Total Usual Dietary Intakes of Pregnant Women in the United States, 2001-2014 (FS08-01-19)

Abstract Objectives Nutrition during pregnancy is a critical dimension not only for women’s heath, but also for the offspring’s lifelong health. Very limited national data exist on the usual dietary intakes of pregnant women. The objective of this study was to estimate total usual nutrient intakes (from foods and dietary supplements) of pregnant women in the U.S. Methods Cross-sectional analysis of a nationally-representative sample of pregnant U.S. women, ages 20-40 years (n = 1,003) from NHANES 2001-2014. Total usual dietary intakes were estimated using the National Cancer Institute (NCI) method to adjust 2, 24-hour dietary recalls for within-person variation. Adherence with the Dietary Reference Intakes were used to assess the proportion at risk of inadequacy by the Estimated Average Requirement (%< EAR), assumed to be adequate by the Adequate Intake (% >AI), and at risk of excess by the Tolerable Upper Intake Level (% >UL). Results About 70% of pregnant women use a dietary supplement. Less than 5% of pregnant women have usual diets that are at risk for inadequate intakes of riboflavin (3%), niacin (1%), vitamin B12 (1%), iron (2%), phosphorus (< 0.5%), and selenium (< 0.5%). More pregnant women have usual intakes < EAR for vitamins A (15%), B6 (11%), folate (16%), C (11%), D (46%), E (43%), and minerals including copper (5%), calcium (13%), magnesium (47%) and zinc (11%). Few pregnant females have usual intakes >AI for potassium (2%) and choline (8%), whereas only 48% have vitamin K intakes >AI. The majority of pregnant women (95%) exceed the UL for sodium, while folic acid (34%), iron (28%), calcium (3%), and zinc (7%) were also of concern for intakes >UL. Conclusions Many U.S. pregnant women ( >10% < EAR or < 10% >AI) do not consume enough of key nutrients during pregnancy specifically vitamins A, C, D, E, K, B6, folate, and choline and minerals including potassium, calcium, magnesium, and zinc, while almost all are at risk of excessive consumption of sodium, and many at risk of excessive consumption of folic acid and iron. Improved dietary guidance to help pregnant women meet and not exceed dietary recommendations is warranted. Funding Sources Nestle Nutrition.

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Abstract 15274: Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in United States

Circulation ◽

10.1161/circ.142.suppl_3.15274 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Garima Sharma ◽

Gowtham R Grandhi ◽

Isaac Acquah ◽

Reed Mszar ◽

Laxmi S Mehta ◽

...

Keyword(s):

United States ◽

Pregnant Women ◽

Risk Score ◽

Social Determinants ◽

Cardiovascular Health ◽

The United States ◽

Cumulative Number ◽

Cross Sectional ◽

High Risk Women ◽

Nationally Representative

Introduction: Cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We assessed the association and cumulative effects of SDOH on CVH among a nationally representative sample of pregnant women in the United States. Methods: We included cross-sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013-2017). We ascertained CVH based on the following CV risk factors: hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, and physical activity; classifying participants into optimal (0-1) and suboptimal (≥2) CVH. For each individual, SDOH risk score was calculated that represents the cumulative number of distinct variables (present vs absent) identified on 39 sub-components for 6 domains (economic stability, neighborhood and physical environment, community and social context, food, education, and healthcare system access). SDOH risk score was aggregated and divided into 4 quartiles. Results: Among 1,433 (3.3%, representing 2.2 million) pregnant women in US, one third (33%) of pregnant women (mean age: 33 years, 13% non-Hispanic black) had suboptimal CVH. The prevalence of hypertension, smoking, obesity and physical inactivity across the increasing SDOH quartiles were noted. Overall, 52% pregnant women with unfavorable (4 th quartile) vs 27% with favorable (1 st quartile) SDOH had suboptimal CVH. In multivariable analyses, accounting for demographics and co-morbid conditions, pregnant women with unfavorable SDOH in 4 th quartile had nearly 3-fold higher odds of suboptimal CVH. (Figure). Conclusions: Aggregate SDOH risk score provides significant discrimination of CVH in pregnant women. In pregnant women, suboptimal CVH is common and more than 1 in 2 women with highest risk of SDOH inequities have suboptimal CVH, highlighting the public health urgency for intervention in young high risk women.

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Are Dietary Intakes and Eating Behaviors Related to Childhood Obesity? A Comprehensive Review of the Evidence

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2007.00112.x ◽

2007 ◽

Vol 35 (1) ◽

pp. 35-60 ◽

Cited By ~ 117

Author(s):

P. K. Newby

Keyword(s):

At Risk ◽

Childhood Obesity ◽

Mexican Americans ◽

Eating Behaviors ◽

Task Force ◽

The United States ◽

Asia Pacific ◽

Dietary Intakes ◽

The World ◽

Nationally Representative

Childhood obesity is a serious problem for increasing numbers of children around the world. According to the International Obesity Task Force, 1 of 10 schoolaged children worldwide is overweight or obese, a number totaling 155 million; of these, 2-3% (30-45 million) are obese. Prevalence is highest in the Americas and Europe, followed by the Near/Middle East, with smaller but growing numbers in the Asia-Pacific and Sub-Saharan regions of the world.In the United States, which provides the data for much of this report, prevalence continues to rise. The most recent nationally representative data indicate that 33.6% of individuals aged 2-19 years were overweight and 17.1% were at risk for overweight in 2003-2004, compared to 28.2% and 13.9% in 1999-2000, respectively. In this age group, the prevalence of overweight or at risk for overweight was highest among Mexican Americans (56.2%), followed by Non-Hispanic blacks (55.1%) and Non-Hispanic whites (49.8%), and a higher percentage of males were overweight (18.2%) compared to females (16.0%).

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Minerals Intake Distributions in a Large Sample of Iranian at-Risk Population Using the National Cancer Institute Method: Do They Meet Their Requirements?

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000232 ◽

2015 ◽

Vol 85 (3-4) ◽

pp. 129-144 ◽

Cited By ~ 3

Author(s):

Zahra Heidari ◽

Awat Feizi ◽

Leila Azadbakht ◽

Nizal Sarrafzadegan

Keyword(s):

At Risk ◽

National Cancer Institute ◽

Population Based ◽

Cross Sectional Study ◽

Normal Function ◽

Dietary Intakes ◽

Middle Aged ◽

Cross Sectional ◽

Nutritional Interventions ◽

High Prevalence

Abstract. Background: Minerals are required for the body’s normal function. Aim: The current study assessed the intake distribution of minerals and estimated the prevalence of inadequacy and excess among a representative sample of healthy middle aged and elderly Iranian people. Methods: In this cross-sectional study, the second follow up to the Isfahan Cohort Study (ICS), 1922 generally healthy people aged 40 and older were investigated. Dietary intakes were collected using 24 hour recalls and two or more consecutive food records. Distribution of minerals intake was estimated using traditional (averaging dietary intake days) and National Cancer Institute (NCI) methods, and the results obtained from the two methods, were compared. The prevalence of minerals intake inadequacy or excess was estimated using the estimated average requirement (EAR) cut-point method, the probability approach and the tolerable upper intake levels (UL). Results: There were remarkable differences between values obtained using traditional and NCI methods, particularly in the lower and upper percentiles of the estimated intake distributions. A high prevalence of inadequacy of magnesium (50 - 100 %), calcium (21 - 93 %) and zinc (30 - 55 % for males > 50 years) was observed. Significant gender differences were found regarding inadequate intakes of calcium (21 - 76 % for males vs. 45 - 93 % for females), magnesium (92 % vs. 100 %), iron (0 vs. 15 % for age group 40 - 50 years) and zinc (29 - 55 % vs. 0 %) (all; p < 0.05). Conclusion: Severely imbalanced intakes of magnesium, calcium and zinc were observed among the middle-aged and elderly Iranian population. Nutritional interventions and population-based education to improve healthy diets among the studied population at risk are needed.

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A Silenced Population

Crisis ◽

10.1027/0227-5910/a000470 ◽

2017 ◽

Vol 38 (6) ◽

pp. 433-442 ◽

Cited By ~ 1

Author(s):

Kim Gryglewicz ◽

Melanie Bozzay ◽

Brittany Arthur-Jordon ◽

Gabriela D. Romero ◽

Melissa Witmeier ◽

...

Keyword(s):

At Risk ◽

Depressive Symptomatology ◽

The United States ◽

Future Research ◽

At Risk Youth ◽

Peer Relationship ◽

Student Records ◽

Cross Sectional ◽

Increased Risk ◽

Method Student

Abstract. Background: Given challenges that exceed the normal developmental requirements of adolescence, deaf and hard-of-hearing (DHH) youth are believed to be at elevated risk for engaging in suicide-related behavior (SRB). Unfortunately, little is known about the mechanisms that put these youth potentially at risk. Aims: To determine whether peer relationship difficulties are related to increased risk of SRB in DHH youth. Method: Student records (n = 74) were retrieved from an accredited educational center for deaf and blind students in the United States. Results: Peer relationship difficulties were found to be significantly associated with engagement in SRB but not when accounting for depressive symptomatology. Limitations: The restricted sample limits generalizability. Conclusions regarding risk causation cannot be made due to the cross-sectional nature of the study. Conclusion: These results suggest the need for future research that examines the mechanisms of the relationship between peer relationship difficulties, depression, and suicide risk in DHH youth and potential preventive interventions to ameliorate the risks for these at-risk youth.

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Pregnant Women Living with Obesity: A Cross-Sectional Observational Study of Dietary Quality and Pregnancy Outcomes

Nutrients ◽

10.3390/nu13051652 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1652

Author(s):

Margaret Charnley ◽

Lisa Newson ◽

Andrew Weeks ◽

Julie Abayomi

Keyword(s):

Pregnant Women ◽

Maternal Obesity ◽

Maternal Nutrition ◽

Saturated Fatty Acids ◽

Poor Quality ◽

Dietary Quality ◽

Obstetric Outcomes ◽

Dietary Intakes ◽

Singleton Pregnancy ◽

Cross Sectional

Good maternal nutrition is key to optimal maternal and foetal health. A poor-quality diet is often associated with obesity, and the prevalence and severity of maternal obesity has increased significantly in recent years. This study observed dietary intakes in pregnant women living with obesity and assessed the quality of their diet. In total, 140 women with a singleton pregnancy, aged > 18 years and BMI ≥ 35 kg/m2, were recruited from antenatal clinics, weighed and completed food diaries at 16-, 28- and 36-weeks’ gestation. Clinical data were recorded directly from the women’s medical records. Nutrient intake was determined using ‘MicrodietTM’, then compared to Dietary Reference Values (DRVs). Energy intakes were comparable with DRVs, but intakes of sugar and saturated fatty acids were significantly higher. Intake of fibre and several key micronutrients (Iron, Iodine, Folate and Vitamin D) were significantly low. Several adverse obstetric outcomes were higher than the general obstetric population. Women with obesity, often considered ‘over nourished’, may have diets deficient in essential micronutrients, often associated with poor obstetric outcomes. To address the intergenerational transmission of poor health via poor diets warrants a multi-disciplinary approach focusing away from ‘dieting’ onto positive messages, emphasising key nutrients required for good maternal and foetal health.

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Knowledge and intake of folic acid to prevent neural tube defects among pregnant women in urban China: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03893-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mingming Cui ◽

Xiao-Lin Lu ◽

Yan-Yu Lyu ◽

Fang Wang ◽

Xiao-Lu Xie ◽

...

Keyword(s):

Folic Acid ◽

Pregnant Women ◽

Neural Tube ◽

Neural Tube Defects ◽

Rural Women ◽

Rural Areas ◽

Urban Areas ◽

Unplanned Pregnancy ◽

Urban China ◽

Cross Sectional

Abstract Background The prevalence of neural tube defects (NTDs) in China declined during 2000–2017 with periconceptional folic acid (FA) supplementation, which is effective in reducing the risk of birth defects. We aimed to assess the knowledge and actual use of FA among Chinese pregnant women and to explore factors associated with FA use before pregnancy. Methods All data were collected in face-to-face interviews during health visits among pregnant women. We collected information about knowledge and use of FA supplements and demographic, socioeconomic, and health status. One maternity and childcare hospital was chosen in each of four cities: Beijing, Huaibei, Kunming, and Haikou. In total, 435 pregnant women were randomly recruited for interviews conducted from June to December 2016. Results A total of 428 pregnant women were included in this survey. Of these, 82.0% (351/428) knew that FA can prevent NTDs, and 75.9% (325/428) knew the correct time to take FA. Overall, 65.9% (282/428) of women knew both that FA can prevent NTDs and the recommended time to take FA before pregnancy. Approximately 95.1% (407/428) of women reported having ever taken FA, only 46.3% (198/428) had begun to take FA supplementation before conception, and 64.5% (109/169) of women from rural areas failed to take FA before pregnancy. Women living in northern China (odds ratio [OR] = 1.81, 95% confidence interval [CI], 1.18–2.77), those with unplanned pregnancy (OR = 1.99, 95% CI 1.30–3.04), and highly educated women (OR = 2.37, 95% CI 1.45–3.88) were more likely to know about FA. Women who were homemakers (OR = 1.94, 95% CI 1.21–3.11) and had unplanned pregnancy (OR = 6.18, 95% CI 4.01–9.53) were less likely to begin taking FA before pregnancy. Conclusions Our survey showed that most pregnant women knew about FA. Although preconception intake of FA can help to reduce NTDs, improving the rate of FA intake before pregnancy is needed in urban areas of China, especially among homemakers and women from rural areas or with unplanned pregnancy. Campaigns are needed to increase awareness about FA and FA use before pregnancy among rural women, homemakers, and those with unplanned pregnancy and lower education levels.

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Patterns of Red and Processed Meat Consumption across North America: A Nationally Representative Cross-Sectional Comparison of Dietary Recalls from Canada, Mexico, and the United States

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010357 ◽

2021 ◽

Vol 18 (1) ◽

pp. 357

Author(s):

Sarah M. Frank ◽

Lindsay M. Jaacks ◽

Carolina Batis ◽

Lana Vanderlee ◽

Lindsey Smith Taillie

Keyword(s):

North America ◽

Meat Consumption ◽

The United States ◽

Processed Meat ◽

Cross Sectional ◽

The Us ◽

Total Meat ◽

Nationally Representative ◽

Processed Meat Consumption ◽

Red And Processed Meat

Close economic ties encourage production and trade of meat between Canada, Mexico, and the US. Understanding the patterns of red and processed meat consumption in North America may inform policies designed to reduce meat consumption and bolster environmental and public health efforts across the continent. We used nationally-representative cross-sectional survey data to analyze consumption of unprocessed red meat; processed meat; and total red and processed meat. Generalized linear models were used to separately estimate probability of consumption and adjusted mean intake. Prevalence of total meat consumers was higher in the US (73.6, 95% CI: 72.3–74.8%) than in Canada (65.6, 63.9–67.2%) or Mexico (62.7, 58.1–67.2%). Men were more likely to consume unprocessed red, processed, and total meat, and had larger estimated intakes. In Mexico, high wealth individuals were more likely to consume all three categories of meat. In the US and Canada, those with high education were less likely to consume total and processed meat. Estimated mean intake of unprocessed red, processed, and total meat did not differ across sociodemographic strata. Overall consumption of red and processed meat remains high in North America. Policies to reduce meat consumption are appropriate for all three countries.

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Nutrient supplementation among pregnant women in China: an observational study

Public Health Nutrition ◽

10.1017/s1368980021001269 ◽

2021 ◽

pp. 1-19

Author(s):

Tao Han ◽

Jingwen Dong ◽

Jiangtao Zhang ◽

Chenxiao Zhang ◽

Yuxuan Wang ◽

...

Keyword(s):

Vitamin D ◽

Folic Acid ◽

Pregnant Women ◽

Family Members ◽

Primary Source ◽

Cross Sectional Study ◽

Cross Sectional ◽

Nutrient Supplementation ◽

Face To Face ◽

Source Of Information

Abstract Objective: To clarify nutrient supplementation usage and primary source of information among pregnant women in China. Design: This cross-sectional study used information on nutrient supplementation and primary source of information collected via face-to-face interviews. Data on the usage of folic acid, calcium/vitamin D, iron, vitamins, docosahexaenoic acid, and other dietary supplements were collected. Primary source of information were categorized as family/relatives, friends/co-workers, the Internet, books/magazines, television/radio, doctors, other people, and oneself. Setting: Maternal and Child Health Hospital in Chengdu, China. Participants: 1081 Chinese pregnant women aged ≥ 20 years with singleton pregnancies. Results: In all three trimesters of pregnancy, usage was highest and most stable for folic acid (81.7%), followed by vitamins (vitamin A, B-group vitamins, vitamin C, and multivitamins; 75.0%), whereas calcium/vitamin D (51.4%) and iron (18.1%) usage was low, potentially indicating a deficiency risk. All supplementation usage percentages increased with pregnancy duration (p < 0.05). Notably, approximately 10% of the pregnant women in our study did not use any nutrient supplementation, and this was especially common in early pregnancy. More than 50% of the women reported getting information on nutrient supplementation from family members, and about 30% reported getting this information from doctors. Conclusions: Among pregnant women in China, awareness about nutrient supplementation increases as the pregnancy progresses, but some types of nutrient supplementation (such as calcium/vitamin D and iron) remain at low levels. It is necessary to pay more attention to the health education of pregnant women in China, and the influence of family members should be emphasized.

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Concentration of folic acid (FA) in serum of Japanese pregnant women

Reviews on Environmental Health ◽

10.1515/reveh-2020-0014 ◽

2020 ◽

Vol 35 (3) ◽

pp. 277-280

Author(s):

Nathan Mise ◽

Mayumi Ohtsu ◽

Akihiko Ikegami ◽

Yoko Hosoi ◽

Yoshihiko Nakagi ◽

...

Keyword(s):

Folic Acid ◽

Pregnant Women ◽

Epigenetic Modification ◽

Large Fraction ◽

Body Burden ◽

Inorganic Arsenic ◽

Health Concern ◽

Japanese Children ◽

Cross Sectional ◽

Japanese Pregnant Women

AbstractObjectivesExposure to inorganic arsenic (iAs) is a world-wide health concern. We reported that Japanese children and pregnant women are exposed to moderate levels of iAs through food. Reducing iAs contamination from foods of high iAs is an important issue unique in Japan. Integrated iAs is methylated to less toxic organic forms, and S-adenosyl-L-methyonine (SAM), a common methyl-donor of DNA and histones, is utilized in this process. Chronic consumption of SAM by iAs metabolism due to exposure to iAs might alter the epigenetic modification of genome. The SAM biosynthesis pathway is dependent on folate cycle, and it is possible that ingestion of sufficient folic acid (FA) is protective to iAs induced toxicity.MethodsIn the course of our cross-sectional body burden analyses of Pb and iAs in Japanese children and pregnant women, termed “PbAs study”, FA concentration in serum of 104 pregnant women was measured.ResultsMean (±SEM) of serum FA concentration was 15.8 ± 1.3 (ng/mL). There are significant number of people showing very high FA (>30 ng/ mL), and large fraction of them were taking supplements daily.ConclusionsThese results suggested that level of FA ingestion of Japanese pregnant women is high for supporting normal fetal development.

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‘At-risk’ individuals’ responses to direct to consumer advertising of prescription drugs: a nationally representative cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-017865 ◽

2017 ◽

Vol 7 (12) ◽

pp. e017865 ◽

Cited By ~ 3

Author(s):

Neda Khalil Zadeh ◽

Kirsten Robertson ◽

James A Green

Keyword(s):

At Risk ◽

Health Status ◽

Prescription Drugs ◽

Cross Sectional ◽

Drug Advertising ◽

Behavioural Responses ◽

Reported Health ◽

Nationally Representative ◽

Self Reported Health Status ◽

Direct To Consumer Advertising

ObjectivesThe factors determining individuals’ self-reported behavioural responses to direct to consumer advertising of prescription drugs were explored with an emphasis on ‘at-risk’ individuals’ responses.DesignNationally representative cross-sectional survey.SettingCommunity living adults in New Zealand.Participants2057 adults (51% women).Primary outcome measuresSelf-reported behavioural responses to drug advertising (asking a physician for a prescription, asking a physician for more information about an illness, searching the internet for more information regarding an illness and asking a pharmacist for more information about a drug).MethodsMultivariate logistic regressions determined whether participants’ self-reported behavioural responses to drug advertising were predicted by attitudes towards advertising and drug advertising, judgements about safety and effectiveness of advertised drugs, self-reported health status, materialism, online search behaviour as well as demographic variables.ResultsIdentifying as Indian and to a less extent Chinese, Māori and ‘other’ ethnicities were the strongest predictors of one or more self-reported responses (ORs 1.76–5.00, Ps<0.05). Poorer self-reported health status (ORs 0.90–0.94, all Ps<0.05), favourable attitude towards drug advertising (ORs 1.34–1.61, all Ps<0.001) and searching for medical information online (ORs 1.32–2.35, all Ps<0.01) predicted all self-reported behavioural outcomes. Older age (ORs 1.01–1.02, Ps<0.01), less education (OR 0.89, P<0.01), lower income (ORs 0.89–0.91, Ps<0.05) and higher materialism (ORs 1.02–1.03, Ps<0.01) also predicted one or more self-reported responses.ConclusionsTaken together, the findings suggest individuals, especially those who are ‘at-risk’ (ie, with poorer self-reported health status, older, less educated, lower income and ethnic minorities), may be more vulnerable to drug advertising and may make uninformed decisions accordingly. The outcomes raise significant concerns relating to the ethicality of drug advertising and suggest a need for stricter guidelines to ensure that drug advertisements provided by pharmaceutical companies are ethical.

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