Sharma Shantanu, Akhtar Faiyaz, Kumar Singh Rajesh, Mehra Sunil
Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden.
Reproductive, Maternal, Newborn, Child and Adolescent Health Division, MAMTA Health Institute for Mother and Child, New Delhi, India.
Front Nutr. 2020 Nov 13;7:595170. doi: 10.3389/fnut.2020.595170. eCollection 2020.
Dietary pattern analysis has emerged as a balanced and realistic approach that reflects how the food is consumed in real life. However, previous studies have overlooked the two important phases in women's life, pregnancy, and lactation. We aimed to explore dietary patterns and their determinants among pregnant and lactating women from marginalized families in rural areas and urban slums of India. It was a community-based cross-sectional study conducted across four districts of India, one from each region (North, West, East, and South). We used a structured questionnaire to collect data on socio-demographic characteristics and access to nutrition services. The dietary data were collected using a qualitative food frequency questionnaire having 204 food items, which were clubbed into 16 major food groups. The principal component analysis method was employed to identify dietary patterns (prefixed at 4). We used multinomial logistic regression to explore associations of socio-demographic and access to nutrition services' variables with identified dietary patterns. The data of 476 pregnant and 446 lactating women were assessed. Four patterns explained for 54% of the variation in their food intake. The patterns identified were low-mixed vegetarian (19%), non-vegetarian (15%), high-mixed vegetarian (11%), and calorie-rich (9%). The low-mixed diet was rich in rice, roots and tubers, green leafy vegetables, and other vegetables. The non-vegetarian diet was characterized by high loadings for nuts or seeds, chicken, meat or fish, eggs, beverages (milk-based), and snacks. The high-mixed vegetarian diet was rich in cereals other than rice and wheat, pulses, and fruits. The calorie-rich diet had high factor loadings for wheat, butter and oil, sweets, and milk and milk products. Hindus and women who lived in rural areas had higher odds of consuming a low-mixed vegetarian diet and lower odds of a high-mixed vegetarian diet. Working women and those who received nutrition advice during pregnancy or lactation had 2-3 times higher odds of consuming a high-mixed vegetarian diet. A high prevalence of a low-mixed vegetarian diet among women can have adverse pregnancy and birth outcomes. Healthy dietary patterns during pregnancy and lactation are required to meet the increased micro- and macronutrient requirements for improved maternal and child health.
饮食模式分析已成为一种平衡且现实的方法，它反映了食物在现实生活中的消费方式。然而，以往的研究忽视了女性生命中的两个重要阶段，即怀孕和哺乳期。我们旨在探讨印度农村地区和城市贫民窟边缘化家庭中孕妇和哺乳期妇女的饮食模式及其决定因素。这是一项基于社区的横断面研究，在印度的四个地区进行，每个地区各选一个（北部、西部、东部和南部）。我们使用结构化问卷收集社会人口学特征和营养服务获取情况的数据。饮食数据通过一份包含204种食物的定性食物频率问卷收集，这些食物被归为16个主要食物组。采用主成分分析法确定饮食模式（预先设定为4种）。我们使用多项逻辑回归来探讨社会人口学因素和营养服务获取情况变量与确定的饮食模式之间的关联。对476名孕妇和446名哺乳期妇女的数据进行了评估。四种模式解释了她们食物摄入量变化的54%。确定的模式为低混合素食（19%）、非素食（15%）、高混合素食（11%）和高热量（9%）。低混合饮食富含大米、块根和块茎、绿叶蔬菜及其他蔬菜。非素食饮食的特点是坚果或种子、鸡肉、肉类或鱼类、鸡蛋、饮料（奶类）和零食的负荷较高。高混合素食饮食富含除大米和小麦之外的谷物、豆类和水果。高热量饮食中，小麦、黄油和油、甜食以及牛奶和奶制品的因子负荷较高。印度教徒和居住在农村地区的妇女食用低混合素食的几率较高，而食用高混合素食的几率较低。职业女性以及在怀孕或哺乳期接受营养建议的女性食用高混合素食的几率高出2至3倍。女性中低混合素食的高流行率可能会对妊娠和分娩结局产生不利影响。孕期和哺乳期需要健康的饮食模式来满足增加的微量和宏量营养素需求，以改善母婴健康。
