and improving health outcomes for women and their children”.​

The study​

The objective of the study was to evaluate whether racial or ethnic and educational inequalities were a factor in the overall nutrition of periconceptional women in the United States.

Women who were less than 14 weeks into their first pregnancy were measured across eight medical centres in the US: Case Western Reserve University; Columbia University; Indiana University; University of Pittsburgh; Northwestern University; University of California at Irvine; University of Pennsylvania; and the University of Utah.

Participants self-reported their level of educational, race and ethnicity, smoking status, marital status, medical insurance and the number of times they had been pregnant before.

Women were not allowed to participate if: they were under the age of 13; had a history of three or more miscarriages; planning a pregnancy termination; having a donor oocyte pregnancy; detected malformations likely to be lethal; or had aneuploidies (chromosome abnormalities) known at enrolment.

Source: Journal of the Academy of Nutrition and Dietetics​
doi: 10.1016/j.jand.2017.01.016.
“Racial or Ethnic and Socioeconomic Inequalities in Adherence to National Dietary Guidance in a Large Cohort of US Pregnant Women”.​
Authors: Lisa M. Bodnar, et al.​