Abstract
Adolescent pregnant women are at greater risk for nutritional deficits, stress, and depression than their adult counterparts, and these risk factors for adverse pregnancy outcomes are likely interrelated. This study evaluated the prevalence of nutritional deficits in pregnant teenagers and assessed the associations among micronutrient dietary intake, stress, and depression. One hundred and eight pregnant Latina adolescents completed an Automated Self-Administered 24-hour dietary recall (ASA24) in the 2nd trimester. Stress was measured using the Perceived Stress Scale and the Prenatal Distress Questionnaire. Depressive symptoms were evaluated with the Reynolds Adolescent Depression Scale. Social support satisfaction was measured using the Social Support Questionnaire. More than 50% of pregnant teenagers had an inadequate intake (excluding dietary supplement) of folate, vitamin A, vitamin E, iron, zinc, calcium, magnesium, and phosphorous. Additionally, >20% of participants had an inadequate intake of thiamin, riboflavin, niacin, vitamin B6, vitamin B12, vitamin C, copper, and selenium. Prenatal supplement inclusion improved dietary intake for most micronutrients except for calcium, magnesium, and phosphorous, (>50% below the Estimated Average Requirement (EAR)) and for copper and selenium (>20% below the EAR). Higher depressive symptoms were associated with higher energy, carbohydrates, and fats, and lower magnesium intake. Higher social support satisfaction was positively associated with dietary intake of thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, vitamin C, vitamin E, iron, and zinc. The findings suggest that mood and dietary factors are associated and should be considered together for health interventions during adolescent pregnancy for the young woman and her future child.
Highlights
The spread of industrialized agriculture has allowed for a net increase in calories and macronutrients consumed by the United States population, leading to an overall rise in averageNutrients 2017, 9, 1212; doi:10.3390/nu9111212 www.mdpi.com/journal/nutrientsNutrients 2017, 9, 1212 body mass; these gains are not necessarily associated with adequate micronutrient intake [1].Teenagers in the U.S typically have energy-dense diets with poor micronutrient content [2]
In this study of healthy pregnant adolescents engaged in prenatal care, over 60% reported inadequate dietary intake of either folate, vitamin A, vitamin E, iron, zinc, calcium, magnesium, and/or phosphorous on a randomly chosen day during the second trimester
Deficiencies in micronutrient intake were identified even in the context of adequate calories and ongoing prenatal care. This suggests that, for pregnant teenagers, a healthy diet cannot be guaranteed by sufficient energy intake and that measures of weight gain obtained during prenatal care may be a poor proxy for the assessment of nutrient adequacy
Summary
The spread of industrialized agriculture has allowed for a net increase in calories and macronutrients consumed by the United States population, leading to an overall rise in averageNutrients 2017, 9, 1212; doi:10.3390/nu9111212 www.mdpi.com/journal/nutrientsNutrients 2017, 9, 1212 body mass; these gains are not necessarily associated with adequate micronutrient intake [1].Teenagers in the U.S typically have energy-dense diets with poor micronutrient content [2]. Previous studies have indicated that U.S pregnant adolescents often do not meet the Institute of Medicine’s (IOM) recommendations for micronutrient intake [7,8,9,10,11]. These studies have found that the mean intake of iron, zinc, folate, vitamin E, calcium, and magnesium often falls below the IOM’s recommended dietary allowance (RDA). This is a matter of concern because vitamins and minerals are essential for healthy gestation and fetal development, and an insufficient intake may affect pregnancy outcomes [12]
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