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

Abstract

Background:Between January and April 2020, China implemented differentiated prevention and control strategies across the country, based on the severity of the COVID-19 epidemic/pandemic in different regions. These strategies included lockdowns, social distancing, and the closure of public places. These measures may have affected dietary intake to varying degrees. This study aimed to assess variations in food intake and diet quality among pregnant women according to regional severity and related control measures during the most severe period of COVID-19 restrictions in 2020.MethodsA total of 3,678 pregnant women from 19 provinces/municipalities in mainland China were analyzed in this nationwide, multi-center study. Food intake data were obtained and assessed using a validated food frequency questionnaire (FFQ). Diet quality was quantified using the Diet Balance Index for Pregnancy (DBI-P), which included high bound score (HBS, excessive dietary intake), low bound score (LBS, insufficient dietary intake), and diet quality distance (DQD, dietary imbalance). Linear trend tests and multivariable regression analyses were performed to examine the association between food intake, DBI-P and the severity of pandemic.ResultsThe median daily intake of vegetables, fruit, livestock/poultry meat, dairy, and nuts decreased (p < 0.05) according to low, moderate, and high severity of the pandemic, while no significant differences in cereals/potatoes, eggs, and fish/shrimp intake. The median daily intake of cereals/potatoes exceeded the recommended ranges, and the daily intake of eggs and fish/shrimp was below recommended ranges regardless of the pandemic severity (p < 0.05). Regarding diet quality, HBS decreased (lower excessive consumption) (p = 0.047) and LBS increased (greater insufficient consumption) (p = 0.046) with increased severity of the pandemic. On multivariable analyses, moderate and high pandemic severity were related to lower HBS risk (OR = 0.687, OR = 0.537) and higher LBS risk (β = 1.517, β = 3.020) when compared to low pandemic severity.ConclusionsUnder more severe COVID-19 pandemic conditions, pregnant women consumed less quality food, characterized by reduced consumption of vegetables, fruit, livestock/poultry meat, dairy and nuts, while the quality of the foods that pregnant women consumed in excess tended to improve, but the overconsumption of cereals/potatoes was a problem.

Dietary changes among pregnant individuals compared to pre-pandemic: A cross-sectional analysis of the Pregnancy during the COVID-19 Pandemic (PdP) study

“…Results from the previous studies regarding anxiety and depression are not consistent. Higher anxiety and depression scores were associated with increase in unhealthy foods intake in some studies ( 27 , 45 ), increased intake of both healthy and unhealthy foods in one study ( 59 ), and restrained eating in another study ( 60 ). Stress-related eating can result in a paradox, in which there is an inconsistent direction of association between stress and eating.…”

“…Higher emotional eating was associated with increased consumption of cereals and oil, and decreased intake of fish and seafood ( 26 ). Diet quality of pregnant individuals was also associated with the severity of the pandemic conditions in another Chinese study ( 27 ). According to a cross-national study, approximately one third of the pregnant individuals reported that the pandemic had at least moderately impacted their diet.…”

Nutrition as Personalized Medicine against SARS-CoV-2 Infections: Clinical and Oncological Options with a Specific Female Groups Overview

“…The Authors reported that a median daily intake of so-called functional food, like vegetables and fruit, significantly decreased to low, moderate, and high severity of pandemic, and, in this sense making immune system more vulnerable. In addition to the low quality of the foods consumed, the perinatal outcomes got worse [ 101 ]. Interestingly, researchers in Northern New England have proposed a model to identify and address questionable food choices among pregnant women during the pandemic period, highlighting the need for specific food programs [ 107 ].…”

Postpartum Depressive Symptoms, Perceived Social Support and Their Associations of Women Under Different COVID-19 Pandemic Severities: Analysis of A Chinese Nationwide Multicenter Study

“…A sample of 452 postpartum women, from 19 hospitals in 19 provinces/municipalities distributed across seven geographical regions, was enrolled into our research. Speci c sampling methods have been reported on previous surveys [19].…”

“…Classi cation of COVID-19 pandemic severity COVID-19 pandemic severity was classi ed as low, moderate, high severity and Hubei Province based on the cumulative number of con rmed cases reported on the o cial website of the health commission of each province/municipality by February 29, 2020. The pandemic severity was classi ed as low if less than 100 laboratory con rmed cases were reported, as de ned in our previous study [19]. The pandemic severity was de ned as moderate or high, when 100 to 1000 or more than 1000 laboratory con rmed cases were reported, respectively.…”