Diet Quality of a Pregnant Primarily African American Cohort Residing in the Mississippi Delta: Delta Healthy Sprouts

Abstract

At no point during a woman's life is good nutrition more important than during her reproductive years as her dietary choices affect not only her health but also that of her child. Delta Healthy Sprouts is a randomized, controlled, comparative trial testing the impact of two Maternal, Infant, and Early Childhood Home Visiting programs on health behaviors of mothers and their infants residing in the rural Mississippi Delta. This region of the US is characterized by high rates of poverty, obesity, and chronic diseases, low educational attainment, high proportion minority, poor nutrition, as well as poor pregnancy, delivery, and birth outcomes. We examined the impact of in‐home one‐on‐one nutrition education starting in the 5th gestational month (GM) on diet quality during pregnancy. The experimental arm (PATE) received monthly home visits using the Parents as Teachers curriculum enhanced with nutrition and physical activity education. Gestational intervention components of the PATE arm included healthy weight gain during pregnancy, nutrition and physical activity, and breastfeeding. Lessons included hands‐on activities, instructional DVDs, and goal setting for both diet and exercise. The control (PAT) arm received monthly home visits using the Parents as Teachers curriculum only. For both arms, maternal dietary intake during the gestational period was based on 24‐hour dietary recalls at GM4 (baseline), GM6, and GM8. Diet quality was computed using the Healthy Eating Index‐2010 (HEI‐2010; total score range 0–100 points). HEI‐2010 mean scores for PAT participants at GM4, GM6, and GM8 were 41, 41, and 43 points, respectively; corresponding scores for PATE participants were 46, 44, and 45 points, respectively, reflecting overall poor diet quality for all participants at all time points. In particular, HEI‐2010 component mean scores were low for greens and beans, whole grains, seafood and plant protein foods, and sodium for both treatment arms at all 3 time points. Significant effects were not found for time, treatment, or time by treatment for the HEI‐2010 total or component scores. Results indicate that 3 months of nutrition education had no apparent effect on diet quality during pregnancy in this cohort of rural Southern primarily African American women. Explanations for this lack of effect are discussed.Support or Funding InformationSupported by the USDA Agricultural Research Service with in kind support from the Delta Health Alliance.