Objective To investigate primarily the dietary intake, as well as demographics and selected lifestyle factors, of women experiencing nausea and vomiting in pregnancy, nausea only, or women who are symptom free.Design Prospective cohort study.Setting The Norwegian Mother and Child Cohort Study, a population-based pregnancy cohort.Sample Analyses were based on 51 675 Norwegian pregnancies.Methods Dietary intake was assessed by a self-reported food frequency questionnaire answered in the first trimester of pregnancy, as were data regarding nausea and vomiting. Chi-squared tests, one-way analysis of variance, and multiple linear regression were used.Main outcome measures Nausea and vomiting in pregnancy (NVP), gestational weight gain (GWG), and dietary intake.Results We found that 17 070 (33%) women experienced NVP, 20 371 (39%) experienced only nausea, and 14 234 (28%) were symptom free. Women with NVP were younger and heavier at pregnancy onset, with the lowest GWG and highest energy intake during pregnancy, primarily from carbohydrates and added sugars, compared with the other groups (P < 0.001). In multiple linear regression analysis of GWG and group adjusted for body mass index (BMI), gestational length, smoking during pregnancy, and energy intake, a significant interaction was found between BMI and group (P < 0.001). A significant effect of group (P < 0.001) was found in all BMI strata, except among underweight women (P = 0.65).Conclusions Our study suggests that women with NVP are characterised by high intakes of carbohydrates and added sugar, primarily from sugar-containing soft drinks. Whether higher intakes of carbohydrates are a response aimed to alleviate symptoms, or are actually provoking the condition, is not known.
Several nutrition intervention programmes have been implemented to alleviate malnutrition among young children in South Africa. However, both nationwide studies and smaller, region-based reports show that many of these programmes have failed to improve nutritional health among the target groups. This is an overview of the most important nutrition intervention programmes implemented in post -apartheid South Africa. It is based on data sampled between 1994 and 2010, and collected from HighWire Press and MEDLINE data bases, local journals, official reports as well as experience gathered over the past two decades. Abstracts and nutrition issues related to chronic and communicable and non-communicable diseases were not included. The main aim of the implemented supplementation programmes after the Second World War was to correct states of undernutrition. However, these efforts did not benefit the disadvantaged groups, particularly the coloureds and the blacks. Following the downfall of the apartheid regime, various nutrition intervention programmes have been implemented with varying degrees of success. These include health facility-based programmes, community-based programmes as well as nutrition promotion strategies. The more holistic approach of the Integrated Nutrition Programme since 1994 is commendable, but programmes have failed to restore adequate growth rates among the impoverished children. Most likely, the failures are not as a result of inappropriate policies and strategies or lack of knowledge about relevant solutions, but rather inadequate implementation and scale of the programmes. In order to ensure a satisfactory improvement in nutritional health in South Africa, the various programmes should undergo regular evaluations to identify pitfall s and shortcomings. The fight against undernutrition and hunger, which are rooted in poverty and social inequalities, remains a major challenge for the South African health authorities. Urgent scale-up of the current nutrition intervention programmes as well as evaluation of their implementation are needed, coupled with strategies for education, skills development, job creation and poverty alleviation.
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