This article is more than 5 years old. Information may no longer be current.

Nulliparous women not eating healthy immediately before first pregnancy

Although no women in a recent study met U.S. dietary guidelines, well-educated, white women were more likely than black, Hispanic and less-educated women to eat more nutritiously in the weeks leading up to their first pregnancy, according to research recently published in the Journal of the Academy of Nutrition and Dietetics.

"Little is known about the quality of periconceptional dietary intakes in the United States because too few pregnant women are included in national nutrition surveys. Diet quality of nonpregnant adults in the United States is generally poor, but some data indicate that diet improves when women are planning a pregnancy or once they become pregnant,” Lisa Bodnar, PhD, MPH, RD, department of epidemiology, University of Pittsburgh, and colleagues wrote. “There is a striking disparity in diet quality by socioeconomic position and race or ethnicity in the United States that has grown over time. Understanding whether these trends apply to pregnant women is critical because poor diet is modifiable and associated with the long-standing inequalities in maternal and child health outcomes.”

Bodnar and colleagues analyzed results of a semi-quantitative, self-administered questionnaire completed by 7,511 women during their first trimester of pregnancy, representing different ethnic groups and education levels. The women’s diet quality, as well as what she ate, during the 3 months around conception was measured against the Healthy Eating Index-2010. According to the National Cancer Institute, this index measures diet quality, independent of quantity, to evaluate compliance with U.S. Dietary Guidelines for Americans and watch for changes in dietary patterns.

Bodnar and colleagues also studied differences across maternal, ethnic and education groups.

Researchers found that average scores for Healthy Eating Index-2010 components were below recommendations for all women; however, the higher a woman’s education level, the higher her Healthy Eating Index-2010 score. The increase attributed to education among non-Hispanic black women was smaller than that among non-Hispanic whites and Hispanics (P < .0001). Overall, primary energy sources among nulliparous women were sugar-sweetened beverages, pasta dishes, and grain desserts, but these differed by race or ethnicity and education. Top sources of vitamin C, folate and iron were juices and enriched breads. About 34% of energy consumed was from empty calories, such as alcohol use beyond moderate levels, solid fats and sugars.

“Unlike many other pregnancy and birth risk factors, diet is something we can improve,” Bodnar said in a press release. “While attention should be given to improving nutritional counseling at doctor appointments, overarching societal and policy changes that help women to make healthy dietary choices may be more effective and efficient.” – by Janel Miller

Disclosure: The researchers report no relevant financial disclosures.

References: Overview and Background of The Healthy Eating Index – 2010 (Accessed from the National Cancer Institute’s website on 04-07-2017.)