Diet quality among pregnant women in the Navajo Birth Cohort Study

Abstract

Proper nutrition during pregnancy is vital to maternal health and fetal development and may be challenging for Navajo Nation residents because access to affordable and healthy foods is limited. It has been several decades since reported diet quality during pregnancy was examined on Navajo Nation. We present the first study to estimate iodine intake and use the Healthy Eating Index (HEI‐2015) to assess maternal diet quality among pregnant women in the Navajo Birth Cohort Study (NBCS). Based on dietary intake data derived from food frequency questionnaires, overall estimated micronutrient intake has remained similar since the last assessment in 1981, with potential improvements evident for folate and niacin. A high proportion of women (>50%) had micronutrient intakes from dietary sources below the Estimated Average Requirements during pregnancy. The median urinary iodine concentration for NBCS women (90.8 μg/L; 95% CI [80, 103.5]) was less than adequate and lower than concentrations reported for pregnant women that participated in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014. Overall, average diet quality of NBCS women estimated using the HEI‐2015 (62.4; 95% CI [60.7, 64.0]) was similar to that reported for women of child‐bearing age and pregnant women in NHANES. Although, NBCS women had diets high in added sugar, with sugar‐sweetened beverages as the primary contributors. Our study provides updated insights on maternal diet quality that can inform health and nutrition initiatives in Navajo communities emphasizing nutrition education and access to prenatal vitamins and calcium, iodine, and vitamin E dense foods.

Diet quality and its relationship with iodine status in pregnant women living in a Brazilian region where table salt is iodine-fortified according to Public Health Policies

“…Similarly to us, a limitation about the application of the HEI-2015, intending to assess sodium intake, was already noticed, since this instrument was not designed to this aim [15]. In pregnant from the NBCS cohort and with lower insu cient iodine status it was also not demonstrated different scores in the component sodium of HEI-2015 in comparison to pregnant women from HNANES and with adequate iodine status [15].…”

“…In contrast, excessive UIC was related to worse intake of "whole fruits" and "total vegetables". As previously noted, data in literature regarding the relationship diet quality and iodine status are scarce [15]. A study evaluating pregnant women in the Navajo Birth Cohort Study (NBCS) demonstrated that they had lower UIC than pregnant from the National Health and Nutrition Examination Survey (NHANES), with higher risk for iodine insu ciency [15].…”

“…To the best of our knowledge, few studies evaluated diet quality and urinary status in pregnancy [15]. Furthermore, data regarding the association between both conditions are missing.…”

Food Intake and Diet Quality of Pregnant Women in China During the COVID-19 Pandemic: A National Cross-Sectional Study

“…Our partial results are similar to a systematic review indicating that the great recession of 2008 caused a decrease in consumptions of foods such as fruit and vegetable ( 35 ). Two studies ( 36 , 37 ) conducted in the Navajo nation found that access to and availability of foods are particularly important and determine food consumption. It is possible that during the COVID-19 pandemic, there was reduced consumption of foods with short shelf lives related to the number of shopping opportunities and locations.…”

Prenatal Metal Exposures and Infants’ Developmental Outcomes in a Navajo Population

“…In the current study, we also considered the effects of the micronutrients iodine, zinc, and selenium. These micronutrients are important for normal growth but deficient in our population [ 29 ]. Iodine deficiency has been recognized as detrimental and damaging for organogenesis and brain development in the fetus [ 30 , 31 ].…”