Abstract
A behavioral lifestyle intervention with partial meal replacement reduced excess gestational weight gain in ethnically diverse women with overweight/obesity, but the effects on micronutrient intake remained unknown. A secondary analysis of a randomized, controlled trial tested whether the intervention improved micronutrient intake relative to usual care. Pregnant women (n = 211; 30.5 years of age, body mass index, BMI, of 32.0 kg/m2) were enrolled and randomized within site and ethnicity (40% were Hispanic) into intervention (n = 102) or usual care (n = 109) groups. Two 24 h dietary recalls were conducted on random days at study entry and late pregnancy (35–36 weeks gestation). Nutrient adequacy was defined using the Estimated Average Requirement cut-point method. At study entry and including prenatal vitamins, ≥90% of participants reported inadequate intake of vitamins D and E and iron; 40–50% reported inadequate intake of calcium, protein, vitamins A, C, B6, folate, magnesium, and zinc. From study entry to late pregnancy, the behavioral intervention with partial meal replacement increased the overall intake of vitamins A, E, and D and copper and reduced the odds of inadequate intake of calcium (odds ratio (OR) = 0.37 (0.18, 0.76)), vitamins A (OR = 0.39 (0.21, 0.72)) and E (OR = 0.17 (0.06, 0.48)), and magnesium (OR = 0.36 (0.20, 0.65)). A behavioral intervention with partial meal replacement during pregnancy improved the intake of several micronutrients in Hispanic and non-Hispanic women with overweight/obesity.
Highlights
Maternal pre-pregnancy obesity and excess gestational weight gain are well established risk factors for several adverse short- and long-term maternal and child health outcomes, including pregnancy complications, diabetes, obesity, and cardio-metabolic comorbidities [1]
Nutrients 2019, 11, 1071 excess gestational weight gain in women with obesity [7], but less is known about intervention effects on micronutrient intake
The provision of micronutrient-rich foods [14,15] and nutrition educational interventions [16] can improve dietary quality and pregnancy outcomes, but few randomized clinical trials have been done, in pregnant women with obesity who are at risk of micronutrient insufficiency [15]
Summary
Maternal pre-pregnancy obesity and excess gestational weight gain are well established risk factors for several adverse short- and long-term maternal and child health outcomes, including pregnancy complications, diabetes, obesity, and cardio-metabolic comorbidities [1]. Compounding risks, pregnant women with obesity are more likely than those with normal weight to have micronutrient insufficiency [2,3,4], conferring additional potential risks of pregnancy complications and chronic conditions in later life [5,6]. The Academy of Nutrition and Dietetics recommends that the optimal prenatal diet should limit overconsumption yet prevent micronutrient insufficiency [5]. Nutrients 2019, 11, 1071 excess gestational weight gain in women with obesity [7], but less is known about intervention effects on micronutrient intake. The provision of micronutrient-rich foods [14,15] and nutrition educational interventions [16] can improve dietary quality and pregnancy outcomes, but few randomized clinical trials have been done, in pregnant women with obesity who are at risk of micronutrient insufficiency [15]
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