Johnson Tatyana, Kan Ann K, Bonner Lauren B, Van Horn Linda, Kershaw Kiarri N, Grobman William A, Lindsay Karen L, Debbink Michelle P, Mercer Brian M, Haas David M, Saade George R, Reddy Uma, Parry Samuel, Simhan Hy, Robinson Daniel T
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
J Acad Nutr Diet. 2024 Nov 12. doi: 10.1016/j.jand.2024.11.007.
Implications of lifelong, perceived discrimination on nutrient intake during the preconception period are unclear.
The objective was to identify associations between perceived discrimination and consumption of specific nutrients associated with risk of adverse pregnancy outcomes.
This is a secondary data analysis of the prospective Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort. Participants completed a Block food frequency questionnaire assessing diet during the 3 months before pregnancy and a Krieger Experiences of Discrimination Scale assessing personal encounters of discrimination.
Participants were recruited from 8 clinical centers across the United States between 2010 and 2013. Each participant completed the food frequency and Krieger questionnaires and self-identified as belonging to a minoritized racial or ethnic group for this analysis (n = 2457).
Main outcomes include reported total energy and macronutrient intake, percent of energy from macronutrients, saturated and unsaturated fatty acids, added sugar, sodium, dietary fiber, and Healthy Eating Index-2010 Seafood and Plant Proteins component score.
Participants were grouped as reporting fewer (< 3) or more (≥ 3) circumstances of discrimination on the Krieger scale. Multivariable regression models examined associations between discrimination group and nutrient intake. Variables with nonnormal distributions were log transformed. Associations were adjusted for total energy intake. Primary outcomes underwent false discovery rate correction.
Those reporting 3 or more circumstances of discrimination had higher reported energy intake (P = .002) and higher reported intake of total fat, saturated fat, unsaturated fats, protein, added sugar, and sodium after false discovery rate correction (all P values < .05) compared with those reporting fewer circumstances. After adjustment for total energy intake, reporting 3 or more circumstances was associated with greater reported intake of saturated fat and n-3 polyunsaturated fatty acids, and lower reported intake of dietary fiber (all P values < .05).
Reporting 3 or more circumstances of discrimination was associated with higher reported total energy intake. After adjustment for total energy, reporting 3 or more circumstances of perceived discrimination was associated with less nutritious intake for some (higher saturated fat and lower dietary fiber) but not all (higher eicosapentaenoic and docosahexaenoic acids) nutrients.
孕前长期存在的、自我感知到的歧视对营养摄入的影响尚不清楚。
确定自我感知到的歧视与不良妊娠结局风险相关的特定营养素摄入之间的关联。
这是一项对前瞻性初产妊娠结局研究：监测准妈妈队列的二次数据分析。参与者完成了一份食物频率问卷，评估孕前3个月的饮食情况，并完成了一份克里格歧视经历量表，评估个人遭遇歧视的情况。
2010年至2013年期间，从美国8个临床中心招募参与者。每位参与者都完成了食物频率问卷和克里格问卷，并在本次分析中自我认定为属于少数族裔或种族群体（n = 2457）。
主要观察指标包括报告的总能量和宏量营养素摄入量、宏量营养素提供的能量百分比、饱和脂肪酸和不饱和脂肪酸、添加糖、钠、膳食纤维，以及健康饮食指数 - 2010海鲜和植物蛋白成分得分。
根据克里格量表，将参与者分为报告歧视情况较少（<3种）或较多（≥3种）的两组。多变量回归模型检验了歧视分组与营养摄入之间的关联。对非正态分布的变量进行对数转换。关联因素根据总能量摄入量进行调整。主要观察指标进行了错误发现率校正。
报告有3种或更多歧视情况的参与者，经错误发现率校正后，其报告的能量摄入量更高（P = 0.002），总脂肪、饱和脂肪、不饱和脂肪、蛋白质、添加糖和钠的摄入量也更高（所有P值<0.05），与报告歧视情况较少的参与者相比。在调整总能量摄入量后，报告有3种或更多歧视情况与饱和脂肪和n - 3多不饱和脂肪酸的摄入量增加以及膳食纤维的摄入量减少有关（所有P值<0.05）。
报告有3种或更多歧视情况与报告的总能量摄入量较高有关。在调整总能量后，报告有3种或更多自我感知到的歧视情况与某些营养素（饱和脂肪较高和膳食纤维较低）但并非所有营养素（二十碳五烯酸和二十二碳六烯酸较高）的营养摄入较差有关。
