Dietary intakes of women during pregnancy in low- and middle-income countries

Abstract

Objective: To provide a better understanding of dietary intakes of pregnant women in low-and middle-income countries. Design: Systematic review was performed to identify relevant studies which reported nutrient intakes or food consumption of pregnant women in developing countries. Macronutrient and micronutrient intakes were compared by region and the FAO/WHO Estimated Average Requirements. Food consumption was summarized by region. Setting: Developing countries in Africa, Asia, and the Caribbean and Central/ South America. Subjects: Pregnant women in the second or third trimester of their pregnancies. Results: From a total of 1499 retrieved articles, sixty-two relevant studies were analysed. The ranges of mean/median intakes of energy, fat, protein and carbohydrate were relatively higher in women residing in the Caribbean and Central/South America than in Africa and Asia. Percentages of energy from carbohydrate and fat varied inversely across studies in all regions, whereas percentage of energy from protein was relatively stable. Among selected micronutrients, folate and Fe intakes were most frequently below the Estimated Average Requirements, followed by Ca and Zn. Usual dietary patterns were heavily cereal based across regions. Conclusions: Imbalanced macronutrients, inadequate micronutrient intakes and predominantly plant-based diets were common features of the diet of pregnant women in developing countries. Cohesive public health efforts involving improving access to nutrient-rich local foods, micronutrient supplementation and fortification are needed to improve the nutrition of pregnant women in developing countries. Keywords Pregnant women Nutrient intakes Food consumption Developing countriesAdequate nutrition during pregnancy is essential for maternal and child health. Pregnant women are vulnerable to inadequate nutritional status because of the high nutrient demands of pregnancy. Women living in developing countries are particularly at risk for malnutrition during pregnancy due to socio-economic constraints, poor diet quality, high intensity of agricultural labour, and frequent reproductive cycles. There is much evidence supporting the link between inadequate maternal nutritional status and adverse pregnancy outcomes (1)(2)(3) , poor infant survival (4,5) , and risk of chronic diseases and impaired mental development in later life (6)(7)(8) .Poor dietary intake during pregnancy is a significant contributor to global maternal malnutrition in less developed countries (5) . A previous review indicated that pregnant women in developing countries suffer from energy deficiencies due to relatively insufficient energy intake (9) . In addition, 42 % of pregnant women worldwide (5) and more than 50 % of pregnant women in developing countries are anaemic, mainly due to Fe deficiency (10) . Dietary deficiencies in other important vitamins and minerals, including vitamin A, folate, Ca and Zn, are also estimated to be high (5,(11)(12)(13)(14)(15)(16) . The FAO/WHO have established diet-based guidelines for n...

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