Determinants of diet quality in pregnancy: sociodemographic, pregnancy-specific, and food environment influences

Abstract

Objective: To advance the knowledge of determinants of diet quality in pregnancy by focusing on both personal characteristics and the food environment.

Design: Cross-sectional study in which participants from the Prenatal Health Project were linked to a geographic dataset by home address. Access to fast food, convenience stores, and grocery stores was measured using a geographic information system (ArcGIS9.3).

Setting: Pregnant women (n = 2,282) were recruited between 2002 and 2005 in London, Ontario, Canada.

Main outcome measure: Dietary quality was measured using a validated food frequency questionnaire and the Canadian Diet Quality Index for Pregnancy.

Analysis: Univariate and multivariate linear regressions were calculated with the predictor variables on the Canadian Diet Quality Index for Pregnancy.

Results: Pregnant women who were born in Canada, common-law, nulliparous, less physically active, smokers, more anxious, or lacking family support had lower diet quality on average. Presence of fast-food restaurants, convenience stores, and grocery stores within 500 m of participants' homes was not associated with diet quality after controlling for personal variables.

Conclusions and implications: The food environment does not seem to have a large influence on diet quality in pregnancy. Further research is needed to determine other potential reasons for low diet quality among pregnant women.

Keywords: diet; food environment; geographic information systems; nutrition; pregnancy.