Development of a dietary screening questionnaire to predict excessive weight gain in pregnancy

Abstract

Excessive gestational weight gain (GWG) is a risk factor for several adverse pregnancy outcomes, including macrosomia. Diet is one of the few modifiable risk factors identified. However, most dietary assessment methods are impractical for use in maternal care. This study evaluated whether a short dietary screening questionnaire could be used as a predictor of excessive GWG in a cohort of Icelandic women. The dietary data were collected in gestational weeks 11-14, using a 40-item food frequency screening questionnaire. The dietary data were transformed into 13 predefined dietary risk factors for an inadequate diet. Stepwise backward elimination was used to identify a reduced set of factors that best predicted excessive GWG. This set of variables was then used to calculate a combined dietary risk score (range 0-5). Information regarding outcomes, GWG (n = 1,326) and birth weight (n = 1,651), was extracted from maternal hospital records. In total, 36% had excessive GWG (Icelandic criteria), and 5% of infants were macrosomic (≥4,500 g). A high dietary risk score (characterized by a nonvaried diet, nonadequate frequency of consumption of fruits/vegetables, dairy, and whole grain intake, and excessive intake of sugar/artificially sweetened beverages and dairy) was associated with a higher risk of excessive GWG. Women with a high (≥4) versus low (≤2) risk score had higher risk of excessive GWG (relative risk = 1.23, 95% confi- Tian et al., 2016). Excessive GWG is also the primaryThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Insufficient iodine status in pregnant women as a consequence of dietary changes

“…Insufficient iodine status was observed for the first time in an Icelandic population, most likely related to a decline in fish and dairy intake. The reasons for the decrease in fish and dairy intake in Iceland (11,12,16) remain unknown. However, it could be speculated that public discussion on suggested negative health effects of dairy consumption and increased awareness of environmental aspects might have contributed.…”

“…Women selected between 10 potential frequency responses ranging from 'less than once a month' to 'more than 5 times a day'. The development of the FFQ has previously been described in detail and the FFQ published (12). The frequency responses for fish (lean and oily) and dairy intake (drinking milk and fermented dairy products, excluding cheese) were used to categorize women to compare UIC and I/Cr ratio across intake groups.…”

“…However, the sample size was not large enough to assess the possible risk of iodine deficiency in groups consuming less fish and dairy. A more recent study on iodine intake among 183 pregnant women (at 20 weeks gestation) in Reykjavík from 2012 found that 25% of the participants had suboptimal iodine intake (11), and results from 2015 to 2016 suggest that the intake of important dietary sources of iodine has continued to decrease (12). Given the trends seen with decreased fish and dairy consumption of the pregnant population in Iceland, it is pivotal to monitor their iodine status to avoid adverse, nonreversible health effects on fetal development (4,5).…”

Poor Dietary Quality Is Associated with Low Adherence to Gestational Weight Gain Recommendations among Women in Sweden

“…A total of 1113 women from the GraviD cohort were eligible for inclusion in this paper. Power calculations showed that this sample size would yield 77% power (alpha 0.05) to detect a 23% increased risk of excessive GWG among those with poor diet [23], (31% vs. 38% excessive GWG among those with high and poor quality diet, respectively). We assumed an overall 60% prevalence of poor dietary quality [16].…”

Can a Simple Dietary Screening in Early Pregnancy Identify Dietary Habits Associated with Gestational Diabetes?

“…The PREWICE cohort (PREgnant Women of ICEland) has been described elsewhere [18]. All women ( n = 2734) with singleton pregnancies who attended a routine early ultrasound (11–14 week of gestation) at the prenatal diagnostic unit at Landspitali University Hospital in Reykjavik, South Iceland between 1 October, 2015 to 31 September, 2016, were invited to take part in the study.…”