Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-10-31T23:26:42.616Z Has data issue: false hasContentIssue false

A Diet Quality Index for Pregnancy detects variation in diet and differences by sociodemographic factors

Published online by Cambridge University Press:  02 January 2007

Lisa M Bodnar*
Affiliation:
Department of Nutrition, University of North Carolina, Schools of Public Health and Medicine, Chapel Hill, NC, USA Carolina Population Center, Chapel Hill, NC, USA
Anna Maria Siega-Riz
Affiliation:
Department of Nutrition, University of North Carolina, Schools of Public Health and Medicine, Chapel Hill, NC, USA Carolina Population Center, Chapel Hill, NC, USA Department of Maternal and Child Health, University of North Carolina, School of Public Health, Chapel Hill, NC, USA
*
*Corresponding author: Email lisa_bodnar@unc.edu
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

Methods currently used to assess nutritional status during pregnancy have limitations if one wishes to examine the overall quality of the diet. A Diet Quality Index for Pregnancy (DQI-P) was developed to reflect current nutritional recommendations for pregnancy and national dietary guidelines.

Design:

Dietary intake was assessed during the second trimester using a food-frequency questionnaire. The DQI-P includes eight components: % recommended servings of grains, vegetables and fruits, % recommendations for folate, iron and calcium, % energy from fat, and meal/snack patterning score. Scores can range from 0 to 80; each component contributed 10 points.

Setting:

Two public prenatal clinics in central North Carolina.

Subjects:

N = 2063 pregnant women who participated in the Pregnancy, Infection, and Nutrition (PIN) Study.

Results:

The DQI-P quantitatively differentiated diets. The mean score for the population was 56.0 (standard deviation 12.0). Women who were <30 years old, <350% of poverty, nulliparous and high school graduates had significantly higher overall DQI-P scores. Higher percentages of recommended vegetable servings were consumed by higher-income, older and better-educated women. Greater percentages of recommended intakes of folate and iron were seen among black, low-income and nulliparous women. Higher iron intakes were also seen among women who graduated high school and were less than 30 years old. Other differences were observed for intake of fat and meal/snack pattern. Because this index was based on national recommendations, the DQI-P may be a useful tool for research and public health settings to evaluating overall diet quality of pregnant women.

Type
Research Article
Copyright
Copyright © CABI Publishing 2002

References

1Institute of Medicine, National Academy of Sciences. Nutrition during Pregnancy: Weight Gain and Nutrient Supplements. Washington, DC: National Academy Press, 1990.Google Scholar
2Koblinsky, MA. Beyond maternal mortality – magnitude, interrelationship, and consequences of women's health, pregnancy-related complications and nutritional status on pregnancy outcomes. Int. J. Gynaecol. Obstet. 1995; 48: S21–32.CrossRefGoogle ScholarPubMed
3Haines, PS, Siega-Riz, AM, Popkin, BM. The Diet Quality Index Revised: a measurement instrument for populations. J. Am. Diet. Assoc. 1999; 99: 697704.CrossRefGoogle ScholarPubMed
4Patterson, RE, Haines, PS, Popkin, BM. Diet Quality Index: capturing a multidimensional behavior. J. Am. Diet. Assoc. 1994; 94: 5764.CrossRefGoogle ScholarPubMed
5Kennedy, ET, Ohis, F, Carlson, S, Fleming, K. The Healthy Eating Index: design and applications. J. Am. Diet. Assoc. 1995; 95: 1103–8.Google Scholar
6Basiotis, PP, Guthrie, JF, Bowman, SA, Welsh, SO. Construction and evaluation of a Diet Status Index. Farm. Econ. Nutr. Rev. 1995; 8(2): 213.Google Scholar
7US Department of Agriculture, Department of Health and Human Services. Dietary Guidelines for Americans, 5th ed [Online]. Available at http://www.usda.gov/cnpp/DietGd.pdf. Accessed 29 January 2001Google Scholar
8Shaw, A, Fulton, L, Savis, C, Hogbin, M. Using the Food Guide Pyramid: A Resource for Nutrition Educators [Online]. Available at http://www.nal.usda.gov/fnic/Fpyr/guide.pdf. Accessed 29 January 2001.Google Scholar
9Food Surveys Research Group, Agriculture Research Service (ARS). 1994 Continuing Survey of Food Intakes by Individuals (CSFII) 1994 [CD-ROM]. Disks 1 and 2. Riverdale, MD: ARS, 1994.Google Scholar
10US Department of Agriculture. USDA Nutrient Data Base for Standard Reference, Release *12. Riverdale, MD: Agriculture Research Service, 1998.Google Scholar
11Block, G, DiSogra, C. WIC Dietary Assessment Validation Study. Final Report. Alexandria, VA: US Department of Agriculture, Food and Nutrition Service, 1995.Google Scholar
12Block, G, Coyle, LM, Hartman, AM, Scoppa, SM. Revision of dietary analysis software for the health habits and history questionnaire. Am. J. Epidemiol. 1994; 139: 1190–6.Google Scholar
13Block, G, Thompson, FE, Hartman, AM, Larkin, FA, Guire, KE. Comparison of two dietary questionnaires validated against multiple dietary records collected during a 1-year period. J. Am. Diet. Assoc. 1992; 92: 686–93.CrossRefGoogle ScholarPubMed
14Block, G, Woods, M, Potosky, A, Clifford, C. Validation of a self-administered diet history questionnaire using multiple diet records. J. Clin. Epidemiol. 1990; 43: 1327–35.CrossRefGoogle ScholarPubMed
15Subar, AF, Thompson, FE, Smith, AF, Jobe, JB, Ziegler, RG. Improving food frequency questionnaires: a qualitative approach using cognitive interviewing. J. Am. Diet. Assoc. 1995; 95: 781–8.Google Scholar
16National Cancer Institute. Dietsys Software Version 4.0 for Block–NCI HHHQ [Online]. Available at http://www.nutritionquest.com.Google Scholar
17National Cancer Institute (NCI). 5-A-Day for Better Health. RFA No. CA-92-17: Bethesda, MD: NCI, 1992.Google Scholar
18National Research Council, Subcommittee on the 10th Edition of the RDAs, Food and Nutrition Board, Commission on Life Sciences. Recommended Dietary Allowances, 10th ed. Washington, DC: National Academy Press, 1989.Google Scholar
19Kopp-Hoolihan, LE, van Loan, MD, Wong, WW, King, JC. Longitudinal assessment of energy balance in well-nourished, pregnant women. Am. J. Clin. Nutr. 1999; 69: 697704.CrossRefGoogle ScholarPubMed
20Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: Applications in Dietary Assessment. Washington, DC: National Academy Press, 2000.Google Scholar
21Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B-6, Folate, Vitamin B-12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press, 1998.Google Scholar
22Yates, AA, Schlicker, SA, Suitor, CW. Dietary Reference Intakes: the new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J. Am. Diet. Assoc. 1998; 98: 699706.CrossRefGoogle ScholarPubMed
23Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2001.Google Scholar
24Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press, 1997.Google Scholar
25Institute of Medicine, Committee on Nutritional Status during Pregnancy and Lactation, Food and Nutrition Board, Subcommittee for Clinical Application Guide. Nutrition during Pregnancy and Lactation: An Implementation Guide. Washington, DC: National Academy Press, 1992.Google Scholar
26Siega-Riz, AM, Herrmann, TS, Savitz, DA, Thorp, J. The frequency of eating during pregnancy and its effect on preterm delivery. Am. J. Epidemiol. 2001; 153: 647–52.CrossRefGoogle ScholarPubMed
27Lawrence, KM, James, N, Miller, MH, Tennant, GB, Campbell, H. Double-blind randomized controlled trial of folate treatment before conception to prevent recurrence of neural-tube defects. Br. Med. J. 1981; 282: 1509–11.CrossRefGoogle Scholar
28Scholl, TO, Hediger, ML, Schall, JI, Khoo, C, Fisher, RL. Dietary and serum folate: their influence on the outcome of pregnancy. Am. J. Clin. Nutr. 1996; 63: 520–5.Google Scholar
29Siega-Riz, AM, Bodnar, LM, Savitz, DA. What are pregnant women eating? Nutrient and food group differences by race. Am. J. Obstet. Gynecol. 2002; 186: 480–6.CrossRefGoogle ScholarPubMed
30Goldenberg, RL, Tamura, T, Neggers, Y, Copper, RL, Johnston, KE, DuBard, MB, et al. The effect of zinc supplementation on pregnancy outcome. J. Am. Med. Assoc. 1995; 274: 463–8.CrossRefGoogle ScholarPubMed
31Neggers, YH, Cutter, GR, Acton, RT, Alvarez, JO, Bonner, JL, Goldenberg, RL, et al. A positive association between maternal serum zinc concentration and birth weight. Am. J. Clin. Nutr. 1990; 51: 678–84.Google Scholar
32Rosner, B, Gore, R. Measurement error correction in nutritional epidemiology based on individual foods, with application to the relation of diet to breast cancer. Am. J. Epidemiol. 2001; 154: 827–35.Google Scholar
33Carmichael, SL, Shaw, GM, Selvin, S, Schaffer, DM. Diet quality and risk of neural tube defects [abstract]. Am. J. Epidemiol. 2000; 151(11): S6.Google Scholar
34Philipps, C, Johnson, NE. The impact of quality of diet and other factors on birth weight of infants. Am. J. Clin. Nutr. 1977; 30: 215–25.CrossRefGoogle ScholarPubMed
35Burke, BS, Beal, VA, Kirkwood, SB, Stuart, HC. Nutrition studies during pregnancy. Am. J. Obstet. Gynecol. 1943; 46: 3852.Google Scholar
36Loris, P, Dewey, KG, Poirier-Brode, K. Weight gain and dietary intake of pregnant teenagers. J. Am. Diet. Assoc. 1985; 85(10): 1296–305.CrossRefGoogle ScholarPubMed
37Haste, FM, Brooke, OG, Anderson, HR, Bland, JM, Peacock, JL. Social determinants of nutrient intake in smokers and non-smokers during pregnancy. J. Epidemiol. Community Health 1990; 44: 205–9.Google Scholar
38Haste, FM, Brooke, OG, Anderson, HR, Bland, JM, Shaw, JM, Griffin, J, Peacock, JL. Nutrient intakes during pregnancy: observations on the influence of smoking and social class. Am. J. Clin. Nutr. 1990; 51: 2936.Google Scholar
39Block, G, Abrams, G. Vitamin and mineral status of women of childbearing potential. Ann. N.Y. Acad. Sci. 1993; 678: 244–54.CrossRefGoogle ScholarPubMed
40Skinner, JD, Carruth, BR, Pope, J, Varner, L, Goldberg, D. Food and nutrient intake of white, pregnant adolescents. J. Am. Diet. Assoc. 1992; 92(9): 1127–9.CrossRefGoogle ScholarPubMed
41Endres, J, Dunning, S, Poon, S, Welch, P, Duncan, H. Older pregnant women and adolescents: nutrition data after enrollment in WIC. J. Am. Diet. Assoc. 1987; 87(8): 1011–9.Google Scholar
42Lenders, CM, McElrath, TF, Scholl, TO. Nutrition in adolescent pregnancy. Curr. Opin. Pediatr. 2000; 12: 291–6.Google Scholar
43Suitor, CW, Gardner, JD, Feldstein, ML. Characteristics of diet among culturally diverse group of low-income pregnant women. J. Am. Diet. Assoc. 1990; 90: 543–9.Google Scholar
44Rush, D, Sloan, NL, Leighton, J, Alvir, JM, Horvitz, DG, Seaver, WBV, et al. Longitudinal study of pregnant women. Am. J. Clin. Nutr. 1988; 48: 439–83.Google Scholar
45NDS-R Software, © Regents of the University of Minnesota Nutrition Coordinating Center. All Rights Reserved.Google Scholar
46Lewis, CJ, Crane, NT, Wilson, DB, Yetley, EA. Estimated folate intakes: data updated to reflect food fortification, increased bioavailability, and dietary supplement use. Am. J. Clin. Nutr. 1999; 70: 189207.Google Scholar