Choline intake and associations with egg and dairy consumption among pregnant women attending a high-risk antenatal clinic in South Africa: the NuEMI study

Robb, Liska; Joubert, Gina; Jordaan, Elizabeth Margaretha; Ngounda, Jennifer; Walsh, Corinna M.

doi:10.1186/s12884-021-04314-2

Cited by 5 publications

(3 citation statements)

References 27 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23 - 25 Dietary intake was determined for the previous 28 days, and nutrient intake values were divided by 28 to calculate daily intake. 26 Daily or weekly (28 days intake divided by 4) intake of relevant food groups included in the MeDAS 14-item questionnaire 14 were extracted from the QFFQ. The MeDAS 14 was adapted for the current study on pregnant women to a 13-item questionnaire; the question on alcohol (wine) was omitted.…”

Section: Methodsmentioning

confidence: 99%

Adherence to the Mediterranean Diet of Pregnant Women in Central South Africa: The NuEMI Study

Spies

Nel

Walsh

2022

Nutr Metab Insights

Self Cite

View full text Add to dashboard Cite

Introduction: The Mediterranean diet (MeD) has been shown to have significant health benefits for adults and children. A mother’s diet during pregnancy directly impacts the health of her offspring. This study aimed to investigate the adherence to the MeD of pregnant women attending antenatal care at a Regional Hospital in Bloemfontein, South Africa (SA). Methods: A cross-sectional study was conducted on a consecutive sample of 681 pregnant women who attended the antenatal clinic of a Regional Hospital in Bloemfontein. Socio-demographics included: age, highest level of education, household income, employment status, and income stability. Food group intake was assessed with a quantitative food frequency questionnaire. The adapted Mediterranean Diet Adherence Screener (MeDAS) consisted of 13 of the original 14 questions that measured intake of key food groups (score of ⩽7 poor, 8-9 moderate, ⩾10 good) (wine intake was excluded for pregnant women). Results: A total of 681 pregnant women with a median age of 31.8 years (IQR: 26.8-36.5 years) and a median gestational age of 32.0 weeks at the time of the interview participated in the study. The vast majority showed poor adherence to the MeD (99.6%), with only 0.4% (n = 3) having moderate adherence and 0% good adherence. The median adherence score was 5 points and the maximum 8 points. Of those with poor adherence, only 11.5% had tertiary education, 43.2% earned less than R 3000 (<201 USD) per month, 52.5% were unemployed, and 42.0% did not have a stable income in the past 6 months. Of the 3 participants with moderate adherence, all had grade 11 to 12 education, 2 out of the 3 earned more than R3000 (201 USD), one was unemployed, and 2 had a stable income over the past 6 months. Compared to those with an income ⩽ R3000 (⩽201 USD), those with an income above R3000 were significantly more likely to eat nuts (including peanuts) (2.0% vs 4.6%, P = .05), and adhere to sofrito (similar to tomato and onion relish) intake (9.2% vs 15.6%, P = .02). Compared to those who only had a primary education level up to grade 10 (n = 229), those who had a secondary education level or more (grade 11 and higher, n = 452) were significantly more likely to consume enough olive oil per day (1.3% vs 5.0%, P = .01), and to consume sofrito (6.6% vs 18.0%, P = .02). Conclusion: Pregnant participants showed poor adherence to the MeD. Although almost all women fell in the poor adherence group, secondary education contributed to consuming recommended amounts of olive oil and sofrito and higher income was associated with an adequate intake of nuts and sofrito. Based on the findings, we recommend the development of a contextualized MeDAS tool that includes foods that are typically eaten by most South Africans for similar MeD benefits.

show abstract

Section: Methodsmentioning

confidence: 99%

Adherence to the Mediterranean Diet of Pregnant Women in Central South Africa: The NuEMI Study

Spies

Nel

Walsh

2022

Nutr Metab Insights

Self Cite

View full text Add to dashboard Cite

show abstract

“…For several vital nutrients, eggs can contribute a large portion of the Recommended Daily Allowance (RDA) or adequate intake (AI) for pregnant and lactating women; for instance, two 50-g eggs provide between 20% and 35% of the AI/ RDA for vitamin A, riboflavin, pantothenic acid, vitamin B12 and phosphorus for pregnant and lactating women, and more than 18% of the RDA for protein and 50% of the AI/RDA for choline and selenium (Lutter et al, 2018). Studies in the US and South Africa show that pregnant mothers had choline intakes below the AI, and this was associated with lower egg and dairy intake (Wallace and Fulgoni, 2017;Robb et al, 2021). Wallace and Fulgoni (2017) reported that meeting the AI for choline without egg consumption or a dietary supplement is challenging, even in the US.…”

Section: Pregnant and Lactating Womenmentioning

confidence: 99%

Benefits, perceived and actual risks and barriers to egg consumption in low- and middle-income countries

Tiwari,

Balehegn,

Adesogan

et al. 2023

Front. Anim. Sci.

View full text Add to dashboard Cite

Eggs like other animal-source foods (ASFs), contain an array of macro and micronutrients that promote physical and cognitive growth, nutrition, and health outcomes. Hence, they can be used to reduce rampant undernutrition in low-and middle-income countries (LMICs). Yet consumption of eggs remains low in such countries for various reasons. Given their potential as a tool for reducing malnutrition, this paper reviews the literature on the benefits, risks, and barriers to egg consumption in LMICs. Research indicates that egg consumption is associated with several nutritional and health benefits in newborns, young children, and pregnant and lactating women, but few studies on other groups exist. Effects of egg consumption on diet-related chronic diseases seem to be inconclusive, and early introduction of eggs to infants has reduced allergy risk of eggs later in life in several studies. Some main barriers to egg consumption in LMIC include unaffordability and unavailability, partly due to low poultry productivity, high poultry feed prices, cultural beliefs, and social taboos, many of which disproportionately restrict egg consumption among children and pregnant women. The evidence supports egg intake as a mechanism for meeting nutrient recommendations and a healthy diet in LMIC.

show abstract

“…The current study extracted the women's sociodemographic data, gestational body mass index (GBMI) dietary data and birth outcomes of their infants. Dietary data in the NuEMI study were collected with a 28-day quantitative food frequency questionnaire (QFFQ) (techniques and validity of the QFFQ in this population is discussed in detail elsewhere [19]), and a single 24-hour recall administered during the same interview.…”

Section: Data Collectionmentioning

confidence: 99%

Cross sectional analysis of dietary quality among pregnant women in central South Africa: The NuEMI study

Berg

Jordaan

Robb

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Background: During pregnancy, poor dietary quality is linked to maternal complications and poor birth outcomes, but no dietary quality index for pregnancy has been developed using African data. This study aimed to determine the diet quality of South African pregnant women by applying the Diet Quality Index Adapted for Pregnant Women (IQDAG), developed in Brazil, to data collected in the NuEMI (Nutritional status of Expectant Mothers and their newborn Infants) study.Methods: The NuEMI study applied a descriptive study design to collect data from 681 pregnant women visiting an antenatal clinic at a regional hospital in Mangaung, central South Africa. The IQDAG was applied to dietary data collected with a quantitative food frequency questionnaire during structured interviews. Energy and nutrient intakes were quantified with the South African Medical Research Council Food Composition Database. The Women’s Dietary Diversity Score (WDDS) was applied to 24h-recall data obtained during the interviews. Associations of IQDAG scores, nutrient intakes, sociodemographic variables, WDDS and birth anthropometry were explored by contingency tables.Results: Participants had a median age of 31.9 years (IQR: 26.8‒36.7) and a median pregnancy stage of 32.0 weeks (IQR: 26.0‒36.0). The median total dietary quality score (61/100; IQR:53‒68) indicated that most of these women had a suboptimal diet. Only 2.5% had a good dietary quality, reaching at least 80% of the maximum IQDAG score that represents the minimum pregnancy recommendations. The median intakes for none of the nine components of the IQDAQ met the recommendations. Fruit, vegetables, legume, dietary calcium and omega-3 intakes were particularly low, while the intake of ultra-processed foods was above optimal. Most participants consumed only half of the recommended amounts of iron and folate from their diets. IQDAG scores were significantly (p<0.0001) associated with the dietary intakes of most nutrients, even after correction for energy intakes, and with dietary diversity (p<0.0001) and length-for-age z scores at birth (p=0.01).Conclusions: Pregnant women In a South African public health setting had poor to suboptimum dietary quality. Improving the dietary quality of pregnant women in low to middle-income countries would reduce the high financial and human cost of poor birth outcomes and maternal complications. The results also emphasise the importance of prenatal micronutrient supplementation.

show abstract

Choline intake and associations with egg and dairy consumption among pregnant women attending a high-risk antenatal clinic in South Africa: the NuEMI study

Cited by 5 publications

References 27 publications

Adherence to the Mediterranean Diet of Pregnant Women in Central South Africa: The NuEMI Study

Adherence to the Mediterranean Diet of Pregnant Women in Central South Africa: The NuEMI Study

Benefits, perceived and actual risks and barriers to egg consumption in low- and middle-income countries

Cross sectional analysis of dietary quality among pregnant women in central South Africa: The NuEMI study

Contact Info

Product

Resources

About