Nutritional status and household food security of pregnant women: insights from the Nutritional Status of Expectant Mothers and their Newborn Infants (NuEMI) study in South Africa.

OBJECTIVE

To describe the nutritional intake and status of pregnant women in Bloemfontein and compare across different household food security categories.

DESIGN

Cross-sectional.

SETTING

Pelonomi Tertiary Hospital.

PARTICIPANTS

427 pregnant women were interviewed using a standard questionnaire and a quantitative FFQ to collect socio-demographic, HIV status, household food security, supplement and dietary intake data. Weight and height were measured using standard anthropometric techniques and capillary blood taken by finger-prick for anaemia, Fe and inflammation status assessment.

RESULTS

26·7 % of participants were food secure, while 11·5 %, 32·1 % and 29·5 % experienced mild, moderate and severe food insecurity, respectively. 54·5 %, 41·7 % and 31·1 % were obese, anaemic and Fe deficient. Median energy intake was 8808 (6978-9223) KJ/d, with no significant differences between the food security groups (P = 0·517). Based on the dietary reference intakes, 98·1 % met the estimated average requirement (EAR) for carbohydrates, but the majority had sub-optimal intake of protein (58·3 %), fibre (60·9 %), pantothenic acid (67·0 %), vitamins C (65·6 %), D (68·4 %), E (59·0 %) and K (61·8 %), potassium (99·8 %), dietary Ca (95·8 %) and Fe (80·8 %). Compared with the moderately and severely food-insecure counterparts, food-secure participants had a higher intake of animal protein (P < 0·001), total fat (P = 0·014), monounsaturated fat (P = 0·002), vitamins B12 (P = 0·014), C (P < 0·001) and D (P = 0·003) and dietary Ca (P = 0·001). Dietary folate intake was below the EAR in 69·9 %, but was higher among severely food-insecure participants (463·94 (327·39, 609·71) µg than food secure (378·49 (265·99, 496·15) µg, P = 0·007)).

CONCLUSION

The findings show widespread inadequate nutrient intake among pregnant women in Bloemfontein, with food-insecure women showing significantly lower intake of specific nutrients.