Effect of nutrition education among pregnant women with low body mass index: a community based intervention

Abstract

Background: Indian women are chronically undernourished (36%) and anemic (55%) which has consequences on women during their adolescence, pregnancy, and lactation (NFHS-3). The main objectives were to assess the effect of nutrition education on dietary awareness and practice among undernourished pregnant women. Methods: Phase 1 included key informant interview capturing information on food frequency and dietary diversity (24 hour dietary recall). Based on the key informant interview and anecdotal evidences a hypothesis was generated and an experimental study was planned to test the hypotheses. Fifty pregnant women in their first trimester of pregnancy having body mass index (BMI) less than 18.5 were selected from 12 villages to be part of the intervention group. Non-intervention group comprised of age matched women in first trimester with low BMI selected from the neighbouring villages. Phase 2 effect of nutrition education was assessed on mean weight gain in third trimester of pregnancy practice of minimum meal frequency (3 meals a day), adoption of dietary diversity through 24 hour recall method, proportion of change evidenced in hand washing practice were measured. Results: Women enrolled in the intervention had a mean weight gain of 8.7 kg, with more than 3 ante natal care (ANC) visits having regular monthly attendance at ICDS center for awareness programs. Behavioral modification was evidenced by practicing a minimum of 3 meals or more during pregnancy, with consumption of vegetables, lentils and greens in their daily diet along with cereals. Regular hand washing before the meals and after using the toilet were self-reported by the women. Conclusions: Prospective weight gain among women in intervention had significance over those in the non- intervention group by 2.1kg. Women in the intervention group reflected behavioral change by practicing minimum meal of 3 or more, proper hand washing before meals and after toilet and adequate rest. However birth weight on other hand is weakly associated with maternal weight gain between the two arms of the study.