Abstract
Reproductive-aged women are at high risk of developing obesity, and diet quality is a potential modifiable risk factor. There is limited research exploring diet quality and its association with time since childbirth. Using data from the Australian Longitudinal Study on Women’s Health (ALSWH) survey 5 (2009) of women born between 1973–1978, who reported having previously given birth, we investigated the association between time since childbirth and diet quality, and differences in energy, macronutrients, micronutrient intake, and diet quality assessed by the dietary guideline index (DGI) in women stratified by time from last childbirth, early (0–6 months; n = 558) and late (7–12 months; n = 547), and all other women with children (>12 months post childbirth n = 3434). From this cohort, 8200 participants were eligible, of which 4539 participants completed a food frequency questionnaire (FFQ) and were included in this analysis. Overall, diet quality was higher in early and late postpartum women (mean DGI score 89.8 (SD 10.5) and mean DGI score 90.0 (SD 10.2), respectively) compared to all other women with children (>12 months post childbirth), mean DGI score 85.2 (SD 11.7), p < 0.001. Factors positively associated with diet quality included higher education, physical activity, health provider support, and vitamin and/or mineral supplement use. Conversely, increasing time from childbirth (>12 months), smoking compared with non-smoking and medium income level compared with no income was negatively associated with diet quality. A lower diet quality in women greater than 12 months post childbirth may be reflective of increased pressures, balancing childrearing and return to work responsibilities. This highlights the need to support women beyond the postpartum period to improve modifiable factors associated with weight gain, including diet quality, to optimize health and reduce chronic disease risk.
Highlights
Reproductive-aged women are a susceptible population for obesity development [1]
Postpartum women had higher educational attainment and were more likely to be in professional roles or in no paid job and unemployed, yet were more likely to be on a high income in comparison to women >12 months post childbirth
In a large population-based cohort of reproductive-aged women with children, using detailed dietary assessment, we reported that women within 12 months of childbirth had better diet quality, as indicated by total dietary guideline index (DGI) and its components, including a higher diet variety, higher intake of breads and cereals, and a higher proportion of wholegrains and dairy intake in comparison to women who had given birth more than 12 months ago
Summary
Reproductive-aged women are a susceptible population for obesity development [1]. Over 50% of women are overweight or of obese preconception [2,3,4], and, once pregnant, 50%–60% of women gain more than the International Institute of Medicine gestational weight gain (GWG) recommendations [5]. Excessive GWG increases the risk of pregnancy and birthing complications [6], infant mortality [7], and maternal cardiovascular risk factors [8]. Excess GWG drives postpartum weight retention (PPWR), increasing risk in subsequent pregnancies and fueling maternal obesity development associated with chronic diseases long-term [9,10]. A higher diet quality score implies increased consumption of a greater amount and variety of healthy foods and less consumption of energy-dense, nutrient-poor foods [19]. Associations between diet quality and weight change postpartum have not been explored; a higher total energy intake has been reported as an inverse predictor of weight loss postpartum [20]
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