Dietary changes during pregnancy and the postpartum period in Singaporean Chinese, Malay and Indian women: the GUSTO birth cohort study

Abstract

Objective: To examine changes in food consumption during pregnancy and the postpartum period in women of major Asian ethnic groups. Design: Using interviewer-administered questionnaires, we assessed changes in food consumption during pregnancy (26-28 weeks' gestation) and the postpartum period (3 weeks after delivery) as compared with the usual pre-pregnancy diet. Setting: Singapore. Subjects: Pregnant women (n 1027) of Chinese, Malay and Indian ethnicity (mean age 30?4 (SD 5?2) years) who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Results: During pregnancy, participants tended to increase their consumption of milk, fruit and vegetables and decrease their consumption of tea, coffee, soft drinks and seafood (all P , 0?001). Most participants reported adherence to traditional restrictions ('confinement') during the early postpartum period (Chinese: 94?8 %, Malay: 91?6 %, Indian: 79?6 %). During the postpartum period, participants tended to increase their consumption of fish and milk-based drinks and decrease their consumption of noodles, seafood, and chocolates and sweets (all P , 0?001). Ethnic differences in food consumption were pronounced during the postpartum period. For example, most Chinese participants (87?2 %) increased their ginger consumption during the postpartum period as compared with smaller percentages of Malays (31?8 %) and Indians (40?8 %; P for ethnic difference ,0?001). Similar ethnic differences were observed for cooking wine/alcohol, herbs and spices, and herbal tea consumption. Conclusions: Marked changes in food consumption that reflect both modern dietary recommendations and the persistence of traditional beliefs were observed in Singaporean women during pregnancy and the postpartum period. Traditional beliefs should be considered in interventions to improve dietary intakes during these periods.

Changes in beverage consumption from pre-pregnancy to early pregnancy in the Norwegian Fit for Delivery study

“…An increase in milk consumption from pre-pregnancy to pregnancy has also been found in other populations (15,(30)(31)(32) . However, a British prospective study reported stable consumption of milk from pre-pregnancy to early pregnancy (28,38) .…”

“…A decrease in the consumption of alcohol from prepregnancy to early pregnancy has been reported across many populations (14,15,30,38) , but not all studies have reported the same level of abstinence during pregnancy as the women in the present study (30,32,38) . The toxic effects of alcohol on the fetus have been known for more than 40 years (39) and consumption of alcohol during pregnancy is associated with congenital birth defects (23,40) as well as unfavourable developmental (20) and neurological outcomes (16) .…”

“…At inclusion, in median gestational week 15 (range: [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], the women answered an FFQ. The study design was cross-sectional as the women reported how often they consumed the different drinks at inclusion and in retrospect how often they drank the different beverages before they got pregnant.…”

“…Longitudinal studies on diet across the transition to motherhood find that women report changes both in beverage intake and drinking behaviour (14,15) . Much of the research on beverage consumption during pregnancy has focused on specific types of drinks (5)(6)(7)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) or has been part of studies on nutrition during pregnancy (15,(28)(29)(30)(31)(32)(33) . Few, if any, studies have looked specifically at a broader range of beverage intake from pre-pregnancy to early pregnancy.…”

Insights from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Cohort Study

“…Interethnic differences in health among the 3 major Singaporean ethnic groups, i.e. Chinese, Malays and Indians, involving the complex interplay of genetics, culture, and environment, can be investigated in Singapore [9,10,11]. We are examining the hypothesis that environmental signals alter the epigenetic state of specific regions of the genome that regulate metabolic and neural function, and that these epigenetic ‘marks' thus serve as a mechanism for enduring influences of perinatal development on health, as well as potential biomarkers that associate directly with states of vulnerability.…”