Diet matters, particularly in pregnancy – Results from MoBa studies of maternal diet and pregnancy outcomes (original) (raw)
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Reported dietary intake in early pregnant compared to non-pregnant women - a cross-sectional study
BMC pregnancy and childbirth, 2014
A woman's nutritional status before conception and during pregnancy is important for maternal health and the health of the foetus. The aim of the study was to compare diet intake in early pregnant women with non-pregnant women. Between September 2006 and March 2009, 226 women in early pregnancy were consecutively recruited at five antenatal clinics in Northern Sweden. Referent women (n = 211) were randomly selected from a current health screening project running in the same region (the Västerbotten Intervention Program; VIP). We collected diet data with a self-reported validated food frequency questionnaire with 66 food items/food aggregates, and information on portion size, alcohol consumption, and supplement intake. Data were analysed using descriptive, comparative statistics and multivariate partial least square modelling. Intake of folate and vitamin D from foods was generally low for both groups. Intake of folate and vitamin D supplements was generally high in the pregnant ...
Assessment of pregnancy dietary intake and association with maternal and neonatal outcomes
Pediatric Research
Background Maternal dietary habits are contributors of maternal and fetal health; however, available data are heterogeneous and not conclusive. Methods Nutrient intake during pregnancy was assessed in 503 women with uncomplicated pregnancies, using the validated Food Frequency Questionnaire developed by the European Prospective Investigation into Cancer and Nutrition (EPIC-FFQ). Results In all, 68% of women had a normal body mass index at the beginning of pregnancy, and 83% of newborns had an appropriate weight for gestational age. Maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and placental weight were independently correlated with birth weight. GWG was not related to the pre-pregnancy BMI. EPIC-FFQ evaluation showed that 30% of women adhered to the European Food Safety Authority (EFSA) ranges for macronutrient intake. In most pregnant women (98.1%), consumption of water was below recommendations. Comparing women with intakes within EFSA ranges for mac...
Maternal & Child Nutrition, 2010
The objective of the present study was to systematically review the literature exploring the associations between different dietary patterns obtained from Food Frequency Questionnaires during pregnancy and the development of health-related maternal and infant outcomes in the Framework of the Eurreca Network of Excellence. A systematic search was conducted on Pubmed for literature published up to September 2009. The search strategy resulted in an initial amount of 2048 articles. After applying the selection criteria, seven studies were finally identified. Five articles were based on prospective cohort studies and the other two were case-control studies. The methods used to elaborate the dietary pattern could be classified as hypothesis-oriented (three studies) or empirically-derived (four studies). The different food frequency questionnaires used for diet assessment were self-administered, semi-quantitative and had been previously validated, but just four studies employed questionnaires validated specifically for their use in a pregnant population. The divergent methods used to assess the dietary patterns make it difficult to compare results. However, some resulting recommendations can be applied when dietary patterns during pregnancy are analyzed: to employ a validated food frequency questionnaire designed for use in pregnancy, to consider the special role exerted by mineral and vitamin supplements in this particular population group, to adequately select the time in which dietary data is collected, to adjust the results for life-style and educational characteristics, and in the case of hypothesis-oriented dietary patterns, to correctly choose the components comprising the score.
Validity and Reproducibility of a Food Frequency Questionnaire for Pregnant Finnish Women
American Journal of Epidemiology, 2001
The authors developed a self-administered 181-item food frequency questionnaire (FFQ) to assess dietary intake during pregnancy for Finnish women from August 1995 to July 1996. In the validation study (n = 113), the data that were collected by using two 5-day food records completed during the eighth month of pregnancy were compared with FFQ data. The intake of foods and nutrients was higher as determined by FFQ than that assessed using food records. Pearson correlation coefficients for nutrients, after adjustment for energy, ranged from 0.19 (vitamin E) to 0.70 (thiamin) and, for foods, from 0.03 (high-fat milk) to 0.84 (low-fat milk). Energy adjustment improved the correlations for nutrients. Correction for attenuation improved correlations for both foods and nutrients. On average, 70% of the foods and 69% of the nutrients fell into the same or adjacent quintiles, according to the FFQ and the food record. In the reproducibility study, 111 women completed the FFQs twice at a 1-month interval. The intraclass correlation coefficients for nutrients ranged from 0.42 (ethanol) to 0.72 (sucrose, riboflavin, and calcium), and for foods, they ranged from 0.44 (ice cream) to 0.91 (coffee). The authors conclude that the FFQ has an acceptable reproducibility and represents a useful tool for categorizing pregnant women according to their dietary intake. Am J Epidemiol 2001;154:466-76. diet; pregnancy; questionnaires; reproducibility of results
The American Journal of Clinical Nutrition, 2011
There has been a thrilling development , as well as profound changes, in our understanding of the effect of fetal nutrition on the development and health of the child. The Norwegian Mother and Child Cohort Study (MoBa) is an ongoing nationwide population-based pregnancy cohort study that between 1999 and 2008 recruited 90,723 women with 106,981 pregnancies and 108,487 children. The objective of MoBa is to test specific etiologic hypotheses by estimating the association between exposures and diseases with a special focus on disorders that may originate in early life. An important aspect in this regard is maternal diet and nutritional status during pregnancy. Nutritional factors have long been considered to be important determinants of maternal and fetal health, and dietary information is currently being collected in a number of pregnancy cohorts in Europe and the United States. Thus far, pregnancy complications studied in MoBa are preterm birth, preeclampsia, and fetal growth; and the aim of this article is to report results of recently published studies of dietary factors in relation to these outcomes. Numerous studies are planned using MoBa data, and the aim is to add to the knowledge of the interplay between dietary factors, nonnutrients, and toxic dietary substances and epigenetic modulation on fetal development and health later in life.
Nutrients
Linkages between diet and other lifestyle factors may confound observational studies. We used cluster analysis to analyze how the intake of food and nutrients during pregnancy co-varies with lifestyle, clinical and demographic factors in 567 women who participated in the NICE (nutritional impact on immunological maturation during childhood in relation to the environment) birth-cohort in northern Sweden. A food frequency questionnaire, Meal-Q, was administered in pregnancy Week 34, and the reported food and nutrient intakes were related to maternal characteristics such as age, education, rural/town residence, parity, pre-pregnancy smoking, first-trimester BMI, allergy and hyperemesis. Two lifestyle-diet clusters were identified: (1) High level of education and higher age were related to one another, and associated with a diet rich in fruits, vegetables, whole grains and fish, and (2) smoking before pregnancy and higher BMI in early pregnancy were related to one another and associated...
Dietary patterns in pregnancy and associations with socio-demographic and lifestyle factors
European Journal of Clinical Nutrition, 2008
Despite the recent popularity in the use of dietary patterns to investigate diet -disease associations, the associations between dietary patterns and nutrient intakes have not been fully explored. This paper determines the linear and non-linear associations between estimated nutrient intake (considered as both absolute and relative intake) and distinct dietary patterns, obtained during the third trimester of pregnancy using principal components analysis (PCA). It also examines the proportion of variability explained by the patterns in food and nutrient intakes. Pregnant women were asked to record the frequency of consumption of a variety of food items as part of regular self-completion questionnaires, the primary source of data collection in the Avon Longitudinal Study of Parents and Children, 12 035 cases were available. Individual dietary components were identified using PCA and scores on these components were related to estimated nutrient intakes. Five individual dietary patterns were established to best describe the types of diet being consumed in pregnancy. Scores on the 'processed' and 'confectionery' patterns were negatively related to the estimated intake of most nutrients with the exception of energy, fats and sugars, which increased with higher scores. Scores on the 'health-conscious' and 'traditional' components showed positive linear relationships with all nutrients. The results presented here suggest that dietary patterns adequately characterize dietary intake. There is, therefore, potential for dietary patterns to be used as a valid tool in assessing the relationship between diet and health outcomes, and dietary pattern scores could be used as covariates in specific nutrient -disease studies.
Public Health Nutrition, 2008
To identify and describe dietary patterns in a cohort of pregnant women and investigate whether the dietary patterns are associated with dietary intake and sociodemographic factors. Mothers entering the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study in 1997-2002 were retrospectively asked to complete a food-frequency questionnaire concerning their diet during pregnancy. Principal components analysis was used to identify dietary patterns. Finland. Subjects were 3730 women with a newborn infant carrying increased genetic susceptibility to type 1 diabetes mellitus. Seven factors were identified and named. Energy intake correlated positively with 'Healthy', 'Fast food', 'Traditional bread', 'Traditional meat' and 'Coffee' patterns and inversely with the 'Alcohol and butter' pattern. Intake of dietary fibre correlated positively with 'Healthy', 'Traditional bread' and 'Low-fat foods' patterns and inversely with the 'Alcohol and butter' pattern. The seven dietary patterns seemed to account for relatively large proportions of the variance in energy and nutrient intakes except for the intake of vitamin D, vitamin C, carotenoids and calcium. Maternal age and higher level of education were associated with higher scores on 'Healthy', 'Low-fat foods' and 'Alcohol and butter' patterns. Principal components analysis produced seven dietary patterns which may be useful for further research concerning maternal diet and health outcomes among both mothers and their offspring.
Dietary patterns and diet quality during pregnancy and low birthweight: The PRINCESA cohort
Maternal & Child Nutrition
Although the isolated effects of several specific nutrients have been examined, little is known about the relationship between overall maternal diet during pregnancy and fetal development and growth. This study evaluates the association between maternal diet and low birthweight (LBW) in 660 pregnant women from the Pregnancy Research on Inflammation, Nutrition,& City Environment: Systematic Analyses (PRINCESA) cohort in Mexico City. Using prior day dietary intake reported at multiple prenatal visits, diet was assessed prospectively using a priori (Maternal Diet Quality Score [MDQS]) and a posteriori (dietary patterns extracted by factor analysis) approaches. The association between maternal diet and LBW was investigated by logistic regression, controlling for confounders. Adherence to recommended guidelines (higher MDQS) was associated with a reduced risk of LBW (OR, 0.22; 95% confidence interval [0.06, 0.75], P < .05, N = 49) compared with the lowest adherence category (reference group), controlling for maternal age, education, height, marital status, pre-pregnancy body mass index, parity, energy intake, gestational weight gain, and preterm versus term birth; a posteriori dietary patterns were not associated with LBW risk. Higher adherence to MDQS was associated with a lower risk of having an LBW baby in this sample. Our results support the role of advocating a healthy overall diet, versus individual foods or nutrients, in preventing LBW.
European Journal of Clinical Nutrition, 2018
Background/Objectives To assess whether quality of maternal diet affects birth weight and the risk of small for gestational age (SGA) and/or large for gestational age (LGA) babies. Subjects/Methods This study is based on the Norwegian Mother and Child Cohort Study (MoBa) and includes 65,904 pregnant women who answered a validated food frequency questionnaire at mid-pregnancy. Three maternal dietary patterns were extracted based on characteristics of food items in each pattern. From these we created four non-overlapping groups: "high prudent," "high Western," "high traditional," and "mixed". We obtained information about birth weight from the Norwegian Medical Birth Registry and calculated birth weight z-scores, SGA, and LGA according to an ultrasound-based, population-based, and a customized growth standards. Associations were studied by linear and multiple logistic regression. Results Compared to the high Western group, the high prudent group was associated with lower birth weight (β ultrasound zscores −0.041 (95% confidence interval (CI): −0.068, −0.013)) and the high traditional group with higher birth weight (β ultrasound 0.067 (95% CI: 0.040, 0.094)) for all three growth standards. The high prudent pattern was associated with increased SGA risk (SGA ultrasound odds ratio (OR) 1.25 (95% CI: 1.02, 1.54)) and decreased LGA risk (LGA population OR 0.84 (95% CI: 0.75, 0.94)), while the high traditional group on the contrary was associated with decreased SGA (SGA customized OR 0.92 (95% CI: 0.84, 0.99)) and increased LGA risk (LGA population OR 1.12 (95% CI: 1.02, 1.24)). Conclusions Food quality was associated with birth weight in this well-nourished Norwegian population. Food quality may affect a woman's risk of giving birth to a SGA or LGA baby.