Do the Dietary Intakes of Pregnant Women Attending Public Hospital Antenatal Clinics Align with Australian Guide to Healthy Eating Recommendations?

Abstract

The maternal diet influences the long-term health status of both mother and offspring. The current study aimed to compare dietary intakes of pregnant women compared to food and nutrient recommendations in the Australian Guide to Healthy Eating (AGHE) and Nutrient Reference Values (NRVs). Usual dietary intake was assessed in a sample of women in their 3rd trimester of pregnancy attending antenatal outpatient clinics at John Hunter Hospital, Newcastle, New South Wales (NSW). Dietary intake was measured using the Australian Eating Survey, a validated, semi-quantitative 120-item food frequency questionnaire. Daily food group servings and nutrient intakes were compared to AGHE and NRV targets. Of 534 women participating, none met the AGHE recommendations for all food groups. Highest adherence was for fruit serves (38%), and lowest for breads and cereals (0.6%). Only four women met the pregnancy NRVs for folate, iron, calcium, zinc and fibre from food alone. Current dietary intakes of Australian women during pregnancy do not align with national nutrition guidelines. This highlights the importance of routine vitamin and mineral supplementation during pregnancy, as intakes from diet alone may commonly be inadequate. Future revisions of dietary guidelines and pregnancy nutrition recommendations should consider current dietary patterns. Pregnant women currently need more support to optimise food and nutrient intakes.

High-Fiber Diet during Pregnancy Characterized by More Fruit and Vegetable Consumption

“…The Australian Dietary Guidelines recommend 2 servings of fruit and 5 serves of vegetables (including legumes) each day during pregnancy [ 26 ]. Similar to previous studies, our dietary intake analysis demonstrated that pregnant women are not meeting nutritional guidelines [ 20 , 27 , 28 , 29 , 30 ]. In this study, the median fruit intake for the pregnant women was 1.6 serves per day, with only a quarter (24.8%) of the women meeting the target aim of two serves of fruit per day.…”

“…Even more concerning was our finding that only 3.5% ( n = 28) of the pregnant women in this study met the Australian Dietary Guidelines recommendation for 5 serves of vegetables (including legumes) per day [ 25 ]. Our findings for fruit intake were comparable to those from previous Australian-based studies in which the dietary intake of pregnant women was assessed [ 20 , 27 , 28 , 29 ]. In a recent observational study by Slater et al (2020), using the Australian Eating Survey method to assess intakes of 503 pregnant women, the median fruit intake was 1.7 serves of fruit, with only 38.2% meeting the target of 2 serves per day [ 20 ].…”

“…However, in our pregnancy cohort ( n = 804), we found that only 29.5% of women were meeting the recommended AI for dietary fiber of 28 g/day. The median fiber and energy intakes in our cohort were 24.1 (IQR 19.0–29.7) g/day and 8116 (IQR 6745–9945) KJ/day, similar to 26.3 (IQR 20–33) g/day and 8280 (IQR 6718–10,004) KJ/day reported from another recent Australian cohort ( n = 503 pregnant women) [ 20 ]. Hence as highlighted by these two cohorts, many Australian women appear to be consuming insufficient dietary fiber intakes during pregnancy.…”

“…In a recent observational study by Slater et al (2020), using the Australian Eating Survey method to assess intakes of 503 pregnant women, the median fruit intake was 1.7 serves of fruit, with only 38.2% meeting the target of 2 serves per day [ 20 ]. Although the number of participants in our study meeting the recommended serving quantities of vegetables (3.5%) was lower than other Australian cross-sectional studies by Lee et al, Malek et al, and Slater et al with 10%, 10.3% and 26.6%, respectively [ 20 , 27 , 28 ], it was similar to the percentage of women meeting recommended vegetable servings (2.0%) in a study by Mishra et al published in 2016 [ 29 ].…”

Maternal Diet Influences Fetal Growth but Not Fetal Kidney Volume in an Australian Indigenous Pregnancy Cohort

“…Sodium intake above the recommended level has also been reported in a remote Indigenous Australian general population, where 46% of all sodium intake was contributed by discretionary salt, bread and processed meat [ 59 ]. Findings were similar in a number of studies conducted in the wider population of pregnant women from Australia [ 60 , 61 , 62 , 63 , 64 ], the United States of America [ 65 ] and the United Kingdom [ 66 ]. There are potential health consequences associated with a high-fat, high-sodium diet, particularly in highly processed foods during pregnancy, including altered placental function and predisposition to metabolic disease in the offspring [ 67 ].…”