Diet quality and its associates among women during middle and late pregnancy: a balance-index based assessment

  Objective  To assess diet quality of pregnant women using dietary balance index and analyze related factors of die quality.

  Methods   Totally 400 healthy pregnant women (24 – 30 weeks of gestation) were recruited at maternal and child health institutions in two districts of Beijing and a prefecture of Shandong province for a voluntary survey from November 2020 to April 2021. Information on dietary intake and related factors were collected by interviews with 3-day 24-hour food frequency recall instrument and a self-designed questionnaire. Diet quality was evaluated using Chinese Diet Balance Index-Pregnancy (DBI-P).

  Results  Valid data from 346 of the women were finally included in the analysis. The median of higher bound score (HBS) (25th percentile P₂₅, 75th percentile P₇₅) was 2.00 (0.00, 2.00) and the proportion of the women assessed as having excessive food intake was 11.00%; the median of lower bound score (LBS) was – 22.00 (– 27.00, – 15.00) and the proportion of insufficient intake was 85.80%; the median of diet quality distance (DQD) was 23.00 (17.75 – 28.00) and the proportion of dietary balance was 21.7%. For all the women, the median (P₂₅, P₇₅) was 242.73 (186.29, 300.95) g for the intake of cereal and potato food, 330.68 (191.69, 498.83) g for vegetables, 23.38 (0 , 129.00) g for fruits, 104.09 (50.98, 234.48) g for milk, 16.33 (0, 54.52) g for soybeans and nuts, 106.41 (61.75, 168.94) g for livestock and poultry meat, 23.64 (0, 59.37) g for fish and shrimp, and 18.84 (0 – 56.24) g for eggs, respectively. The women′s dietary quality differed significantly by education, household income per capita, community food environment, and nutrition literacy. The women with higher education, household income per capita, planned pregnancy, and better community food environment had significantly lower LBS and DQD scores (P < 0.05 for all) ; the women with higher nutrition literacy had significantly lower DQD score (P < 0.05); but the women′s HBS′s score was not significantly related to all of the above factors.

  Conclusion  For second/third trimester pregnant women in two regions of China, the dietary quality is obviously unbalanced and influenced mainly by education, household income per capita, and community environment. Targeted measures need to be promoted to improve dietary condition of the women.