Adherence to nutritional guidelines in pregnancy: evidence from the Growing Up in New Zealand birth cohort study

Abstract

Objective: To determine adherence to nutritional guidelines by pregnant women in New Zealand and maternal characteristics associated with adherence. Design: A cohort of the pregnant women enrolled into New Zealand's new birth cohort study, Growing Up in New Zealand. Setting: Women residing within a North Island region of New Zealand, where onethird of the national population lives. Subjects: Pregnant women (n 5664) were interviewed during 2009-2010. An FFQ was administered during the face-to-face interview. Results: The recommended daily number of servings of vegetables and fruit (≥6) were met by 25 % of the women; of breads and cereals (≥6) by 26 %; of milk and milk products (≥3) by 58 %; and of lean meat, meat alternatives and eggs (≥2) by 21 %. One in four women did not meet the recommendations for any food group. Only 3 % met all four food group recommendations. Although adherence to recommendation for the vegetables/fruit group did not vary by ethnicity (P = 0·38), it did vary for the breads/cereals, milk/milk products and meat/eggs groups (all P < 0·001). Adherence to recommendations for the vegetables/fruit group was higher among older women (P = 0·001); for the breads/cereals group was higher for women with previous children (P < 0·001) and from lower-income households (P < 0·001); and for the meat/eggs group was higher for women with previous children (P = 0·003) and from lower-income households (P = 0·004). Conclusions: Most pregnant women in New Zealand do not adhere to nutritional guidelines in pregnancy, with only 3 % meeting the recommendations for all four food groups. Adherence varies more so with ethnicity than with other sociodemographic characteristics.

Changes in fruit and vegetable consumption habits from pre-pregnancy to early pregnancy among Norwegian women

“…Similarly, Blumfield et al found no evidence that women trying to conceive increased their consumption on nutrient rich foods such as FV [48]. In line with our results, several studies have found that only a small proportion of women consume the recommended number of vegetable servings per day, both pre-pregnancy [48] and during pregnancy [18, 35, 36, 44, 48, 49]. A national study from Australia showed that only 10% of pregnant women reported an intake of vegetables at or above recommendations [49].…”

“…Worldwide, higher socio-economic status tends to be associated with healthier food choices [40, 41]. In line with others, we found that a high intake of FV was associated with older age [8, 32–35, 42–44] and higher educational attainments [36, 42]. …”

Adherence to the Australian dietary guidelines during pregnancy: evidence from a national study

“…The effectiveness of such strategies among women who have poor dietary quality but perceive their diets to be healthy may, however, be influenced by their willingness to increase their nutrition knowledge and understanding of a healthy diet, as suggested by Kearney and McElhone's (31) findings. As in previous research, women in our study reported avoiding or eating less high-listeria-risk foods during pregnancy and eating less fish and seafood (10,32) . Considering the following factors, it may be timely to reconsider how messages around fish intake during pregnancy are framed and delivered to the public: seafood has a relatively small impact on maternal blood Hg levels (accounting for approximately 9 % of the variation in whole-blood total Hg levels) (33) ; fish is rich in n-3 fatty acids and other essential nutrients such as iodine and vitamin D; and the positive associations found between fish intake during pregnancy and fetal neurodevelopmental outcomes (34) .…”

“…It is therefore concerning that suboptimal dietary quality has been consistently reported during pregnancy, reflecting poor adherence with dietary guidelines (6,7) . Moreover, studies from Australia and other developed countries including New Zealand, the UK, the USA and Canada have consistently shown poor adherence to food group recommendations during pregnancy (7)(8)(9)(10)(11)(12) .…”

Nutrition education during pregnancy: Are final year midwifery trainees ready to offer this service?

“…It has been asserted that midwives often lack the essential knowledge and skills to provide adequate and reliable nutrition advice to pregnant and lactating women on how to meet increased nutrient requirements during these critical and nutrient-demanding stages of their lives (Morton et al, 2014). Improving the quality of nutrition training of midwifery trainees is vital for building the necessary human resource capacity to provide effective nutrition education and counselling services in order to tackle the public health issue of malnutrition among vulnerable groups in Ghana (Yawson et al, 2017;Sodjinou et al, 2014).…”