Dietary and Health Profiles of Spanish Women in Preconception, Pregnancy and Lactation

The nutritional status and lifestyle of women in preconception, pregnancy and lactation determine maternal, fetal and child health. The aim of this cross-sectional study was to evaluate dietary patterns and lifestyles according the perinatal physiological status in a large sample of Spanish women. Community pharmacists that were previously trained to collect the data recruited 13,845 women. General information, anthropometric measurements, physical activity, unhealthy habits and dietary data were assessed using a validated questionnaire. Mean values and percentages were used as descriptive statistics. The t-test, ANOVA or chi-squared test were used to compare groups. A score that included dietary and behavioral characteristics was generated to compare lifestyles in the three physiological situations. The analysis revealed that diet quality should be improved in the three stages, but in a different manner. While women seeking a pregnancy only met dairy recommendations, those who were pregnant only fulfilled fresh fruits servings and lactating women only covered protein group requirements. In all cases, the consumption allowances of sausages, buns and pastries were exceeded. Food patterns and unhealthy behaviors of Spanish women in preconception, pregnancy and lactation should be improved, particularly in preconception. This information might be useful in order to implement educational programs for each population group.

[1]  Isabel Romieu,et al.  Determinantes sociales de los patrones dietéticos durante el embarazo , 2009 .

[2]  L. Hou,et al.  Maternal Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes , 2013, PloS one.

[3]  L. Vila,et al.  Iodine nutritional status in pregnant women of two historically different iodine-deficient areas of Catalonia, Spain. , 2011, Nutrition.

[4]  S. Innis Impact of maternal diet on human milk composition and neurological development of infants. , 2014, The American journal of clinical nutrition.

[5]  M. L. Martínez-Frías Adecuación de las dosis de ácido fólico en la prevención de defectos congénitos , 2007 .

[6]  J. de Irala,et al.  Dietary patterns and difficulty conceiving: a nested case-control study. , 2011, Fertility and sterility.

[7]  J. Ray,et al.  Evidence for suboptimal use of periconceptional folic acid supplements globally , 2004, BJOG : an international journal of obstetrics and gynaecology.

[8]  C. Collins,et al.  Systematic review and meta-analysis of energy and macronutrient intakes during pregnancy in developed countries. , 2012, Nutrition reviews.

[9]  H. Sesso,et al.  Who uses multivitamins? A cross-sectional study in the Physicians’ Health Study , 2014, European Journal of Nutrition.

[10]  R. Norman,et al.  Lifestyle factors in people seeking infertility treatment – A review , 2010, The Australian & New Zealand journal of obstetrics & gynaecology.

[11]  S. McNally,et al.  Periconceptional folic acid supplementation in a nationally representative sample of mothers. , 2012, Irish medical journal.

[12]  L. Serra-Majem,et al.  Association between the adherence to the Mediterranean diet and overweight and obesity in pregnant women in Gran Canaria. , 2013, Nutricion hospitalaria.

[13]  Amanda J. Anderson,et al.  Effect of iodine supplementation in pregnancy on child development and other clinical outcomes: a systematic review of randomized controlled trials. , 2013, The American journal of clinical nutrition.

[14]  M. Kogevinas,et al.  A comparative analysis of dietary intakes during pregnancy in Europe: a planned pooled analysis of birth cohort studies. , 2011, The American journal of clinical nutrition.

[15]  E. Steegers,et al.  Evidence-based preconceptional lifestyle interventions. , 2014, Epidemiologic reviews.

[16]  Jean M Harnisch,et al.  Family medicine obstetrics: pregnancy and nutrition. , 2012, Primary care.

[17]  Peter Gluckman,et al.  Developmental origins of noncommunicable disease: population and public health implications. , 2011, The American journal of clinical nutrition.

[18]  H. Meltzer,et al.  Early Life Nutritional Programming of Obesity: Mother-Child Cohort Studies , 2013, Annals of Nutrition and Metabolism.

[19]  M. Martínez-González,et al.  Nutritional assessment interpretation on 22 007 Spanish community-dwelling elders through the Mini Nutritional Assessment test , 2009, Public Health Nutrition.

[20]  R. Lamuela-Raventós,et al.  Lifestyles and Risk Factors Associated with Adherence to the Mediterranean Diet: A Baseline Assessment of the PREDIMED Trial , 2013, PloS one.

[21]  C. Collins,et al.  Disparities exist between National food group recommendations and the dietary intakes of women , 2011, BMC women's health.

[22]  Christine Thomson,et al.  American Dietetic Association , 1948 .

[23]  F. Ballester,et al.  Dietary intake in pregnant women in a Spanish Mediterranean area: as good as it is supposed to be? , 2012, Public Health Nutrition.

[24]  A. Olshan,et al.  Maternal dietary patterns are associated with risk of neural tube and congenital heart defects. , 2013, American journal of epidemiology.

[25]  Claudia Buss,et al.  Developmental Origins of Health and Disease: Brief History of the Approach and Current Focus on Epigenetic Mechanisms , 2009, Seminars in reproductive medicine.

[26]  F. Viteri,et al.  Pre-pregnancy iron reserves, iron supplementation during pregnancy, and birth weight. , 2011, Early human development.

[27]  M. Mendez,et al.  [Social determinants of dietary patterns during pregnancy]. , 2009, Gaceta sanitaria.

[28]  C. Rivas,et al.  [Factors associated with early weaning in a Spanish region]. , 2014, Anales de pediatria.

[29]  V. Smith Multiple-micronutrient supplementation for women during pregnancy. , 2014, The practising midwife.

[30]  B. Jack,et al.  The clinical content of preconception care: nutrition and dietary supplements. , 2008, American journal of obstetrics and gynecology.

[31]  D. James,et al.  Position of the American Dietetic Association: promoting and supporting breastfeeding. , 2005, Journal of the American Dietetic Association.

[32]  C. Wagner,et al.  Nutritional management of the breastfeeding dyad. , 2013, Pediatric clinics of North America.

[33]  T. Dowswell,et al.  Support for healthy breastfeeding mothers with healthy term babies. , 2012, The Cochrane database of systematic reviews.

[34]  A. Trichopoulou,et al.  Mediterranean diet pyramid today. Science and cultural updates , 2011, Public Health Nutrition.

[35]  D. Mozaffarian,et al.  Prepregnancy adherence to dietary patterns and lower risk of gestational diabetes mellitus. , 2012, The American journal of clinical nutrition.

[36]  V. Arija,et al.  Dietary patterns and associated lifestyles in preconception, pregnancy and postpartum , 2006, European Journal of Clinical Nutrition.

[37]  M. D. L. Hera,et al.  Ingesta dietética y de suplementos de ácido fólico en mujeres embarazadas de Valencia , 2010 .

[38]  H. Ricciotti Nutrition and Lifestyle for a Healthy Pregnancy , 2013 .

[39]  I. Bautista-Castaño,et al.  Maternal Obesity in Early Pregnancy and Risk of Adverse Outcomes , 2013, PloS one.

[40]  A. Anderson Pregnancy as a time for dietary change? , 2001, Proceedings of the Nutrition Society.

[41]  Optimizing natural fertility: a committee opinion. , 2013, Fertility and sterility.

[42]  J. Wyka,et al.  [Folate intake in Poland on the basis of literature from the last ten years (2000-2010)]. , 2011, Roczniki Panstwowego Zakladu Higieny.

[43]  J. M. Hernández,et al.  Validation of a questionnaire to assess the nutritional status and lifestyles in stages of preconception, pregnancy and lactation Validación de una encuesta para evaluar el estado nutricional y los estilos de vida en las etapas preconcepcional, embarazo y lactancia , 2013 .

[44]  J. Lumley,et al.  WITHDRAWN: Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects. , 2011, The Cochrane database of systematic reviews.

[45]  A. Tardón,et al.  Determinants of self-reported smoking and misclassification during pregnancy, and analysis of optimal cut-off points for urinary cotinine: a cross-sectional study , 2013, BMJ Open.

[46]  F. Alla,et al.  Recherche en épidémiologie clinique : quelles règles appliquer ? , 2008 .

[47]  C. Collins,et al.  A systematic review and meta-analysis of micronutrient intakes during pregnancy in developed countries. , 2013, Nutrition reviews.

[48]  D. James,et al.  Position of the American Dietetic Association: Promoting and supporting breastfeeding. , 2005, Journal of the American Dietetic Association.

[49]  E. Pearce,et al.  Iodine supplementation during pregnancy and lactation. , 2012, JAMA.

[50]  Juan Pablo Peña-Rosas,et al.  Effects and safety of periconceptional folate supplementation for preventing birth defects. , 2010, The Cochrane database of systematic reviews.

[51]  M. Kogevinas,et al.  Mediterranean diet adherence during pregnancy and fetal growth: INMA (Spain) and RHEA (Greece) mother–child cohort studies , 2011, British Journal of Nutrition.

[52]  A. Anderson Symposium on 'nutritional adaptation to pregnancy and lactation'. Pregnancy as a time for dietary change? , 2001, The Proceedings of the Nutrition Society.

[53]  Diego Ramiro Fariñas Maternal education and perinatal outcomes among Spanish women (2001-2011) , 2014 .

[54]  Iodine supplementation during pregnancy and lactation. Position statement of the working group on disorders related to iodine deficiency and thyroid dysfunction of the Spanish Society of Endocrinology and Nutrition. , 2014 .

[55]  A. Tardón,et al.  Socio-Economic Inequalities in Health, Habits and Self-Care During Pregnancy in Spain , 2013, Maternal and Child Health Journal.

[56]  S. Wilkinson,et al.  Evaluation of the 'healthy start to pregnancy' early antenatal health promotion workshop: a randomized controlled trial , 2012, BMC Pregnancy and Childbirth.

[57]  V. Arija,et al.  Consumo, hábitos alimentarios y estado nutricional de la poblaciÓn de Reus en la etapa preconcepcional, el embarazo y el posparto , 2004 .

[58]  N. Lelong,et al.  Maternal and health care determinants of preconceptional use of folic acid supplementation in France: results from the 2010 National Perinatal Survey , 2013, BJOG : an international journal of obstetrics and gynaecology.

[59]  Y. Linné,et al.  Diet or exercise, or both, for weight reduction in women after childbirth. , 2013, The Cochrane database of systematic reviews.

[60]  L. Allen,et al.  Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome. , 2002, Journal of the American Dietetic Association.

[61]  R. Perez-Iglesias,et al.  Smoking among pregnant women in Cantabria (Spain): trend and determinants of smoking cessation , 2007, BMC public health.

[62]  S. Juárez,et al.  Maternal Education and Perinatal Outcomes Among Spanish Women Residing in Southern Spain (2001–2011) , 2014, Maternal and Child Health Journal.

[63]  P. Kendall,et al.  Online continuing education course enhances nutrition and health professionals' knowledge of food safety issues of high-risk populations. , 2007, Journal of the American Dietetic Association.

[64]  I. Nerín,et al.  [Prevalence of smoking and second-hand smoke exposure: differences between Spanish and immigrant pregnant women]. , 2012, Gaceta sanitaria.

[65]  A. Malata,et al.  Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care , 2014, The Lancet.

[66]  G. Martínez,et al.  Características socioculturales, obstétricas y antropométricas de los recién nacidos hijos de madre fumadora , 2012 .

[67]  Juan Pablo Peña-Rosas,et al.  Effects and safety of periconceptional oral folate supplementation for preventing birth defects. , 2015, The Cochrane database of systematic reviews.

[68]  J. Sánchez,et al.  Análisis nutricional en el aporte del mineral calcio en mujeres con lactancia , 2008 .

[69]  Inés Velasco,et al.  Suplementación con yodo durante el embarazo y la lactancia. Toma de posición del Grupo de Trabajo de Trastornos relacionados con la Deficiencia de Yodo y Disfunción Tiroidea de la Sociedad Española de Endocrinología y Nutrición , 2014 .

[70]  Hannah Badal,et al.  Change in Women's Knowledge of General and Personal Preconception Health Risks following Targeted Brief Counseling in Publicly Funded Primary Care Settings , 2013, American journal of health promotion : AJHP.

[71]  K. Pitkala,et al.  The effects of nutrition education on professionals' practice and on the nutrition of aged residents in dementia wards , 2007, European Journal of Clinical Nutrition.