Abstract
Diet is believed to play a major role in maternal recovery, postpartum weight retention (PPWR) is one of the challenges for Chinese women. However, the association between puerperal women’s diet and PPWR remained unclear and complicated in China. The study assessed the dietary quality of puerperal women using adjusted Chinese Dietary Balance Index-16 (DBI-16) and explored its associations with PPWR. Participants were enrolled in the Mother-Infant Cohort Study of China. Dietary intake and demographic characteristics were obtained by a semi-quantitative food frequency questionnaire and a self-designed questionnaire at 0–3 months postpartum. PPWR was calculated by the weight difference at 0-3months and 6-8months postpartum minus pre-pregnancy weight. Dietary quality was assessed using adjusted DBI-16. 316 puerperal women were enrolled. According to adjusted DBI-16, 84.8% of participants had an insufficient dietary intake (vegetables 84.8%, fruits 91.8%, dairy 87.3%, soybean 61.4% and aquatic foods 79.4%, respectively), 67.1% had an excessive intake (cereals 60%, meat 57.3% and eggs 64.9%, respectively), 98.4% had an imbalanced diet consumption. PPWR at 0–3, and 6–8 months were 6.0 (±5.1) kg and 5.2 (±7.7) kg, and the percentage of PPWR (≥5kg) were 63.0% and 52.8% respectively. Multivariable linear regression showed the intake of fish and shrimp at 0–3 months postpartum was negatively associated with PPWR at 6–8 months (β = -0.114, SE = 0.279, p < 0.05). The diet quality of Chinese puerperal women was unreasonable and imbalanced. Fish intake tended to be a favorable factor for postpartum weight loss.
Highlights
The dietary quality during the puerperium period is believed to play a major role in maternal recovery and the breastfeeding infant’s development and health [1]
The Dietary Balance Index 2016 (DBI-16) was developed based on Chinese dietary guidelines and Food Guide Pagoda (2016), to evaluate the overall quality, inadequacy, excess, and imbalance of diet by Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD)
The dietary quality depends on the existing dietary patterns, which were assessed generally by two approaches: a priori method based on prior nutrition knowledge translated into dietary guidelines, and posteriori method, in which dietary patterns are extracted once the dietary intake are investigated [9]
Summary
The dietary quality during the puerperium period is believed to play a major role in maternal recovery and the breastfeeding infant’s development and health [1]. Given that dietary intake plays an important impact on maternal and offspring health, there have been growing interests in using dietary quality indices, such as Healthy Eating Index (HEI-2015) [6], Diet Quality Index (DQI) [7] and Mediterranean Diet Scale (MDS) [8], to evaluate the women’s adherence to a balanced diet. In China, several dietary quality indices have been developed, such as Chinese Healthy Eating Index [10], Chinese Dietary Balance Index 2016 (DBI-16) [11]. The DBI-16 was developed based on Chinese dietary guidelines and Food Guide Pagoda (2016), to evaluate the overall quality, inadequacy, excess, and imbalance of diet by Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD). Because nutritional requirements are different according to age and sex, the general DBI for normal adults may not fit all target groups well, which has been revised/adjusted to meet the requirements of pregnant women [13], the elderly [14] and other specific populations except puerperal women
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