Food Intake and Diet Quality of Pregnant Women in China During the COVID-19 Pandemic: A National Cross-Sectional Study

Haitian Chen; Hailin Li; Yinli Cao; Hongbo Qi; Yuyan Ma; Xiaoxia Bai; Yangyu Zhao; Li Wu; Caixia Liu; Jun Wei; Hong Wang; Yan Jin; Zilian Wang; Yanna Zhu

doi:10.3389/fnut.2022.853565

Food Intake and Diet Quality of Pregnant Women in China During the COVID-19 Pandemic: A National Cross-Sectional Study

Front Nutr. 2022 Apr 5:9:853565. doi: 10.3389/fnut.2022.853565. eCollection 2022.

Authors

Haitian Chen¹, Hailin Li², Yinli Cao³, Hongbo Qi⁴, Yuyan Ma⁵, Xiaoxia Bai⁶, Yangyu Zhao⁷, Li Wu⁸, Caixia Liu⁹, Jun Wei⁹, Hong Wang³, Yan Jin¹⁰, Zilian Wang¹, Yanna Zhu²

Affiliations

¹ Department of Obstetrics and Gynecology of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
² Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
³ Department of Obstertrics, Northwest Women and Children Hospital, Xi'an, China.
⁴ Department of Gynecology and Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁵ Department of Gynecology and Obstetrics, Qilu Hospital, Shandong University, Ji'nan, China.
⁶ Department of Obstertrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
⁷ Department of Gynecology and Obstetrics, Peking University Third Hospital, Beijing, China.
⁸ Reproductive Medical Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁹ Obstetrics and Gynecology at Shengjing Hospital of China Medical University, Shenyang, China.
¹⁰ Nutrition Department, The International Peace Maternity and Child Health Hospital of Medicine College Shanghai Jiaotong University, Shanghai, China.

Abstract

Background: Between January and April 2020, China implemented differentiated prevention and control strategies across the country, based on the severity of the COVID-19 epidemic/pandemic in different regions. These strategies included lockdowns, social distancing, and the closure of public places. These measures may have affected dietary intake to varying degrees. This study aimed to assess variations in food intake and diet quality among pregnant women according to regional severity and related control measures during the most severe period of COVID-19 restrictions in 2020.

Methods: A total of 3,678 pregnant women from 19 provinces/municipalities in mainland China were analyzed in this nationwide, multi-center study. Food intake data were obtained and assessed using a validated food frequency questionnaire (FFQ). Diet quality was quantified using the Diet Balance Index for Pregnancy (DBI-P), which included high bound score (HBS, excessive dietary intake), low bound score (LBS, insufficient dietary intake), and diet quality distance (DQD, dietary imbalance). Linear trend tests and multivariable regression analyses were performed to examine the association between food intake, DBI-P and the severity of pandemic.

Results: The median daily intake of vegetables, fruit, livestock/poultry meat, dairy, and nuts decreased (p < 0.05) according to low, moderate, and high severity of the pandemic, while no significant differences in cereals/potatoes, eggs, and fish/shrimp intake. The median daily intake of cereals/potatoes exceeded the recommended ranges, and the daily intake of eggs and fish/shrimp was below recommended ranges regardless of the pandemic severity (p < 0.05). Regarding diet quality, HBS decreased (lower excessive consumption) (p = 0.047) and LBS increased (greater insufficient consumption) (p = 0.046) with increased severity of the pandemic. On multivariable analyses, moderate and high pandemic severity were related to lower HBS risk (OR = 0.687, OR = 0.537) and higher LBS risk (β = 1.517, β = 3.020) when compared to low pandemic severity.

Conclusions: Under more severe COVID-19 pandemic conditions, pregnant women consumed less quality food, characterized by reduced consumption of vegetables, fruit, livestock/poultry meat, dairy and nuts, while the quality of the foods that pregnant women consumed in excess tended to improve, but the overconsumption of cereals/potatoes was a problem.

Keywords: COVID-19 pandemic; diet quality; food intake; pregnancy; severity; variations.