thesis

Dietary assessment of pregnant women in Sheffield, UK.

Abstract

As a part of an on-going project to develop a dietary risk assessment tool for low income pregnant women, we evaluated the performance of a modified version of an existing semi-quantified food frequency questionnaire (FFQ) in terms of validity and assessed the nutrient intakes of a sample of English speaking, Caucasian pregnant women living in economically deprived and non-deprived electoral wards of Sheffield. Two statistical techniques were also applied to on energy-adjusted data for identification of discriminatory food items among women living in economically deprived wards. A critical assessment of the influence of individual and social factors on food choice, of the dietary intakes of different socioeconomic groups, of the importance of nutrition prior and during pregnancy and of methods of dietary assessment and associated methodological concerns was undertaken. One-hundred and twenty three pregnant women were recruited for the validation study, which were also included in the main study analysis together with another sub sample of 127 pregnant women. In total 250 pregnant women aged 15 to 43 years provided complete dietary information, of which 174 resided in the 40% most deprived electoral wards and 76 in other wards within Sheffield. The validity of the FFQ was tested against two 24-hour recalls. The FFQ overestimated nutrient intakes but an acceptable agreement between the two assessment methods was observed. Macronutrient intakes of the Sheffield women were similar to other UK pregnancy studies. Mean intakes of calcium, iron, folate and vitamin C however, were relatively lower. Subgroup comparisons showed wide variations in nutrient intakes. The results of regression and discriminant analyses identified food items which might be of importance in the evaluation of the habitual diet of the low income group of pregnant women in Sheffield. The study findings confirm that the FFQ is a valid tool for categorising pregnant women according to dietary intake and that the diet of pregnant women in Sheffield is possibly characterised by low intakes of important nutrients for pregnancy. This study makes an important contribution to future planning and development of interventions for pregnant populations in Sheffield and similar conurbations

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