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Title: Maternal diet quality and nutrient intake in the gestational period: results from the Delta Healthy Sprouts comparative impact trial

Author
item TUSSING-HUMPHREYS, LISA - University Of Illinois
item Thomson, Jessica
item Goodman, Melissa
item OLENDER, SARAH - University Of Illinois

Submitted to: Maternal Health, Neonatology, and Perinatology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/3/2016
Publication Date: 8/17/2016
Publication URL: http://handle.nal.usda.gov/10113/5510078
Citation: Tussing-Humphreys, L.M., Thomson, J.L., Goodman, M.H., Olender, S. 2016. Maternal diet quality and nutrient intake in the gestational period: results from the Delta Healthy Sprouts comparative impact trial. Maternal Health, Neonatology, and Perinatology. 2:8. https://doi.org/10.1186/s40748-016-0036-7.
DOI: https://doi.org/10.1186/s40748-016-0036-7

Interpretive Summary: A woman’s diet throughout pregnancy can play an important role in her reproductive health as well as the health of her unborn child. Suboptimal maternal nutrition is linked to adverse pregnancy outcomes including excessive maternal weight gain, development of gestational complications including gestational diabetes, increased rates of preterm birth, restricted infant growth, and maternal and infant morbidity and mortality. This is especially concerning for pregnant women residing in the Lower Mississippi Delta region of the United States as their diets are strikingly inadequate. The Delta Healthy Sprouts Project was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, and health behaviors of women and their infants residing in the Lower Mississippi Delta region. In this paper, results pertaining to maternal diet quality and nutrient intake in the gestational period are reported. Beginning in the second trimester of pregnancy, the experimental group (PATE) received monthly home visits using the Parents as Teachers curriculum enhanced with nutrition and physical activity components. The control group (PAT) received monthly home visits using the Parents as Teachers curriculum only. Maternal diet was assessed three times during the gestational period using 24-hour dietary recalls and diet quality was computed using the Healthy Eating Index-2010 (scale range 0-100 points). At all three time points, diet quality was low ranging from 44 to 46 points for PATE participants and from 41 to 43 points for PAT participants. Diet quality did not change over time nor were there differences between the two groups of participants. Likewise, nutrient intakes did not change over time and did not differ between the two groups. Designing effective interventions that enable women to improve their dietary intake during pregnancy remains a challenge as evidenced by the lack of impact on maternal diet quality observed in this study.

Technical Abstract: A woman’s diet while pregnant can play an important role in her reproductive health as well as the health of her unborn child. Diet quality and nutrient intake amongst pregnant women residing in the rural Lower Mississippi Delta (LMD) region of the United States is strikingly inadequate. The Delta Healthy Sprouts Project was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, and health behaviors of women and their infants residing in the LMD region. This paper reports results pertaining to maternal diet quality and nutrient intake in the gestational period. The experimental arm (PATE) received monthly home visits beginning in the second trimester using the Parents as Teachers curriculum enhanced with a nutrition and lifestyle behavior curriculum. The control arm (PAT) received monthly home visits using the Parents as Teachers curriculum only. Maternal diet was assessed via 24-hour dietary recall at gestational month (GM) 4 (baseline), 6, and 8. Diet quality was computed using the Healthy Eating Index-2010 (HEI-2010). Gestational period retention rates for PAT and PATE arms were 77% (33/43) and 67% (26/39), respectively. Significant effects were not found for time, treatment, or time by treatment for the HEI-2010 total or component scores, macro- or micronutrient intake or percentage of women meeting recommended nutrient intakes. The PATE and PAT interventions had no significant effect on maternal diet quality or nutrient intake during pregnancy in this cohort of rural, Southern, primarily African American women.