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  • Title: Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy.
    Author: Sauder KA, Harte RN, Ringham BM, Guenther PM, Bailey RL, Alshawabkeh A, Cordero JF, Dunlop AL, Ferranti EP, Elliott AJ, Mitchell DC, Hedderson MM, Avalos LA, Zhu Y, Breton CV, Chatzi L, Ran J, Hertz-Picciotto I, Karagas MR, Sayarath V, Hoover J, MacKenzie D, Lyall K, Schmidt RJ, O'Connor TG, Barrett ES, Switkowski KM, Comstock SS, Kerver JM, Trasande L, Tylavsky FA, Wright RJ, Kannan S, Mueller NT, Catellier DJ, Glueck DH, Dabelea D, Program Collaborators for Environmental influences on Child Health Outcomes (ECHO).
    Journal: J Nutr; 2021 Nov 02; 151(11):3555-3569. PubMed ID: 34494118.
    Abstract:
    BACKGROUND: Inadequate or excessive intake of micronutrients in pregnancy has potential to negatively impact maternal/offspring health outcomes. OBJECTIVE: The aim was to compare risks of inadequate or excessive micronutrient intake in diverse females with singleton pregnancies by strata of maternal age, race/ethnicity, education, and prepregnancy BMI. METHODS: Fifteen observational cohorts in the US Environmental influences on Child Health Outcomes (ECHO) Consortium assessed participant dietary intake with 24-h dietary recalls (n = 1910) or food-frequency questionnaires (n = 7891) from 1999-2019. We compared the distributions of usual intake of 19 micronutrients from food alone (15 cohorts; n = 9801) and food plus dietary supplements (10 cohorts with supplement data; n = 7082) to estimate the proportion with usual daily intakes below their age-specific daily Estimated Average Requirement (EAR), above their Adequate Intake (AI), and above their Tolerable Upper Intake Level (UL), overall and within sociodemographic and anthropometric subgroups. RESULTS: Risk of inadequate intake from food alone ranged from 0% to 87%, depending on the micronutrient and assessment methodology. When dietary supplements were included, some women were below the EAR for vitamin D (20-38%), vitamin E (17-22%), and magnesium (39-41%); some women were above the AI for vitamin K (63-75%), choline (7%), and potassium (37-53%); and some were above the UL for folic acid (32-51%), iron (39-40%), and zinc (19-20%). Highest risks for inadequate intakes were observed among participants with age 14-18 y (6 nutrients), non-White race or Hispanic ethnicity (10 nutrients), less than a high school education (9 nutrients), or obesity (9 nutrients). CONCLUSIONS: Improved diet quality is needed for most pregnant females. Even with dietary supplement use, >20% of participants were at risk of inadequate intake of ≥1 micronutrients, especially in some population subgroups. Pregnancy may be a window of opportunity to address disparities in micronutrient intake that could contribute to intergenerational health inequalities.
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