Maternal diet quality and nutrient intake in the gestational period: results from the delta healthy sprouts comparative impact trial

Abstract

BackgroundA 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 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.MethodsThe 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-h dietary recall at gestational months (GM) 4 (baseline), 6, and 8. Diet quality was computed using the Healthy Eating Index-2010 (HEI-2010).ResultsGestational 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.ConclusionsPerhaps due to low participant enrollment and higher than expected rates of drop out and noncompliance, we were not able to demonstrate that the enhanced nutrition and lifestyle curriculum (PATE) intervention had a significant effect on diet quality or nutrient intake during pregnancy in this cohort of rural, Southern, primarily African American women.Trial registrationclinicaltrials.gov, NCT01746394. Registered 5 December 2012.

Low rate of initiation and short duration of breastfeeding in a maternal and infant home visiting project targeting rural, Southern, African American women

“…Results of the primary (gestational weight gain) and secondary outcomes in the gestational period have been reported elsewhere [10–12]. While breastfeeding was a secondary health outcome targeted for improvement, preliminary analyses indicated that differences in breastfeeding outcomes between treatment arms were not significant, likely because the benefits of breastfeeding were discussed in both curriculums.…”

Food Environment in the Lower Mississippi Delta: Food Deserts, Food Swamps and Hot Spots

“…We previously conducted Delta Healthy Sprouts (DHS), a nutrition and physical activity intervention designed for pregnant women and their infants residing in the Lower Mississippi Delta [12], a region characterized by high rates of obesity, chronic disease, and premature death [13][14][15]. Because we suspected that the nutrition environment to which these women and their infants were exposed played a role in their persistently low diet quality [16,17], we collected observational data on the food environments of the towns in which these women lived. Results from the Delta Food Outlets (DFO) study indicated that nutrition environment scores were generally low for all classes of food outlets (grocery stores, convenience stores, full-service restaurants, and fast food restaurants) and many outlets provided little in the way of healthy options [18].…”

Measurement of Nutrition Environments in Grocery Stores, Convenience Stores, and Restaurants in the Lower Mississippi Delta

“…From March 2013 through May 2016, we conducted the Delta Healthy Sprouts Project among pregnant women and their infants residing in the rural Lower Mississippi Delta. We designed the project to compare the effect of 2 maternal, infant, and early childhood home visiting curricula on health behaviors of women and their infants (10). Despite the project's focus on nutrition intervention, early results indicated that the women's baseline diet quality was poor and did not improve in either the gestational or postnatal periods (11,12).…”