Scientist International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) Dhaka, Dhaka, Bangladesh
Disclosure(s):
Md Munirul Islam, MBBS, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: To examine the adequacy of micronutrient intakes during the third trimester of pregnancy and lactation period among women living in an urban slum of Bangladesh, and 2) to explore the determinants of micronutrient adequacy during pregnancy and lactation.
Methods: Well-nourished (BMI >18.5), un-supplemented women (n=359) were recruited during third trimester of pregnancy and followed up until 8.5 months postpartum. Nutrient intakes were estimated with a validated multiple-pass 24-h dietary recall questionnaire at three time points (3rd trimester of pregnancy, between 1-3 months and 3-6 months postpartum). Dietary intake data was converted to nutrients using a locally adapted food composition table. Nutrient adequacy ratio (NAR) was utilized to estimate the nutrient adequacy of each micronutrient. Mean adequacy ratio (MAR) was used as an index of overall micronutrient adequacy in the diet.
Results: Among 13 micronutrients, NAR was significantly different across 3 time points (P < 0.001 for all micronutrients) other than thiamin, vitamin B-6, folate and vitamin B-12. NAR for niacin and copper was above ‘one’ in all time points. NAR for vitamin A, C, E, thiamin, riboflavin, folate, B-12, zinc and calcium was much lower that ‘one’ in all time points. NAR for iron was less than ‘one’ during pregnancy but was above at other two time points. MAR was significantly different at all time points (p,0.001) but was less than ‘one’ (0.56, 0.51 and 0.49 respectively).
Conclusions: Micronutrient adequacy among women during pregnancy is extremely low, and this gets alarmingly lower during the lactation period, which is a crucial time period to continue exclusive breastfeeding. Micronutrient inadequacy is primarily explained by lacking of diversity of food, and lower socio-economic status. Age and education status of women had no association with micronutrient adequacy. The overall diet quality was significantly better during pregnancy period. Increasing dietary diversity, particularly with nutrient-rich foods as well as micronutrient supplementation, or fortification of food, and increasing awareness on nutritious diet intake not only during pregnancy but also during the lactation period is urgently warranted.
Funding Sources: Gates Foundation, Western Human Nutrition Research Center, United States Department of Agriculture, Davis, California
