Sociodemographic and Obesity-Related Disparities in Risks of Inadequate and Excessive Intake of Micronutrients During Pregnancy: The National ECHO Consortium
Year: 2021
Type: article
Abstract: Both inadequate and excessive intake of micronutrients in pregnancy have the potential to negatively impact child health outcomes. We examined micronutrient intake in a large, diverse sample of women with singleton pregnancies across the United States, including intake by maternal age, race/ethnicity, education, and pre-pregnancy body mass index (BMI). Fifteen observational cohorts in the Environmental influences on Child Health Outcomes (ECHO) consortium assessed prenatal food intake and dietary supplement use with 24-hour dietary recalls (5 cohorts; 1859 women) or food frequency questionnaires (10 cohorts; 8064 women) from 1999–2019. We compared mean daily intake of 19 micronutrients to the age-specific estimated average requirement (EAR), adequate intake (AI), and tolerable upper intake level (UL) for pregnancy, overall and within sociodemographic and anthropometric subgroups. For recall data, we used a measurement error method to estimate distributions of usual intake, proportion below the EAR/AI, and above the UL. For FFQ data, we calculated the proportion below the EAR/AI and above the UL. Risk of inadequate intake from foods alone ranged from 0–93%, depending on the micronutrient or assessment method. With dietary supplements, more than 1 in 5 women remained at risk for inadequate intake of choline, magnesium, and vitamins D, E, and K; or excessive intake of folic acid, iron, and zinc. Higher risks for inadequate intakes were observed among women with obesity (magnesium, vitamin K), who were <18 years (magnesium, vitamin K), Hispanic (vitamin E), non-Hispanic Black (vitamin K), non-Hispanic White (choline) or less educated (magnesium, vitamin E) when compared to counterparts. Improved diet quality is needed for most pregnant women. Even with a high prevalence of dietary supplement use, at least 1 in 5 pregnant women were at risk of inadequate intake of ≥ 1 micronutrients, especially in some population subgroups. Pregnancy may be a window of opportunity to address disparities in micronutrient intake that could contribute to intergenerational health inequalities. National Institutes of Health, Environmental Protection Agency, Autism Speaks.
Authors: Katherine Sauder, Robyn Harte, Brandy Ringham, Patricia Guenther, Regan Bailey, Anne Dunlop, Amy Elliott, Monique Hedderson, Lyndsay Avalos, Yeyi Zhu, Carrie Breton, Lida Chatzi, Margaret Karagas, Vicki Sayarath, Joseph Hoover, Debra MacKenzie, Kristen Lyall, Rebecca Schmidt, Thomas G. O’Connor, Emily S. Barrett, Karen Switkowski, Sarah Comstock, Jean Kerver, Leonardo Trasande, Frances Tylavsky, Rosalind Wright, Diane Catellier, Noel Mueller, Deborah Glueck, Dana Dabelea
Institutions: University of Utah, Purdue University West Lafayette, Emory University, Avera Health, Kaiser Permanente Northern California, University of Southern California, Dartmouth College, University of New Mexico, Drexel University, University of California, Davis, University of Rochester Medicine, University of Rochester, Rutgers, The State University of New Jersey, Harvard University, Michigan State University, New York University, University of Tennessee at Knoxville, Brigham and Women's Hospital, Johns Hopkins University
Language: English
Topic: Nutritional Studies and Diet
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,630
OpenAlex ID: W3165928884