Division of Nutritional Sciences, Cornell University, Ithaca, NY14850, USA.
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD21205, USA.
Br J Nutr. 2021 Oct 28;126(8):1247-1256. doi: 10.1017/S0007114520005188. Epub 2020 Dec 28.
Adequate dietary intake is critical to prevent adverse pregnancy outcomes. India has a high burden of maternal and child morbidity and mortality, but there is a lack of adequate tools to assess dietary intake. We validate an FFQ, New Interactive Nutrition Assistant - Diet in India Study of Health (NINA-DISH), among pregnant women living with and without HIV in Pune, India. Women were selected from a cohort study investigating immune responses to HIV and latent tuberculosis during pregnancy. The FFQ was administered during the third trimester and validated against multiple 24-h dietary recalls (24-HDR) collected in second and third trimesters. Data for analysis were available from fifty-eight women out of seventy enrolled into this sub-study, after excluding those with incomplete data or implausible energy intake. The median (Q1, Q3) age of study participants was 23 (20, 25) years. Median (Q1, Q3) daily energy intakes were 10 552 (8000, 11 958) and 10 673 (8510, 13 962) kJ by 24-HDR and FFQ, respectively, with FFQ overestimating nutrient intake. Pearson correlations between log-transformed estimates from FFQ and 24-HDR for energy, protein, carbohydrate, fat, Fe and Zn were 0·47, 0·48, 0·45, 0·33, 0·4 and 0·54, respectively. Energy-adjusted and de-attenuated correlations ranged from 0·41 (saturated fat) to 0·73 (Na). The highest misclassification into extreme tertiles was observed for fat (22 %), saturated fat (21 %) and Na (21 %). Bias existed at higher intake levels as observed by Bland-Altman plots. In conclusion, NINA-DISH is a valid and feasible tool for estimating dietary intakes among urban pregnant women in Western India.
充足的饮食摄入对于预防不良妊娠结局至关重要。印度的母婴发病率和死亡率负担沉重，但缺乏评估饮食摄入的充分工具。我们在印度浦那的 HIV 阳性和阴性孕妇中验证了一份食物频率问卷（FFQ），名为新互动营养助手-印度饮食健康研究（NINA-DISH）。这些女性是在一项研究怀孕期间 HIV 和潜伏性结核病免疫反应的队列研究中选出的。FFQ 在孕晚期进行，并用第二和孕晚期收集的多次 24 小时饮食回忆（24-HDR）进行验证。在这项子研究中，共有 70 名女性入组，其中 58 名女性的数据可用于分析，排除了那些数据不完整或能量摄入不合理的女性。研究参与者的中位（Q1，Q3）年龄为 23（20，25）岁。通过 24-HDR 和 FFQ 分别估计的每日能量摄入量中位数（Q1，Q3）为 10552（8000，11958）和 10673（8510，13962）kJ，FFQ 高估了营养素的摄入量。FFQ 和 24-HDR 对数转换估计值之间的 Pearson 相关系数分别为 0.47、0.48、0.45、0.33、0.4 和 0.54，分别为能量、蛋白质、碳水化合物、脂肪、Fe 和 Zn。经能量调整和去衰减的相关性范围从 0.41（饱和脂肪）到 0.73（Na）。脂肪（22%）、饱和脂肪（21%）和 Na（21%）的极端三分位的分类错误最高。Bland-Altman 图显示，在较高的摄入量水平存在偏差。总之，NINA-DISH 是一种在印度西部城市孕妇中评估饮食摄入的有效且可行的工具。
