[Evaluate the dietary quality of pregnant women using the adjusted diet balance index for pregnancy].

Mengyuan Li, Jie Wang, Yuehui Fang, Yiyao Lian, Zhenyu Yang, Yuna He
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Abstract

Objective: To update the Chinese diet balance index for pregnancy(DBI_P), evaluate the dietary quality of pregnant women at different stages of pregnancy and analyze the influencing factors.

Methods: The DBI_P was adjusted according to the recommended intake of various foods for pregnant women at different stages in the newly released Dietary Guidelines for Chinese Residents(2022) and and the balanced dietary pagoda for pregnant women. A total of 521 pregnant women in Taicang were investigated by questionnaire and 3-day food records method. Their basic information and food intake in the first, second and third trimester were collected. Low bound score(LBS), high bound score(HBS), diet quality distance(DQD) of DBI_P were used to evaluate the dietary quality of each stage of pregnancy and multiple linear regression method was used to analyze the influencing factors of dietary quality.

Results: There was insufficient intake of cereals, vegetables, fruits, dairy products, soy nuts, aquatic products and food categories at all stages of pregnancy. The intake of eggs was sufficient at each stage of pregnancy. The intake of meat and poultry was excessive at all stages of pregnancy. The proportion of pregnant women with insufficient vegetable intake in the first, second and third trimester all exceeded 70%. The proportion with insufficient daily food categories in each term was more than 90%. The proportion with excessive intake of meat and poultry increased from 74.5% in the first trimester to 84.1% in the third trimester. The mean of LBS in each stage of pregnancy were 16.0, 15.5 and 15.1, and the proportion with moderate to severe insufficient intake were 14.2%, 12.2% and 9.2%, respectively. The mean of HBS in each stage of pregnancy were 4.3, 4.8 and 4.9, and the proportion with moderate to severe excessive intake were 4.3%, 5.4% and 4.5%, respectively. The mean of DQD in each stage of pregnancy were 20.3, 20.3 and 20.0, and the proportion with moderate to severe imbalanced intake were 26.9%, 26.1% and 21.7%, respectively. The proportion of pregnant women with low imbalanced intake or balanced diet during the whole pregnancy was 51.1%. Compared with pregnant women under 25 years of age, pregnant women ≥25 years of age had a lower degree of insufficient and unbalanced dietary intake(β=-0.99, 95%CI-1.94--0.03). With the increase of education level, the degree of insufficient and unbalanced dietary intake of pregnant women showed a downward trend, while the degree of excessive intake increased only in college graduates(β=0.66, 95%CI 0.11-1.22). Compared with pregnant women living in rural areas, pregnant women living in urban areas had a lower degree of excessive dietary intake(β=-0.59, 95%CI-0.97--0.21).

Conclusion: The dietary structure of pregnant women in Taicang is imbalanced, and the dietary quality is affected by sociodemographic characteristics.

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[采用调整后的孕期饮食平衡指数评价孕妇膳食质量]。
目的:更新中国妊娠期膳食平衡指数(DBI_P),评价不同妊娠期孕妇的膳食质量并分析其影响因素。方法:根据新发布的《中国居民膳食指南(2022)》中孕妇在不同阶段的各种食物推荐摄入量和孕妇均衡膳食宝塔对DBI_P进行调整。采用问卷调查和3 d饮食记录法对太仓市521名孕妇进行调查。收集她们的基本信息和妊娠前、中、晚期的食物摄入量。采用DBI_P的低界限评分(LBS)、高界限评分(HBS)和饮食质量距离(DQD)评价妊娠各阶段的饮食质量,并采用多元线性回归法分析饮食质量的影响因素。结果:妊娠各阶段谷物、蔬菜、水果、乳制品、大豆坚果、水产品及各类食品的摄取量均不足。在怀孕的每个阶段,鸡蛋的摄入量都是足够的。在怀孕的各个阶段,肉类和家禽的摄入量都是过量的。妊娠前、中、晚期蔬菜摄入不足的孕妇比例均超过70%。各学期每日食物种类不足的比例均在90%以上。肉禽摄入过量的比例由妊娠前期的74.5%上升至妊娠后期的84.1%。妊娠各阶段LBS平均值分别为16.0、15.5和15.1,中度至重度摄入不足比例分别为14.2%、12.2%和9.2%。各妊娠期HBS平均值分别为4.3、4.8和4.9,中度至重度摄入过量的比例分别为4.3%、5.4%和4.5%。各妊娠期DQD平均值分别为20.3、20.3和20.0,中度至重度摄入不平衡的比例分别为26.9%、26.1%和21.7%。全孕期摄入不均衡或饮食均衡的孕妇比例为51.1%。与25岁以下孕妇相比,≥25岁孕妇饮食摄入不足和不平衡的程度较低(β=-0.99, 95%CI-1.94—0.03)。随着受教育程度的提高,孕妇饮食摄入不足和不平衡的程度呈下降趋势,而摄入过量的程度仅在大学毕业生中有所增加(β=0.66, 95%CI 0.11-1.22)。与农村孕妇相比,城市孕妇饮食过量摄入程度较低(β=-0.59, 95%CI-0.97—0.21)。结论:太仓市孕妇膳食结构不均衡,膳食质量受社会人口学特征影响。
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