Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO 80045, USA.
Maternal and Infant Health Center, INCAP (Institute of Nutrition for Central America and Panama), Guatemala City 01011, Guatemala.
Nutrients. 2019 Jul 10;11(7):1560. doi: 10.3390/nu11071560.
Up-to-date dietary data are required to understand the diverse nutritional challenges of pregnant women living in low-middle income countries (LMIC). To that end, dietary data were collected from 1st trimester pregnant women in rural areas of Guatemala, India, Pakistan, and Democratic Republic of the Congo (DRC) participating in a maternal lipid-based nutrient supplement (LNS) Randomized Controlled Trial to examine dietary diversity (DD), usual group energy and nutrient intakes, and prevalence of inadequate dietary intakes.
Two 24-h dietary recalls were conducted in ~240 pregnant women/site (total = 966) prior to 12-week gestation. Adequate DD was assessed, i.e., ≥5 major food groups consumed within the past 24 h. Median, Q1, Q3 intakes (without LNS) of energy, macronutrients, 12 micronutrients, and phytate were examined. The "at risk" prevalence of inadequate intakes were based on international guidelines for pregnant women.
Dietary patterns varied widely among sites, with adequate DD reported: 20% (Pakistan), 25% (DRC), 50% (Guatemala), and 70% (India). Significantly higher intakes of most key nutrients were observed in participants with adequate DD. More than 80% of women in all sites had inadequate intakes of folate, vitamin B12, and choline, and >80% of women in India and DRC also had inadequate intakes of calcium, thiamine, riboflavin, and vitamin B6.
Our data highlight the likely need for micronutrient supplementation in pregnancy, specifically multi-micronutrient interventions, and support the value of increasing DD as part of sustainable long-term nutrition programs for women of reproductive age in these poor rural settings in LMIC.
为了了解生活在中低收入国家（LMIC）的孕妇所面临的多样化营养挑战，我们需要掌握最新的饮食数据。为此，我们对参与母体脂类营养素补充剂（LNS）随机对照试验的危地马拉、印度、巴基斯坦和刚果民主共和国（DRC）农村地区的 1 期妊娠妇女进行了饮食数据收集，以评估饮食多样性（DD）、常规组能量和营养素摄入量以及饮食摄入不足的发生率。
在妊娠 12 周前，每个地点约有 240 名孕妇（总计 966 名）进行了 2 次 24 小时饮食回顾。评估了充足的 DD，即过去 24 小时内摄入了≥5 种主要食物组。分析了（不包括 LNS）能量、宏量营养素、12 种微量营养素和植酸盐的中位数、第 1 四分位数、第 3 四分位数摄入量。基于国际孕妇指南，评估了饮食摄入不足的“风险”发生率。
不同地点的饮食模式差异很大，充足 DD 的报告率为：20%（巴基斯坦）、25%（DRC）、50%（危地马拉）和 70%（印度）。在有充足 DD 的参与者中，大多数关键营养素的摄入量明显更高。所有地点的女性中有超过 80%存在叶酸、维生素 B12 和胆碱摄入不足，印度和 DRC 的女性中有超过 80%还存在钙、硫胺素、核黄素和维生素 B6 摄入不足。
我们的数据突出表明，妊娠期间可能需要补充微量营养素，特别是多种微量营养素干预措施，并且支持增加 DD 作为这些贫困农村地区育龄妇女可持续长期营养计划的一部分的价值。
