School of Epidemiology, Public Health and Preventive Medicine, and
School of Epidemiology, Public Health and Preventive Medicine, and.
Am J Clin Nutr. 2017 Aug;106(2):541-548. doi: 10.3945/ajcn.117.155499. Epub 2017 Jun 14.
Assessments of the dietary intakes in various populations suggest that pregnant women have difficulty meeting all their nutritional requirements through diet alone. Few large-scale studies have considered both food sources and supplements in assessing the adequacy of nutritional intakes during pregnancy. Our study aimed to assess nutritional intakes during pregnancy by examining dietary sources and supplements. It then compared these findings with Dietary Reference Intakes. We conducted a nutrition study in a large pregnancy cohort using a 3-d food record during the second trimester of pregnancy. Detailed information about supplement consumption was obtained by interview at each prenatal visit. We estimated the distribution of total usual intakes for energy, macronutrients, and micronutrients for 1533 pregnant women. A third of the participants had total fat intakes that exceeded the Acceptable Micronutrient Distribution Range. A majority of women (85%) had sodium intakes above the Tolerable Upper Intake Level (UL). Median intakes for fiber and potassium were lower than Adequate Intakes. Dietary intakes of vitamin B-6, magnesium, and zinc were below the Estimated Average Requirements (EARs) for 10-15% of the women. A majority of the women had dietary intakes below the EARs for iron (97%), vitamin D (96%), and folate (70%). When we considered micronutrient intakes from both food and supplements, we found that the prevalence of inadequate intake was <10% for all nutrients except vitamin D (18%) and iron (15%), whereas 32% and 87% of the women had total intakes above the ULs for iron and folic acid, respectively. The level of intake of some nutrients from food alone remains low in the diets of pregnant women. Supplement use reduces the risk of inadequate intake for many micronutrients, but diet-related issues during pregnancy remain and deserve to be addressed in public health interventions. This trial was registered at clinicaltrials.gov as NCT03113331.
对不同人群的膳食摄入量评估表明，孕妇仅通过饮食难以满足所有营养需求。很少有大规模的研究同时考虑食物来源和补充剂来评估孕妇在怀孕期间营养摄入量是否充足。我们的研究旨在通过检查饮食来源和补充剂来评估孕妇的营养摄入量，然后将这些发现与膳食参考摄入量进行比较。我们在一个大型妊娠队列中进行了一项营养研究，在妊娠中期使用了为期 3 天的食物记录。在每次产前就诊时通过访谈获得有关补充剂消费的详细信息。我们估计了 1533 名孕妇的总日常能量、宏量营养素和微量营养素摄入量的分布。三分之一的参与者的总脂肪摄入量超过了可接受的微量营养素分布范围。大多数女性（85%）的钠摄入量超过了可耐受上限（UL）。膳食纤维和钾的中位数摄入量低于充足摄入量。维生素 B-6、镁和锌的饮食摄入量低于 10-15%的女性的估计平均需求量（EAR）。大多数女性的铁（97%）、维生素 D（96%）和叶酸（70%）的饮食摄入量低于 EAR。当我们考虑来自食物和补充剂的微量营养素摄入量时，我们发现除了维生素 D（18%）和铁（15%）之外，所有营养素的摄入不足率都<10%，而分别有 32%和 87%的女性铁和叶酸的总摄入量超过 UL。孕妇饮食中某些营养素的单独摄入量仍然较低。补充剂的使用降低了许多微量营养素摄入不足的风险，但与饮食相关的问题仍然存在，值得在公共卫生干预中加以解决。这项试验在 clinicaltrials.gov 上注册为 NCT03113331。
