The relationship between perceived discrimination and reported nutrient intake among pregnant individuals of minoritized racial and ethnic groups.

Abstract

Background: Implications of life-long, perceived discrimination on nutrient intake during the preconception period are unclear.

Objective: The objective is to identify associations between perceived discrimination and consumption of specific nutrients associated with risk of adverse pregnancy outcomes.

Design: This is a secondary data analysis of the prospective Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (NuMom2b) cohort. Participants completed a Block Food Frequency Questionnaire assessing diet in the three months prior to pregnancy and a Krieger Experiences of Discrimination Scale assessing personal encounters of discrimination.

Participants/setting: Participants were recruited from eight clinical centers across the US between 2010-2013. Each participant completed the Food Frequency and Krieger questionnaires and self-identified as belonging to a minoritized racial or ethnic group for this analysis (n=2457).

Main outcome measures: Main outcomes include reported total energy and macronutrient intake, percent of energy from macronutrients, saturated and unsaturated fatty acids (FA), added sugar, sodium, dietary fiber, and Healthy Eating Index-2010 Seafood and Plant Proteins component score.

Statistical analyses performed: Participants were grouped as reporting fewer (<3) or more (≥3) circumstances of discrimination on the Krieger Scale. Multivariable regression models examined associations between discrimination group and nutrient intake. Variables with non-normal distributions were log transformed. Associations were adjusted for total energy intake. Primary outcomes underwent false discovery rate correction (FDR).

Results: Those reporting three or more circumstances of discrimination had higher reported energy intake (p=0.002) and higher reported intake of total fat, saturated fat, unsaturated fats, protein, added sugar and sodium after FDR (all p<0.05) as compared to those reporting fewer circumstances. After adjustment for total energy intake, reporting three or more circumstances was associated with greater reported intake of saturated fat and n-3 polyunsaturated FA, and lower reported intake of dietary fiber (all p<0.05).

Conclusion: Reporting three or more circumstances of discrimination was associated with higher reported total energy intake. After adjustment for total energy, reporting three or more circumstances of perceived discrimination was associated with less nutritious intake for some (higher saturated fat and lower dietary fiber) but not all (higher eicosapentaenoic and docosahexaenoic acids) nutrients.