Nutrient Intakes of Pregnant Women and their Associated Factors in Eight Cities of China

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.

Maternal Dietary Nutrient Intake and Its Association with Preterm Birth: A Case‐control Study in Beijing, China

“…The mean total energy intake of the preterm group was lower than recent reports in both urban and rural China [18,19]. As most of the participants in our study were well-educated citizens and had a preferable family income, the insufficient energy intake in the preterm group may not be due to limited food resource, but may be associated with less weight gain during pregnancy and smaller infants, which may carry a lower risk of delivery complication [1].…”

“…The intakes of vitamin A, calcium and iron were much lower than DRIs, which was quite different from white pregnant women in the U.S who were reported to have a higher nutrient-dense diet, but similar to black women, who tended to have energy-dense but nutrient-poor diets [23]. This problem was also found in previous studies in China, and one reason was the lack of healthy diet knowledge, another reason was that good food resources of these nutrients (such as dairy products, red meats and animal organs) were not chosen by pregnant women according to traditional eating habits [18]. Nevertheless, the dietary quality seemed to be improved in some ways, as zinc intake was sufficient compared with a previous report in developing countries [24].…”

“…These women were thought to have positive factors for a better diet, but poor dietary habits with less nutrient-dense food played a major role [20]. Similar results were also found in China, and the mean reason may be improper dietary habits, for example, limited milk and plant foods, which are good sources of protein and dietary fiber [18,21,22]. …”

“…Thirdly, we only captured the dietary intake information in the last month before delivery, which may not exactly represent the dietary intakes of the entire pregnancy period. However, previous studies showed the dietary characteristics and dietary nutrient intakes did not change much through different pregnant periods [18,38]. Finally, we could not subdivide the intakes of different kinds of fatty acids according to the Chinese Food Composition Tables, which did not allow us to able to explain the association between fat and preterm births.…”

Dietary guideline adherence during preconception and pregnancy: A systematic review

“…Of the eight studies reporting dietary intake (as food groups) among pregnant women, most indicated that women during pregnancy were least adherent with dietary recommendations for the daily intake of vegetables (Bookari et al, ; Dahiya, ; Jood et al, ; Malek et al, ; Mishra et al, ), cereals and grains (Bookari et al, ;Dahiya, ; Malek et al, ; Mishra et al, ), and most frequently adherent with recommendations for dairy (Bojar et al, ; Bookari et al, ; Dahiya, ; Malek et al, ; Pinto et al, ) and fruit intake (Dahiya, ; Malek et al, ; Mishra et al, ). Of the eleven studies reporting dietary intake (as nutrients) among pregnant women, the consumption of iron (Dahiya, ; Gao et al, ; Hure et al, ; Jood et al, ; Liu et al, ; Okubo et al, ; Panwar & Punia, ; Pick et al, ; Pinto et al, ; Sajjad & Khan, ), folate (Dahiya, ; Hure et al, ; Okubo et al, ; Panwar & Punia, ; Pick et al, ; Pinto et al, ; Sajjad & Khan, ; Yang et al, ), and calcium (Gao et al, ; Liu et al, ; Panwar & Punia, ; Sajjad & Khan, ; Yang et al, ; Zhang et al, ) were considered by most studies as being inadequate. By contrast, fat intake frequently exceeded daily recommended levels (Dahiya, ; Gao et al, ; Jood et al, ; Liu et al, ; Panwar & Punia, ; Yang et al, ).…”