Food and nutrient intakes of pregnant and lactating women in the United States

Food and nutrient intakes of pregnant and lactating women in the U.S. were estimated using 24-hour dietary recall data from USDA's 1985 and 1986 Continuing Surveys of Food Intakes by Individuals. Comparisons were made with intakes of nonpregnant and nonlactating (other) women and with dietary recommendations. Pregnant and lactating women were more likely to use milk products and to consume larger amounts of these products than were other women; however, reported intakes were still below recommended levels. The results also suggest that many pregnant and lactating women consume less than the recommended amounts of vegetables, fruits, and meat, poultry, fish, and meat alternates. Absolute intakes of most nutrients were higher among pregnant and lactating women than among other women. However, except for some nutrients provided by milk products and fruit, nutrient intakes per 1000 kcal were similar between pregnant and lactating women and other women. Pregnant women consumed 66% of their RDA for folate and only 43% of their RDA for iron. Lactating women consumed 63% of their RDA for zinc.     

Food choices of vegetarians and nonvegetarians during pregnancy and lactation

Data on food choices and nutrient intake were obtained from 60 lactating women, including 29 vegetarians. The most common changes in consumption patterns during pregnancy were increased intake of high-protein foods, especially milk products, and decreased intake of coffee, tea, and alcohol. The changes were partially based on food cravings and/or aversions. In addition to high-protein foods, some of the women craved fruits and sweets. Items most commonly eliciting aversive reactions were vegetables, strong-smelling and strong-tasting combination dishes, and greasy foods. Aversions to coffee, tea, and alcohol were almost as frequent as those to greasy foods. Nutrient intake during lactation was measured using 24-hour recalls and 2-day diet records that also considered dietary supplements. A total of 332 intake records were evaluated relative to the RDAs for lactating women. Mean energy intake was 2,200 kcal (88% of the recommendation), and mean protein intake was 86 gm (134% of the RDA). Mean nutrient intakes from diet alone ranged from 89% of the RDA for iron to 154% for vitamin A; mean intakes from diet plus supplements ranged from 133% of the RDA for calcium to 581% of the RDA for thiamin. Dietary supplementation provided a substantial part of the intake of some nutrients; for most women, however, the RDAs were met by diet alone.     

Zinc absorption from zinc oxide, zinc sulfate, zinc oxide + EDTA, or sodium-zinc EDTA does not differ when added as fortificants to maize tortillas

The fortification of staple foods with zinc may play an important role in achieving adequate zinc intakes in countries at risk of zinc deficiency. However, little is known about the relative bioavailability of different zinc compounds that may be used in food fortification. The objective of this study was to measure and compare fractional zinc absorption from a test meal that included a maize tortilla fortified with zinc oxide, zinc sulfate, zinc oxide + EDTA, or sodium-zinc EDTA. A double isotopic tracer ratio method ((67)Zn as oral tracer and (70)Zn as intravenous tracer) was used to estimate zinc absorption in 42 Mexican women living in a periurban community of Puebla State, Mexico. The test meal consisted of maize tortillas, yellow beans, chili sauce, and milk with instant coffee; it contained 3.3 mg zinc and had a phytate:zinc molar ratio of 17. Fractional zinc absorption did not differ significantly between the test groups (ANOVA; P > 0.05). Percent absorptions were (mean +/- SD) zinc oxide, 10.8 +/- 0.9; zinc sulfate, 10.0 +/- 0.02; zinc oxide + EDTA, 12.7 +/- 1.5; and sodium-zinc EDTA, 11.1 +/- 0.7. We conclude that there was no difference in zinc absorption from ZnO and ZnSO(4) when added as fortificants to maize tortillas and consumed with beans and milk. The addition of EDTA with zinc oxide or the use of prechelated sodium-zinc EDTA as fortificants did not result in higher zinc absorption from the test meal.     

Intake of tapwater and total water by pregnant and lactating women.

BACKGROUND. Despite theoretically higher requirements for water due to physiologic demands of pregnancy and lactation, little is known of actual ranges of intake in pregnant and lactating women. METHODS. Population-based estimates of total water and tapwater intake in women of reproductive age were derived using data from the 1977-78 USDA Nationwide Food Consumption Survey. Three-day average intakes were calculated for 188 pregnant women, 77 lactating women, and 6,201 non-pregnant, non-lactating control women. RESULTS. Total water intake (mean +/- SD) was 1,940 +/- 686 g/day (median 1,835) for control women, 2,076 +/- 743 g/day (median 1,928) for pregnant women and 2,242 +/- 658 g/day (median 2,164) for lactating women. Tapwater intake was 1,157 +/- 635 g/day (median 1,065) for control women, 1,189 +/- 699 g/day (median 1,063) for pregnant women, and 1,310 +/- 591 g/day (median 1,330) for lactating women. Total water intake was equal to or greater than 3,000 g/day among 7 percent of control women, 11 percent of pregnant women, and 13 percent of lactating women. Tapwater intake was equal to or greater than 2,000 g/day among 10 percent of control women, 15 percent of pregnant women, and 8 percent of lactating women. CONCLUSIONS. These results should be useful in estimating amounts of nutrients and toxic substances that women of reproductive age obtain through the water supply.     

Do pregnant smokers eat differently from pregnant non-smokers?

Summary. This article describes a study of the relationship between diet and smoking in a group of 821 Norwegian pregnant women. The study is part of a multi-centre project, examining risk factors for intrauterine growth retardation. Two 3-day dietary records were collected during the 17th and 33rd week of pregnancy. Information on smoking habits and other relevant parameters were collected through an extensive questionnaire. The results showed that the smokers consumed significantly less than the non-smokers of bread, cakes and cookies, vegetables, fruits and berries, cheese, yoghurt, low fat milk, juice and tea. The smokers also consumed significantly more meat, margarine, whole milk, soft drinks and coffee than the non-smokers on both occasions. The diet of the smokers contained significantly less protein, carbohydrate, dietary fibre, thiamin, riboflavin, vitamin C, calcium and iron as compared with the non-smokers. Fat contributed significantly more to the energy content of the diet of the smokers and it is concluded that their diet was less nutritious than that of the non-smokers throughout pregnancy.     

The addition of milk or yogurt to a plant-based diet increases zinc bioavailability but does not affect iron bioavailability in women

The addition of milk and milk-based products to the diets of individuals subsisting on plant-based diets was reported to have positive effects on nutritional status and functional outcomes such as growth, morbidity, and cognition. We examined the effect of the addition of milk or yogurt on the bioavailability of zinc and iron from a plant-based rural diet. The subjects were 48 Mexican women (30.9 +/- 5.7 y) who habitually consumed a plant-based diet. The women were assigned to 1 of 3 groups: 1) the typical rural Mexican diet, 2) that diet with milk added, or 3) that diet with yogurt for 13 d. Zinc absorption was measured after extrinsically labeling meals with (67)Zn and an i.v. dose of (70)Zn; iron absorption was measured by extrinsically labeling meals with (58)Fe and a reference oral dose of (57)Fe. Including milk and yogurt in the diet increased zinc absorption by 50 and 68%, respectively (P < 0.05). The 3 groups did not differ in the percentage iron absorption. The total amount of zinc absorbed was increased (P < 0.05) by 70% when milk was added to the meal and 78% when yogurt was added. The total amount of iron absorbed did not differ among the groups. The addition of milk and yogurt to a plant-based diet high in phytate increases zinc bioavailability without affecting iron bioavailability.     

Nutritional risk factors for iron-deficiency anaemia in children 12-24 months old in the area of Thessalia in Greece

Iron-deficiency anaemia (IDA) is a common problem all over the world, which mainly attacks pregnant women, infants and children. The main objectives were to assess the prevalence of IDA in children 12-24 months old in the area of Thessalia located in the central part of Greece and to identify, by means of a simple questionnaire, its nutritional risk factors. The research was applied as a cross-sectional and case-control study. In the first part of the study, the haemoglobin (Hb) levels were estimated by a mobile photometer analyser in 938 children (approximately one-third of the total children population). In the second part, children with Hb?相似文献   

Iron supplement use among women in the United States: science,policy and practice

The use of iron supplements is an accepted treatment for nonhereditary anemia. The use of iron supplements as prophylaxis is more controversial. We estimated the proportion of persons who consumed supplements that contain iron among the following groups: nonpregnant, nonlactating adolescents, aged 14-18 y (n = 992); women aged 19-50 y (n = 5,062); women aged 51 y and older (n = 3,593); pregnant women (n = 295); and lactating women (n = 97) using data from the National Health and Nutrition Examination Survey, 1988-1994. We found that the proportion (% +/- SE) of U.S. women consuming supplements containing iron in the previous month was 9 +/- 2% among nonpregnant, nonlactating adolescents; 23 +/- 1% among women aged 19 y and older; 72 +/- 4% among pregnant women; and 60 +/- 8% among lactating women. Low income women were less likely to consume supplements containing iron. Minority women were less likely to consume supplements containing iron in all groups except adolescents. Among consumers of supplements that contain iron, the median intake of iron was 11 mg/d among nonpregnant adolescents, approximately 17 mg/d among nonpregnant women, 58 mg/d among pregnant women and 57 mg/d among lactating women. Use of supplements that contain iron was associated with a significantly reduced prevalence of iron deficiency among women 19-50 y but not among other groups. Groups at highest risk of iron deficiency (e.g., low income and minority women) are often least likely to consume supplements containing iron, suggesting that supplement use is unrelated to actual need.     

哺乳期农村乳母乳汁无机元素含量的变化

目的了解哺乳期人乳无机元素含量的变化及其与乳母膳食的关联。方法采用横断面调查方法,收集55名陕西省澄城县农村健康乳母清晨乳样,利用原子吸收分光光度法测定乳汁钙、镁、铁、锰、锌和铜的浓度。采用24小时回顾法进行连续3天膳食调查,计算膳食营养素的摄入量。结果农村乳母乳汁中镁、锌、铜浓度随哺乳期延长明显降低,铁浓度随哺乳期延长而上升。乳母膳食钙摄入量约为钙膳食参考摄入量(DRI)1/3,膳食无机元素的摄入量与人乳相应元素之间无明显相关性。多因素分析表明,乳汁中钙与镁、铁与铜、锰与锌均呈正相关,钙分别与乳脂、铁、锌呈负相关。结论随哺乳期时间延长,成熟乳中镁、锌、铜浓度降低而铁浓度增加,乳母膳食钙的摄入严重不足,乳汁各元素与膳食相应元素之间无关联。     

Risk factors associated with anemia and iron deficiency among Kuwaiti pregnant women

A cross-sectional study was carried out to identify the risk factors of anemia and iron deficiency in Kuwaiti pregnant women. Pregnant women (n = 465) aged 18-47 years, of 4-39 weeks at gestation were recruited during antenatal visits from six health facilities in Kuwait. Socio-demographic, pregnancy-related and dietary information were collected. Hemoglobin, serum ferritin and serum C-reactive protein concentrations were determined. Logistic regression analysis revealed that iron deficiency and not taking iron-folate tablets or taking them occasionally were the two most important risk factors associated with anemia. Pregnant women with higher gestational age, short birth spacing ( ≤ 2 years), not taking iron-folate tablets or taking them occasionally, not consuming fruit juice, and consuming brown bread, tea and/or coffee were significant risk factors associated with iron deficiency. In conclusion, various factors including dietary habits appeared to be associated with poor iron status, which is the most important risk factor for anemia among Kuwaiti pregnant women.     

Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages

The effects of different polyphenol-containing beverages on Fe absorption from a bread meal were estimated in adult human subjects from the erythrocyte incorporation of radio-Fe. The test beverages contained different polyphenol structures and were rich in either phenolic acids (chlorogenic acid in coffee), monomeric flavonoids (herb teas, camomile (Matricaria recutita L.), vervain (Verbena officinalis L.), lime flower (Tilia cordata Mill.), pennyroyal (Mentha pulegium L.) and peppermint (Mentha piperita L.), or complex polyphenol polymerization products (black tea and cocoa). All beverages were potent inhibitors of Fe absorption and reduced absorption in a dose-dependent fashion depending on the content of total polyphenols. Compared with a water control meal, beverages containing 20-50 mg total polyphenols/serving reduced Fe absorption from the bread meal by 50-70%, whereas beverages containing 100-400 mg total polyphenols/serving reduced Fe absorption by 60-90%. Inhibition by black tea was 79-94%, peppermint tea 84%, pennyroyal 73%, cocoa 71%, vervain 59%, lime flower 52% and camomile 47%. At an identical concentration of total polyphenols, black tea was more inhibitory than cocoa, and more inhibitory than herb teas camomile, vervain, lime flower and pennyroyal, but was of equal inhibition to peppermint tea. Adding milk to coffee and tea had little or no influence on their inhibitory nature. Our findings demonstrate that herb teas, as well as black tea, coffee and coca can be potent inhibitors of Fe absorption. This property should be considered when giving dietary advice in relation to Fe nutrition.     

Tea and coffee as sources of some minerals in the New Zealand diet

Daily intakes of tea and coffee of a representative sample of adult New Zealanders (865 men and 1100 women) were calculated from 24-h dietary recalls. The mineral concentrations in tea and coffee samples were determined by atomic absorption spectrometry and used to estimate daily mineral intakes from these beverages. More than 80% consumed tea and about 60% consumed coffee on the day of the recall. The men drank significantly more tea than the women (p less than 0.001), but coffee intakes were similar. The results indicate that for New Zealand adults tea is a very good source of manganese and it also contains appreciable amounts of potassium. Coffee is a better source of potassium than tea, has appreciable amounts of magnesium, and may contribute significantly to manganese intakes in some instances. The amounts of copper, zinc, sodium, calcium, and iron extracted from tea leaves and coffee beans in the brewing processes are too low to be of any nutritional significance but minerals in the water used in their preparation may make a significant contribution to dietary intakes.     

A new procedure to assess the energy requirements of lactation in Gambian women

The combined 24-h energy expenditure (24-h EE) of mother and child was measured with a respiratory chamber (indirect calorimeter) in a group of 16 lactating Gambian women and was compared with that of a control group of 16 nonpregnant, nonlactating (NPNL) Gambian women. Breast-milk production (738 +/- 47 g/d: mean +/- SE) was adequate to allow a normal rate of growth of their 2-mo-old babies (28.0 +/- 2.4 g/d). The combined 24-h EE (mother and child) was higher (8381 +/- 180 kJ/d. P less than 0.001) than that of NPNL women (6092 +/- 121 kJ/d). Two-thirds of this differences could be attributed to the child's EE and one-third to a greater spontaneous physical activity of lactating women. The energy retained by the child for growth in conjunction with the calorimetric measurements allowed the calculation of the extra energy requirements for lactation, which were found to be 2100 kJ/d. These results confirm the values of the current dietary recommendations for lactation, based on the energy cost of milk production.     

One-third of pregnant and lactating women may not be meeting their folate requirements from diet alone based on mandated levels of folic acid fortification

Many women are advised to consume a folic acid-containing prenatal supplement for the duration of pregnancy and lactation. Whether this remains necessary after folic acid fortification of the food supply in North America has yet to be determined. Our objective was to assess the dietary folate intake of a sample of pregnant and lactating women at mandated and predicted folic acid-fortification levels and determine the prevalence of inadequate and excessive intakes. Weighed food records (for 3 d) were collected from predominantly university-educated women (32 +/- 4 y of age) at 36 wk of pregnancy (n = 61) and at 4 and 16 wk of lactation (n = 60). Dietary folate intakes during pregnancy and lactation, assuming fortification at mandated levels (140-150 micro g/100 g), were 562 +/- 106 and 498 +/- 99 micro g/d dietary folate equivalents (DFE), respectively. The prevalence of inadequacy for folate, or the proportion of individuals with usual folate intakes less than their nutrient requirement, was 36% for women during pregnancy (estimated average requirement of 520 micro g/d DFE), and 32% during lactation (estimated average requirement of 450 micro g/d DFE). Assuming fortification at twice the mandated level, mean dietary intakes during pregnancy and lactation were 786 +/- 132 and 716 +/- 150 micro g/d DFE, respectively, producing only a 3% prevalence of folate inadequacy. Grains contributed approximately 41% of total folate intake followed by fruits and vegetables (approximately 21%). To conclude, at mandated levels of fortification many pregnant and lactating women are unlikely to meet their folate requirements from dietary sources alone; however, the actual level of inadequacy cannot be determined until the level of folic acid in the food supply is known with greater precision.     

Intervention with traditional food as a major source of energy, protein, iron, vitamin C and vitamin A for rural Dalit mothers and young children in Andhra Pradesh, South India

Intakes of energy, protein, iron and vitamin A in India are usually reported as inadequate. Recognizing that traditional food systems are sustainable, high in species variety, and have rich nutrient sources, we compared dietary intakes and nutrient sources of Dalit mothers and their children living in villages with and without an intervention based on improved access to the traditional Dalit food system. 24-hour recalls were conducted with Dalit mothers and their children aged 6-39 months during summer and rainy seasons in 2003. We found that mothers from intervention villages had significantly higher intakes of energy (mean +/- SD: 12,197 +/- 3,515 kJ vs. 11,172 +/- 3,352 kJ; p =0.02) and protein (77.5 +/- 25.1 g vs. 71.1 +/- 25.2 g; p =0.05) in summer, and higher intakes of energy (11,168 +/- 3,335 kJ vs. 10,168 +/- 3,730 kJ; p = 0.04), protein (68.9 +/- 22.6 g vs. 60.4 +/- 23.8 g; p <0.01) and iron (15.8 +/- 6.6 mg vs. 13.7 +/- 9.1 mg; p <0.01) during rainy season. There were no differences in children's intakes between intervention and control villages. In mothers, sorghum contributed 29% of energy, 33% of protein and 53% of iron, and green leafy vegetables contributed 21% of vitamin C and 38% of vitamin A. Our results indicate that traditional food such as sorghum, pulses and green leafy vegetables are major sources of energy, protein, iron, vitamin C and vitamin A, and that mothers from villages with the traditional food intervention had higher intakes of energy, protein and iron.     

Long-term effect of a plant-based diet on magnesium status during pregnancy

OBJECTIVE: To compare dietary magnesium intake and magnesium concentrations in serum, red blood cells (RBC) and urine during pregnancy of women habitually following a long-term plant-based diet and of women following an average Western (control) diet. DESIGN: Prospective study during pregnancy. SETTING: Giessen, Germany. SUBJECTS: Healthy pregnant women (n=108) in their 9-12th, 20-22nd and 36-38th gestational week habitually following a plant-based diet for more than 3 y or an average Western diet. The vegetarians were subdivided into ovo-lacto vegetarians (n=27) and low-meat eaters (n=43). RESULTS: Significant higher dietary magnesium intakes were observed in pregnant women consuming a plant-based diet (508+/-14 mg/day for ovo-lacto vegetarians, P<0.001 and 504+/-11 mg/day for low-meat eaters, P<0.001) than in pregnant women consuming a control diet (412+/-9 mg/day). Serum magnesium concentrations were similar in all diet groups whereas RBC magnesium was slightly higher in low-meat eaters than in controls (P=0.058). Urinary magnesium excretion was higher in ovo-lacto vegetarians (P=0.023), followed by low-meat eaters (P=0.017) when compared to the control group. During the third trimester of pregnancy, the frequency and the occurrence of calf cramps was lower in the plant-based diet group than in the control group (P=0.004 and 0.008). CONCLUSIONS: Owing to a higher dietary magnesium intake confirmed by higher urinary magnesium excretion, habitual plant-based diets result in a slightly improved magnesium status during pregnancy and reduce the frequency of calf cramps during the third trimester of pregnancy compared to an average Western diet. Therefore, plant-based diets during pregnancy can be recommended with regard to magnesium supply.     

Calcium and magnesium dietary intakes and plasma and milk concentrations of Nepalese lactating women

Dietary calcium and magnesium intakes of 26 Nepalese lactating women were determined from analysis of 24-h duplicate food and beverage composites. In addition, blood, urine, and milk samples were collected. The mean Ca intake of these Nepalese mothers, 482 +/- 249 mg/d, was less than half that of American lactating women yet the Ca concentration of the milk was similar for the two groups of women. The Nepalese mothers appeared to maintain milk Ca concentrations by an increase in bone resorption as demonstrated by an elevated excretion of hydroxyproline. The Nepalese women had a mean Mg intake of 353 +/- 28 mg/d. Two locally available foods considered special for lactating women, jwano and gundruk, were examined for nutrient content and found to contain high concentrations of Ca and Mg. Increased consumption of these locally grown foods could add substantially to the Ca and Mg intakes of these lactating women.     

Iron in the diets of rural Honduran women and children

Iron deficiency, a major cause of nutritional anemia, is the most prevalent micronutrient deficiency in the world. One of the main causes of iron deficiency anemia in developing countries is poor availability of absorbable iron from the diet. This study investigates the level of iron intake, bio‐availability, and adequacy in the diets of women and children in the rural west of Honduras. We find that the dietary iron status of this population is very poor. Fifty‐seven percent of the children under one year of age and 23% of 1 to 2 year olds are likely to have inadequate intakes to prevent iron deficiency anemia. Almost all of the pregnant women and 33% of the non‐pregnant non‐lactating women are at risk of developing iron deficiency anemia. The corn based Honduran diet, owing to high phytate levels, has a low bio‐availabiiity for iron. Extremely low intakes of fruits and vegetables and of meats, coupled with significant intake of coffee by all age groups, further limits the availability of dietary iron in the Honduran population.     

Drink consumption in British preschool children: relation to vitamin C, iron and calcium intakes

Objective To examine the impact of soft drinks, fruit juices, milk and tea consumption on vitamin C, iron and calcium intakes in a large, representative sample of preschool children in the UK.
Design Secondary analysis of 4-day weighed dietary diaries.
Sample 1675 children aged 1.5–4.5 years living in the UK in 1992/993.
Results Fruit juice consumers, but not soft drink consumers, had higher vitamin C intakes and higher plasma ascorbate levels than nonconsumers ( P  < 0.001). However, overall intakes tended to exceed the RNI and 45% of children still had adequate intakes without the contribution of soft drinks and 56% without the contribution of fruit juice. Children who did not consume fruit juice or soft drinks were no more likely to have depleted levels of vitamin C than consumers. Tea drinkers had diets which were lower in iron and vitamin C than nonconsumers ( P  < 0.005). They had lower levels of haemoglobin ( P  < 0.05) but not ferritin. Children under 4 years old were less likely to meet the RNI for iron if they were tea drinkers ( P  < 0.005) but no more likely to be anaemic. Calcium intakes were significantly higher for whole milk consumers than for nonconsumers ( P  < 0.005) and 73% of overall calcium intake was predicted by quantity of all milks consumed. Whole milk consumers both under and over 4 years of age were significantly more likely to reach the RNI for calcium ( P  < 0.00005 and P  < 0.05).
Conclusions Preschool children's drinking has an impact on their intakes of vitamin C, iron and calcium. In particular, intakes of calcium are closely linked to the amount of milk consumed in this age group.     

Children who avoid drinking cow milk have low dietary calcium intakes and poor bone health

BACKGROUND: Information concerning the adequacy of bone mineralization in children who customarily avoid drinking cow milk is sparse. OBJECTIVE: The objective was to evaluate dietary calcium intakes, anthropometric measures, and bone health in prepubertal children with a history of long-term milk avoidance. DESIGN: We recruited 50 milk avoiders (30 girls, 20 boys) aged 3-10 y by advertisement. We measured current dietary calcium intakes with a food-frequency questionnaire and body composition and bone mineral density with dual-energy X-ray absorptiometry and compared the results with those of 200 milk-drinking control children. RESULTS: The reasons for milk avoidance were intolerance (40%), bad taste (42%), and lifestyle choice (18%). Dietary calcium intakes were low (443 +/- 230 mg Ca/d), and few children consumed substitute calcium-rich drinks or mineral supplements. Although 9 children (18%) were obese, the milk avoiders were shorter (P < 0.01), had smaller skeletons (P < 0.01), had a lower total-body bone mineral content (P < 0.01), and had lower z scores (P < 0.05) for areal bone mineral density at the femoral neck, hip trochanter, lumbar spine, ultradistal radius, and 33% radius than did control children of the same age and sex from the same community. The z scores for volumetric (size-adjusted) bone mineral density (g/cm(3)) were -0.72 +/- 1.17 for the lumbar spine and -0.72 +/- 1.35 for the 33% radius (P < 0.001). Twelve children (24%) had previously broken bones. CONCLUSIONS: In growing children, long-term avoidance of cow milk is associated with small stature and poor bone health. This is a major concern that warrants further study.