Framework of Methodology to Assess the Link between A Posteriori Dietary Patterns and Nutritional Adequacy: Application to Pregnancy

This study aimed to explore the nutritional profile of 608 women during the second trimester of pregnancy, in terms of nutrient patterns, dietary quality and nutritional adequacy. Dietary data were collected using a validated Mediterranean-oriented, culture-specific FFQ. Principal component analysis was performed on 18 energy-adjusted nutrients. Two main nutrient patterns, "plant-origin" (PLO) and "animal-origin" (ANO), were extracted. Six homogenous clusters (C) relative to nutrient patterns were obtained and analyzed through a multidimensional methodological approach. C1, C5 and C6 scored positively on PLO, while C1, C2 and C3 scored positively on ANO. When dietary quality was mapped on food choices and dietary indexes, C6 unveiled a group with a distinct image resembling the Mediterranean-type diet (MedDiet Score = 33.8). Although C1-C5 shared common dietary characteristics, their diet quality differed as reflected in the HEI-2010 (C1:79.7; C2:73.3; C3:70.9; C4:63.2; C5:76.6). The appraisal of nutritional adequacy mirrored a "nutritional-quality gradient". A total of 50% of participants in C6 had almost 100% adequate magnesium intake, while 50% of participants in C4 had a probability of adequacy of ≤10%. Our methodological framework is efficient for assessing the link between a posteriori dietary patterns and nutritional adequacy during pregnancy. Given that macro- and micronutrient distributions may induce metabolic modifications of potential relevance to offspring's health, public health strategies should be implemented.