Nav: Home

Women, particularly minorities, do not meet nutrition guidelines shortly before pregnancy

March 17, 2017

PITTSBURGH, March 17, 2017 - Black, Hispanic and less-educated women consume a less nutritious diet than their well-educated, white counterparts in the weeks leading up to their first pregnancy, according to the only large-scale analysis of preconception adherence to national dietary guidelines.

The study, published today in the Journal of the Academy of Nutrition and Dietetics and led by the University of Pittsburgh Graduate School of Public Health, also found that, while inequalities exist, none of the women in any racial and socioeconomic group evaluated achieved recommendations set forth by the Dietary Guidelines for Americans.

Healthy maternal diets have been linked to reduced risks of preterm birth, fetal growth restriction, preeclampsia and maternal obesity.

"Unlike many other pregnancy and birth risk factors, diet is something we can improve," said lead author Lisa Bodnar, Ph.D., M.P.H., R.D., associate professor and vice chair of research in Pitt Public Health's Department of Epidemiology. "While attention should be given to improving nutritional counseling at doctor appointments, overarching societal and policy changes that help women to make healthy dietary choices may be more effective and efficient."

Bodnar and her colleagues analyzed the results of questionnaires completed by 7,511 women who were between six and 14 weeks pregnant and enrolled in The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers to Be, which followed women who enrolled in the study at one of eight U.S. medical centers. The women reported on their dietary habits during the three months around conception.

The diets were assessed using the Healthy Eating Index-2010, which measures 12 key aspects of diet quality, including adequacy of intake for key food groups, as well as intake of refined grains, salt and empty calories (all calories from solid fats and sugars, plus calories from alcohol beyond a moderate level).

Nearly a quarter of the white women surveyed had scores that fell into the highest scoring fifth of those surveyed, compared with 14 percent of the Hispanic women and 4.6 percent of the black women. Almost half--44 percent--of black mothers had a score in the lowest scoring fifth.

The scores increased with greater education levels for all three racial/ethnic groups, but the increase was strongest among white women. At all levels of education--high school or less through graduate degree--black mothers had the lowest average scores.

When scores were broken down into the 12 aspects of diet, fewer than 10 percent of the women met the dietary guideline for the whole grains, fatty acids, sodium or empty calories categories.

Approximately 34 percent of the calories--or energy--the women consumed were from empty calories. Top sources of energy were sugar-sweetened beverages, pasta dishes and grain desserts. Soda was the primary contributor to energy intake among black, Hispanic and less-educated women. Women with a college or graduate degree consumed more energy from beer, wine and spirits than any other source.

Juices and sugar-sweetened beverages combined for a much larger proportion of vitamin C intake than solid fruits or vegetables for black, Hispanic and less-educated women. The opposite was true for white women or more-educated women.

For all groups, green salad was the only vegetable in the top 10 sources of iron. Green salad and processed cereals were the top two sources of folate for all groups except black women, whose second highest folate source was 100 percent orange or grapefruit juice. Folate and iron are important nutrients for developing fetuses and healthy pregnancies.

"Our findings mirror national nutrition and dietary trends. The diet quality gap among non-pregnant people is thought to be a consequence of many factors, including access to and price of healthy foods, knowledge of a healthy diet, and pressing needs that may take priority over a healthy diet," said Bodnar, also an associate professor of obstetrics, gynecology and reproductive sciences at Pitt's School of Medicine. "Future research needs to determine if improving pre-pregnancy diet leads to better pregnancy and birth outcomes. If so, then we need to explore and test ways to improve the diets for everyone, particularly women likely to become pregnant."
-end-
Additional authors on this research include senior author Uma M. Reddy, M.D., of the Eunice Kennedy Shriver National Institute of Child Health and Human Development; as well as Hyagriv N. Simhan, M.D., of Pitt; Corette B. Parker, Dr.P.H., and Heather Meier, both of RTI International; Brian M. Mercer, M.D., of Case Western Reserve University; William A. Grobman, M.D., and Alan M. Peaceman, M.D., both of Northwestern University; David M. Haas, M.D., and Shannon Barnes, R.N., both of Indiana University; Deborah A. Wing, M.D., and Pathik D. Wadhwa, M.D., Ph.D., both of the University of California Irvine; Matthew K. Hoffman, M.D., of the Christiana Care Health System; Samuel Parry, M.D., and Michal Elovitz, M.D., both of the University of Pennsylvania; Robert M. Silver, M.D., and Sean Esplin, M.D., both of the University of Utah; George R. Saade, M.D., of the University of Texas; Ronald Wapner, M.D., of Columbia University; and Jay D. Iams, M.D., of The Ohio State University.

This study is supported by grant funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, as well as RTI International grant U10 HD06336, Case Western Reserve University grant U10 HD063072, Columbia University grant U10 HD063047, Indiana University grant U10 HD063037, Pitt grant U10 HD063041, Northwestern University grant U10 HD063020, University of California Irvine grant U10 HD063046, University of Pennsylvania grant U10 HD063048 and University of Utah grant U10 HD063053.

About the University of Pittsburgh Graduate School of Public Health

The University of Pittsburgh Graduate School of Public Health, founded in 1948 and now one of the top-ranked schools of public health in the United States, conducts research on public health and medical care that improves the lives of millions of people around the world. Pitt Public Health is a leader in devising new methods to prevent and treat cardiovascular diseases, HIV/AIDS, cancer and other important public health problems. For more information about Pitt Public Health, visit the school's Web site at http://www.publichealth.pitt.edu.

http://www.upmc.com/media

Contact: Courtney Caprara
Office: 412-647-6190
Mobile: 412-592-8134
E-mail: CapraraCL@upmc.edu

Contact: Allison Hydzik
Office: 412-647-9975
Mobile: 412-559-2431
E-mail: HydzikAM@upmc.edu

University of Pittsburgh Schools of the Health Sciences

Related Public Health Articles:

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.
Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.
Bloomberg American Health Initiative releases special public health reports supplement
With US life expectancy now on the decline for two consecutive years, the Bloomberg American Health Initiative is releasing a supplement to Public Health Reports, the scholarly journal of the US Surgeon General.
Data does the heavy lifting: Encouraging new public health approaches to promote the health benefits of muscle-strengthening exercise (MSE)
According to a new study in the American Journal of Preventive Medicine, almost 75 percent of US adults do not comply with public health guidelines recommending two or more muscle-strengthening exercise (MSE) sessions a week, with nearly 60 percent of the population doing no MSE at all.
The Lancet Public Health: Moderate carbohydrate intake may be best for health
Low-carb diets that replace carbohydrates with proteins and fats from plant sources associated with lower risk of mortality compared to those that replace carbohydrates with proteins and fat from animal sources.
More Public Health News and Public Health Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...