Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
J Nutr. 2023 Oct;153(10):3012-3022. doi: 10.1016/j.tjnut.2023.08.012. Epub 2023 Aug 19.
Most pregnant women in the United States are at risk of inadequate intake of vitamin A, vitamin D, folic acid, calcium, iron, and omega-3 fatty acids from foods alone. Very few United States dietary supplements provide sufficient doses of all 6 nutrients without inducing excess intake.
We aimed to identify energy-efficient foods that provide sufficient doses of these nutrients and could be consumed in lieu of dietary supplements to achieve the recommended intake in pregnancy.
In a previous analysis of 2,450 pregnant women, we calculated the range of additional intake needed to shift 90% of participants to intake above the estimated average requirement and keep 90% below the tolerable upper level for these 6 nutrients. Here, we identified foods and beverages from the 2019 to 2020 Food and Nutrient Database for Dietary Studies that provide target levels of these nutrients without exceeding the additional energy intake recommended for pregnancy beginning in the second trimester (340 kilocalories).
We identified 2358 candidate foods meeting the target intake range for at least one nutrient. No candidate foods provided target amounts of all 6 nutrients. Seaweed (raw or cooked without fat) provided sufficient vitamin A, folate, calcium, iron, and omega-3s (5 of 6 nutrients) but would require an intake of >5 cups/d. Twenty-one other foods/beverages (mainly fish, vegetables, and beverages) provided target amounts of 4 of the 6 nutrients. Few foods met targets for vitamin D (n = 54) or iron (n = 93).
Results highlight the difficulty in meeting nutritional requirements from diet alone and imply that dietary supplements are likely necessary to meet vitamin D and iron targets in pregnancy, as well as omega-3 fatty acid targets for individuals who do not consume fish products. Other foods could be added in limited amounts to help meet intake targets without exceeding caloric recommendations or nutrient safety limits.
大多数美国孕妇仅从食物中摄入维生素 A、维生素 D、叶酸、钙、铁和欧米伽-3 脂肪酸等，就会面临摄入不足的风险。很少有美国膳食补充剂能在不引起过量摄入的情况下，提供足够剂量的这 6 种营养素。
我们旨在确定能提供足够剂量的这些营养素且能量效率高的食物，这些食物可替代膳食补充剂，以满足孕妇的推荐摄入量。
在之前对 2450 名孕妇的分析中，我们计算出需要额外摄入多少才能使 90%的参与者摄入量超过估计的平均需求量，并使 90%的参与者摄入量低于这 6 种营养素的可耐受最高摄入量。在这里，我们从 2019 年至 2020 年的《食物与营养素数据库用于膳食研究》中确定了能提供这些营养素目标水平且不超过妊娠中期（第二个三个月）推荐的额外能量摄入（340 千卡）的食物和饮料。
我们发现了 2358 种候选食物，它们至少能满足一种营养素的目标摄入量范围。没有一种候选食物能提供所有 6 种营养素的目标量。海藻（生的或无脂肪煮的）提供了足够的维生素 A、叶酸、钙、铁和欧米伽-3（6 种营养素中的 5 种），但需要摄入>5 杯/天。其他 21 种食物/饮料（主要是鱼、蔬菜和饮料）提供了 6 种营养素中的 4 种的目标量。很少有食物能满足维生素 D（n=54）或铁（n=93）的目标。
结果突出了仅从饮食中满足营养需求的困难性，并暗示在妊娠期间，膳食补充剂可能是满足维生素 D 和铁目标以及不食用鱼类产品的个体的欧米伽-3 脂肪酸目标所必需的。其他食物可以限量添加，以帮助满足摄入量目标，而不会超过热量建议或营养素安全限制。
