Well-being in pregnancy: an examination of the effect of socioeconomic, dietary and lifestyle factors including impact of a low glycaemic index dietary intervention.

BACKGROUND/OBJECTIVE: Well-being has been linked to the quality of diet and lifestyle in adults; however, there is a paucity of data in pregnancy. The aim of this study was to examine the relationship between well-being and socioeconomic status, diet and lifestyle during pregnancy and to consider the effect of intervention with low glycaemic index (GI) diet on well-being. SUBJECTS/METHODS: This was a cohort analysis of 619 participants of the ROLO study (Randomised cOntrol trial of LOw GI diet versus no dietary intervention to prevent recurrence of fetal macrosomia). The following data were collected: educational attainment, dietary intakes (food frequency questionnaire), physical activity (self-reported) and well-being (WHO-5-Item Wellbeing Index--expressed as a percentage). RESULTS: Well-being was positively associated with education and physical activity. Third-level education was associated with a 3.07-point higher well-being percentage score, and each day that an individual achieved >30 min walking per week was associated with a 1.10-point increase in percentage well-being score, Radj(2) 2.4% (F=7.260, P=0.001). The intervention low GI group had a significantly lower percentage well-being score than the usual diet group (56.3% vs 59.9%, P=0.015). No correlation was noted between well-being and GI status calculated from food diaries (P=0.469). Well-being was not associated with micronutrient intake. CONCLUSIONS: Well-being in pregnancy was independently and positively associated with education and physical activity and negatively associated with low GI dietary intervention. These findings have significance not only for women at risk of low mood but also for healthcare professionals when counselling women about the importance of healthy lifestyle in pregnancy.

Relative validity of a food frequency questionnaire to assess nutrient intake in pregnant women.

BACKGROUND: To date, there are no food frequency questionnaires that have been validated to assess nutrient intakes in pregnant women in Ireland. The present study aimed to assess the relative validity of a self-administered food frequency questionnaire during pregnancy. METHODS: The food frequency questionnaire was administered once during pregnancy between 12 and 34 weeks. Participants also completed a 3-day food diary during each trimester of pregnancy (reference method) and intakes from both the food frequency questionnaire and the mean of the 3-day food diaries were compared in a sample of 130 participants from the control arm of an intervention study. RESULTS: Energy-adjusted Pearson's correlation coefficients ranged from 0.24 (riboflavin) to 0.59 (magnesium) and were all statistically significant (P < 0.05). The food frequency questionnaire tended to report higher energy and nutrient intakes compared to the food diaries. On average, 74% of participants were classified into the same ± 1 quartile and 7% into opposing quartiles by the two methods. CONCLUSIONS: Overall, our food frequency questionnaire showed good relative validity. We conclude that a single administration of a food frequency questionnaire is a valid tool for ranking women in accordance with their nutrient intakes during pregnancy.

Maternal nutrient intakes and levels of energy underreporting during early pregnancy.

BACKGROUND/OBJECTIVES: Pregnancy is a critical period in a woman's life where nutrition is of key importance for optimal pregnancy outcome. The aim of this study was to assess maternal nutrient intakes during early pregnancy and to examine potential levels of energy underreporting. SUBJECTS/METHODS: Three-day food diaries were collected from 260 healthy pregnant women sampled from the control arm of a large Irish pregnancy cohort at 14 weeks gestation (range 12-20 weeks). RESULTS: Up to 45% of pregnant women may be underreporting daily energy intake (EI). Multiple logistic regression analysis found that having a body mass index (BMI) of ≥ 25 kg/m(2) compared with a BMI <25 kg/m(2) (odds ratio, 4.4; 95% confidence interval, 2.5-7.7) was the main predictor of energy underreporting. Educational attainment is also an important predictor of energy underreporting. Women who underreport their EI tend to be less compliant with the current dietary recommendations for pregnancy. CONCLUSIONS: These data highlight the need for more education and public health interventions among pregnant women to achieve current dietary guidelines. In the analysis of dietary intakes, removal of extreme under reporters (Goldberg's ratio <0.9) may allow for more accurate assessment of nutritional intakes amongst pregnant women.

Insufficient vitamin D intakes among pregnant women.

Vitamin D has an important role in pregnancy in promoting fetal skeletal health. Maternal dietary intake is a key factor influencing both maternal and fetal status. There are limited data available on food groups contributing to vitamin D intake in pregnancy. The aim of this study was to determine dietary intakes of vitamin D throughout pregnancy in 64 women and to determine the main food groups contributing to vitamin D intake. Results showed that median dietary intakes of vitamin D ranged from 1.9-2.1 µg/d during pregnancy, and were 80% below the current recommendation. The principal food groups contributing to vitamin D intake were meat, egg and breakfast cereal groups. Oily fish, the best dietary source of vitamin D, was consumed by <25% of women. These data call for more education; they question the role of vitamin D supplementation and highlight the contribution of other food groups more frequently consumed, namely, breakfast cereals, meat and eggs.