Nutrient intake of low-income pregnant women: laboratory analysis of foods consumed

Nutrient intake of a group of 22 young, mainly black, low-income pregnant women was evaluated by use of data resulting from laboratory analysis of foods prepared and consumed in the home over a 24-hour period. Magnesium, zinc, and folacin were the nutrients least well supplied in the foods consumed. Analyzed values for daily intake of the three were below 50% of the RDAs. Mean energy intake was considerably lower than recommended allowances, even though mean gain in weight was somewhat greater than that recommended for normal pregnancy, a finding like that of other investigators. The wide range in daily intake of energy and various nutrients among subjects is comparable with that found in a number of other studies, which showed that many individuals have marked deviations in intake from day to day. Analyzed diets also were examined in terms of nutrient density. Mean nutrient density for protein, calcium, phosphorus, vitamin A, thiamin, riboflavin, niacin, and ascorbic acid compared favorably with that of the RDAs, in contrast with the poor nutrient density for zinc, magnesium, and folacin. Laboratory analysis of the diets had the advantage of providing information about nutrient content of foods as prepared and consumed in the home. The analysis had particular advantage in the evaluation of content of zinc, magnesium, and folacin, as data for the three nutrients in food composition tables are limited.     

Nutrient intake of pregnant Asian women at Sorrento Maternity Hospital, Birmingham

The dietary intake of pregnant Asian women (that is originating from the Indian subcontinent) attending Sorrento Maternity Hospital in Birmingham was determined, using the weighed and recall techniques, at five-weekly intervals from 18 to 38 weeks of pregnancy. Mean energy intake of the group was 7.1 MJ (1700 kcal)/d. The intakes of most nutrients were substantially below those consumed by pregnant European women in Britain, a little below those of expectant Pakistani mothers in Islamabad, and about the same as those of expectant East London mothers. Intakes of vitamin D, total folate, vitamin B6, zinc and magnesium were particularly low. These observations suggest that a number of Asian women in Birmingham are likely to experience nutritional stress in pregnancy, and there is some anthropometric and biochemical evidence from Sorrento, published elsewhere (Bissenden et al. 1981), to support this. A possibly beneficial feature of the diet was a low sodium intake (2 g/d). Previous work at this hospital has noted a lower prevalence of hypertension in pregnant Asian women (Wharton et al. 1980; Bissenden et al. 1981).     

Dietary zinc intake of low-income pregnant women of Mexican descent.

Zinc intakes of low-income pregnant women of Mexican descent were estimated by the use of 24-hr dietary recalls. Recalls were obtained during the first two trimesters for 344 women and again during the third trimester of pregnancy for 279 of the same women. The daily mean zinc intake was calculated as 9.4 +/- 3.8 mg during the first two trimesters and as 10.0 +/- 4.3 mg during the third trimester. For about 85% of the women, the reported intakes were below two-thirds of the Recommended Dietary Allowance for zinc. In a subsample of the women, no significant correlation was shown between low dietary zinc intakes and low serum zinc levels during either early or late pregnancy. Zinc and protein intakes were highly correlated in both early and late pregnancy (r = 0.83 and 0.89, respectively). Diets that provided 90 to 100 g of protein (about 125% of the Recommended Dietary Allowance) provided a mean of 13.6 g of zinc (67% of the Recommended Dietary Allowance).     

Nutrient intake and food consumption among pregnant women from an agricultural region of Morocco

This study aimed to assess dietary intake and nutrient adequacy in pregnant women selected from an agricultural region of Morocco. On a sample of 172 pregnant women from rural and urban area, data on socio-demographic characteristics and dietary habits by a quantified food frequency were collected using questionnaires. Mean daily intakes of energy and nutrients were estimated and compared to reference nutrient intakes (RNI). The results show that the mean daily intakes of energy (3110.9 kcal in urban; 2707.5 kcal in rural) and some nutrients were adequate. However, iron, folate, zinc and calcium intakes were inadequate for the majority of women and more markedly in rural area. Education level appeared to affect nutrient intakes while no differences were registered across pregnancy stages or according to household size. The study suggests that an education program should be conducted to improve dietary intakes in order to prevent risks for pregnancy outcome in this population.     

Nutrient intake and food consumption among pregnant women from an agricultural region of Morocco

This study aimed to assess dietary intake and nutrient adequacy in pregnant women selected from an agricultural region of Morocco. On a sample of 172 pregnant women from rural and urban area, data on socio-demographic characteristics and dietary habits by a quantified food frequency were collected using questionnaires. Mean daily intakes of energy and nutrients were estimated and compared to reference nutrient intakes (RNI).

The results show that the mean daily intakes of energy (3110.9?kcal in urban; 2707.5?kcal in rural) and some nutrients were adequate. However, iron, folate, zinc and calcium intakes were inadequate for the majority of women and more markedly in rural area. Education level appeared to affect nutrient intakes while no differences were registered across pregnancy stages or according to household size. The study suggests that an education program should be conducted to improve dietary intakes in order to prevent risks for pregnancy outcome in this population.     

Nutrient intake of low-income, black families in southwestern Mississippi

A dietary intake study for 250 low-income households in Claiborne County in southwestern Mississippi was conducted from June through August 1974. Data were obtained during daily home visits for seven days by trained college students. The adequacy of nutrient intake for individuals was evaluated by comparing the data with the 1974 Recommended Dietary Allowances by age and sex. The data was also compared with those of the Ten-State Nutrition Survey and HANES. Mean intakes of protein, vitamin A, thiamin, riboflavin, and ascorbic acid for all subjects were above the RDAS; those of energy, calcium, iron, and preformed niacin were below the allowances. Whereas calcium was the nutrient least adequately consumed by all persons, protein was most adequately consumed. Sixty per cent of children had calcium intakes below two-thirds of the allowance. By sex, 66.7 per cent of all males and 73.3 per cent of all females had calcium intakes below two-thirds of the standard. None of children received less than two-thirds of the allowance for protein. Nutrient intake was low for a substantial number of the subjects. Adolescents, ages eleven to eighteen years, of both sexes had the poorest diets for all nutrients. Regarding the sex difference, females had better nutrient intakes than did males for all nutrients except calcium and iron.     

Breast-feeding intentions among low-income pregnant and lactating women

OBJECTIVES: Provide a better understanding of the process used by low-income pregnant/postpartum women when deciding whether to breast-feed or not. METHODS: Pregnant/postpartum women admitted to an obstetrics floor completed a survey to determine breast-feeding intention (n=88). RESULTS: Subjects were primarily Hispanic and African American women. Beliefs and referent other were related positively to attitude and subjective norm, respectively. Subjective norm was related positively to intention to breast-feed. Breast-feeding knowledge was low. CONCLUSIONS: Others' opinions clearly influence feeding intentions among this population of low-income women. Inclusion of these significant others, family, and friends within the breast-feeding education process is warranted.     

Smoking-related correlates of depressive symptoms in low-income pregnant women

OBJECTIVES: To investigate smoking-related correlates of depressive symptomatology in low-income pregnant women. METHODS: A cross-sectional survey of 245 pregnant women who smoked prior to pregnancy. RESULTS: Women who had lower self-efficacy for maintaining abstinence both in positive affect/social situations and when experiencing negative affect demonstrated greater depressive symptomatology. Additionally, marijuana use, nicotine dependence, and general confidence in one's ability to quit smoking showed a positive relationship to depression. CONCLUSIONS: Several modifiable factors that can be targeted through behavioral and cognitive behavioral intervention strategies appear to influence the relationship between depression and smoking in low-income pregnant women.     

A comparison of food frequency and diet recall methods in studies of nutrient intake of low-income pregnant women

The aim of this study was to develop a self-administered food frequency questionnaire for use with low-income pregnant women and to evaluate its performance in classifying women according to nutrient intake. Index nutrients used were energy, protein, calcium, iron, zinc, and vitamins A, B-6, and C. Two hundred ninety-five Massachusetts women, aged 14 to 43 years, participated in the field test of the questionnaire. A subset of 95 women provided three 24-hour diet recalls for use in comparative studies. Correlation coefficients between questionnaire and diet recall scores were adjusted for measurement error resulting from the limited number of 24-hour recalls per subject, and their confidence intervals were computed. When subjects with implausibly high energy scores (greater than 4,500/day) were removed from the sample, reducing sample size by about 15%, correlation coefficients increased substantially (25% to 64%) for all nutrients except vitamin A. Adjusted correlation coefficients exceeded 0.5, excluding vitamin A (r approximately 0.15), and quintile comparisons indicated that the questionnaire would correctly identify a high proportion of the women having low intake of selected nutrients. We conclude that a self-administered questionnaire can provide useful data about individual recent intake of selected nutrients in a majority of English-speaking, low-income pregnant women, but that overestimation of food use may occur among up to 20% of this population.     

Nutrient intake of Italian women during lactation

OBJECTIVES: Very few data have been published concerning the actual energy and nutrient intakes of lactating women; in particular there have been no reports concerning Italian women. We report our findings on the energy and macronutrient intakes of a group of exclusively breast-feeding Italian women. Differences between the actual intakes and Italian Recommended Dietary Allowances are also discussed. SUBJECTS: Healthy lactating women aged 27-36 years were recruited in the three major geographical areas of Italy (North, Central, and South) METHODS: Dietary evaluation was based on two consecutive 24-hour recalls from each mother (dietary data, n = 125). Energy and nutrient intakes were estimated using a nutritional database. Statistical analysis was performed using parametric and non-parametric tests. RESULTS: Mean energy intakes for the whole country are below recommended values, while the protein intake, and the percentages of energy from fat and saturated fatty acids are higher than the recommended values. The amount of polyunsaturated fats is within the recommended intake. The percentage of energy from carbohydrates and the amount of fiber are lower than the recommended Italian levels. CONCLUSION: The results obtained in this sample of lactating women seem to point to a low energy intake associated with a moderate imbalance in the distribution of energy percentages from macronutrients.     

Increasing the report of alcohol use among low-income pregnant women

PURPOSE: To increase the report of prenatal alcohol use in a community setting. METHODS: A self-administered alcohol screening tool was developed and introduced at 12 randomly selected sites that administer the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A matched sample of 12 WIC sites continued to use the existing verbal standard of care for assessing alcohol use. RESULTS: Rates of reported prenatal alcohol consumption at the 12 WIC intervention sites were compared with rates at 12 control WIC sites using a repeated-measures analysis of variance (ANOVA) and independent-samples t-tests. Within 8 months of study commencement, rates of reported prenatal alcohol consumption were significantly higher at the intervention sites than at the control sites. DISCUSSION: Use of a brief, self-administered screening tool in the WIC setting significantly increased reports of prenatal alcohol use, a key first step in the reduction of prenatal alcohol use. The WIC setting represents an excellent place to address the significant public health issue of prenatal alcohol exposure.     

Smoking among low-income pregnant women: an ethnographic analysis.

This article presents findings from a qualitative study of 53 low-income women who were smokers at the onset of pregnancy. Study participants were interviewed during pregnancy to document smoking trajectories and factors contributing to, or undermining, harm reduction and quit attempts. Thirty percent of women quit smoking completely, 43% engaged in sustained harm reduction, and 26% reduced their smoking levels intermittently. Case studies of women are presented to illustrate reasons for quitting, harm reduction practices, and factors influencing relapse and smoking continuation. Women's motivations to quit are highlighted. Moral identity as a mother was found to be a key motivating factor behind women's quit attempts. Future programs targeting this population would do well to acknowledge moral identity as an issue and recognize the challenges of quitting for women with limited social support and little control over their immediate environment.     

373例孕妇膳食调查分析

目的:了解孕妇膳食摄入情况,并提出合理建议,以利于胎儿生长发育。方法:以湖南省长沙市373例孕妇为调查对象,对孕妇的膳食摄入进行调查分析。结果:孕妇膳食三大产热营养素的热能供给比例基本适宜,但钙、铁、维生素B1、维生素B2的摄入量较低。结论:孕妇的膳食结构比较合理,但要增加钙、铁及B族维生素的摄入,加强孕妇的营养指导。     

Spontaneous cessation of smoking and alcohol use among low-income pregnant women

BACKGROUND: Despite the strong evidence of harmful effects, tobacco and alcohol use during pregnancy continue to be major public health challenges. Some women, however, do stop spontaneously when they learn of their pregnancy. No study has investigated spontaneous cessation of both behaviors in a low-income predominantly unmarried U.S. population. OBJECTIVE: To describe the prevalence of spontaneous cessation of cigarette and alcohol use alone and in combination and associated factors among low-income pregnant women. METHODS: Subjects (N=601) were currently smoking or smoking when they became pregnant and participating in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) programs in the greater Boston, Massachusetts, area. Baseline interviews assessed the factors being studied and the spontaneous cessation of cigarette and alcohol use with pregnancy. Saliva cotinine verified self-reported smoking status.RESULTS: Spontaneous cessation of smoking and alcohol use was reported by 28% and 80% of the women, respectively; 25% spontaneously quit both, and 15% stopped neither. Multivariable analyses indicated that smoking cessation was less likely in women who had previous births, had a husband or partner who smoked, were born in the United States, were black (non-Hispanic, non-Portuguese), had less than a high school education, were highly addicted, reported lower perceived risk to the fetus, and reported "too many other problems in life to stop." Hispanic ethnicity, younger age, and more social support to quit smoking were related to spontaneous alcohol abstinence. CONCLUSIONS: Targeted multiple strategies, including those aimed at increasing participation of partners, are needed for low-income pregnant smokers.     

Supplement use among a culturally diverse group of low-income pregnant women

Among a culturally diverse group of 344 low-income pregnant women, self-reported rates of supplement use prior to confirmation of pregnancy were much lower than those reported for young women in national surveys (16% vs. up to 40%, respectively). Prenatal vitamins, prescribed routinely for all patients, were reportedly taken at least four times a week by 86% of the subjects and two to three times a day by 5%. About 5% of the sample reported consuming highly fortified cereal at least once daily. There is a possibility of higher than recommended use of supplemental vitamins among these women resulting from misunderstanding of the number of pills to be taken and/or high consumption of highly fortified cereals.