Association between 1st trimester diet quality & gestational weight gain rate among pregnant women in Dhulikhel, Nepal

Kelly Martin; Diane Rigassio Radler; Joachim Sackey; Cuilin Zhang; Kusum Shrestha; Abha Shrestha; Archana Shrestha; Emily S Barrett; Shristi Rawal

doi:10.1186/s40795-022-00623-7

Association between 1^st trimester diet quality & gestational weight gain rate among pregnant women in Dhulikhel, Nepal

BMC Nutr. 2022 Nov 11;8(1):129. doi: 10.1186/s40795-022-00623-7.

Authors

Kelly Martin^{1

2}, Diane Rigassio Radler¹, Joachim Sackey¹, Cuilin Zhang³, Kusum Shrestha⁴, Abha Shrestha⁵, Archana Shrestha^{4

6

7}, Emily S Barrett⁸, Shristi Rawal⁹

Affiliations

¹ Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers the State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA.
² Department of Human Ecology, SUNY Oneonta, Oneonta, NY, USA.
³ Eunice Kennedy Shriver National Institute of Child Health and Development, Bethesda, MD, USA.
⁴ Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
⁵ Department of Obstetrics and Gynecology, Dhulikhel Hospital, Dhulikhel, Nepal.
⁶ Department of Chronic Disease and Epidemiology, Center of Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA.
⁷ Institute for Implementation Science and Health, Kathmandu, Nepal.
⁸ Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Rutgers the State University of New Jersey, Piscataway, NJ, USA.
⁹ Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers the State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA. shristi.rawal@rutgers.edu.

Abstract

Background: Despite promising data from high-income countries, the impact of diet quality on gestational weight gain (GWG) has not been investigated in the context of many low-income countries including Nepal.

Methods: We prospectively examined the association between 1^st trimester diet quality and GWG rate among a cohort of singleton pregnant women (n = 101; age 25.9 ± 4.1 years) from a community-based periurban hospital in Dhulikhel, Nepal. Diet quality was assessed from the adapted Nepali version of the 21-item PrimeScreen questionnaire in the 1^st trimester. The diet quality score is based on consumption frequency of 21 food group components (score ranging 0-42), categorized as healthy (12 groups) versus unhealthy (9 groups), with higher scores indicative of better overall diet quality. The GWG rate was calculated as the measured weight at early-to-mid 3^rd trimester (28-35 wks) minus the weight at 2^nd trimester (13-25 wks), divided by the number of weeks in between. Linear regression estimated the association between diet quality and GWG rate, adjusting for a priori covariates (i.e. age, education, ethnicity, pre-pregnancy BMI, and nausea/vomiting.) RESULTS: The mean GWG rate in mid-to-late pregnancy was 0.46 ± 0.2 kg/wk and the mean diet quality score was 23.6 ± 2.5. Based on pre-pregnancy BMI, 49.4% of women had excessive GWG rate, while nearly equal numbers had either adequate GWG or inadequate GWG rate. There was no significant association between diet quality and GWG rate [adjusted β (95% CI) = -0.02 (-0.05, 0.01); p = 0.14]. The mean GWG rate was marginally higher (0.57 vs. 0.44 kg/wk; p = 0.06) among those with high versus low (2 + servings vs. 0-1 serving/wk) intake of red meat; similar findings were seen when comparing red meat intake between women with excessive versus adequate GWG (Cramer's V = 0.2; p = 0.06).

Conclusions: While 1^st trimester diet quality is not related to GWG among Nepali women, a high intake of red meat may be a potential risk factor for excessive GWG in this population.

Keywords: Diet quality; Gestational weight gain; Nepal; Pregnancy.

Abstract

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