Abstract
Micronutrient deficiencies and imbalanced dietary intake tend to occur during the reproductive period among women in China. In accordance with traditional Chinese culture, pregnant women are commonly advised to follow a specific set of dietary precautions. The purpose of this study was to assess dietary intake data and identify risk factors for nutritional inadequacy in pregnant women from urban and rural areas of Deyang region, Sichuan province of China. Cross-sectional sampling was applied in two urban hospitals and five rural clinics (randomly selected) in Deyang region. Between July and October 2010, a total of 203 pregnant women in the third trimester, aged 19–42 years, were recruited on the basis of informed consent during antenatal clinic sessions. Semi-structured interviews on background information and 24-h dietary recalls were conducted. On the basis of self-reported height and pre-pregnancy weight, 68.7% of the women had a pre-pregnancy body mass index (BMI) within the normal range (18.5 ≤ BMI < 25), 26.3% were found to be underweight with a BMI <18.5 (20.8% in urban vs. 35.6% in rural areas), while only 5.1% were overweight with a BMI ≥30. In view of acceptable macronutrient distribution ranges (AMDRs) the women’s overall dietary energy originated excessively from fat (39%), was low in carbohydrates (49.6%), and reached the lower limits for protein (12.1%). Compared to rural areas, women living in urban areas had significantly higher reference nutrient intake (RNI) fulfillment levels for energy (106.1% vs. 93.4%), fat (146.6% vs. 119.7%), protein (86.9% vs. 71.6%), vitamin A (94.3% vs. 65.2%), Zn (70.9% vs. 61.8%), Fe (56.3% vs. 48%), Ca (55.1% vs. 41%) and riboflavin (74.7% vs. 60%). The likelihood of pregnant women following traditional food recommendations, such as avoiding rabbit meat, beef and lamb, was higher in rural (80%) than in urban (65.1%) areas. In conclusion, culturally sensitive nutrition education sessions are necessary for both urban and rural women. The prevalence of underweight before conception and an insufficient supply of important micronutrients were more pronounced in rural areas. Therefore, attention must be given to the nutritional status, especially of rural women before, or at the latest, during pregnancy.
Highlights
Since 2006, China had entered the fourth wave of a baby boom period with an annual increase of about 20 million babies [1]
The objectives of this study were to provide baseline data on dietary intake and food habits in order to identify the risk of nutritional inadequacy, and to give appropriate dietary recommendations for pregnant women in urban and rural areas of Deyang City, Sichuan province, China
Adequacy of nutrient consumption was evaluated by applying the Chinese dietary reference intakes (DRIs) with light physical activity level (PAL) [38] adopted by the Institute of Nutrition and Food
Summary
Since 2006, China had entered the fourth wave of a baby boom period with an annual increase of about 20 million babies [1]. Research at the international level shows that maternal malnutrition is linked to fetal programming for adult diseases and increases the risk of pregnancy-associated complications [2,3,4,5,6]. In China, maternal anemia (Hb < 110 g/L) (14.5%) [7], nutritional deficiencies of. Based on the results of a study conducted in Chengdu, the capital of Sichuan province, the prevalence of anemia among pregnant women in the third trimester was 35.0% [13]. Instead of the internationally accepted anemia cutoff point for pregnant women of Hb < 110 g/L [14], a lower threshold of Hb < 100 g/L was applied by Zhou et al [13]. Development Goal 4 and 5 Targets on Child and Maternal Mortality in China, with Equity.
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