Topical Area: Global Nutrition
Objectives : In low-income countries, where maternal undernutrition is endemic, data on women’s dietary intake is lacking. Thus, the hypothesis that intakes of pregnant or lactating women is similar to that of non-pregnant, non-lactating women remains untested. We use novel quantitative approaches to evaluate whether the hypothesized similarity is statistically significant at a population level. Our study aimed to 1) compare nutrient intakes of non-pregnant, non-lactating (NPNL) women, pregnant women (PW), and lactating women (LW) to reproductive stage- specific recommendations, 2) assess whether exposure to pregnancy and lactation alters dietary intake compared to NPNL group, 3) Test whether nutrient intakes of PW and LW are statistically similar to those of NPNL women
Methods : We used 24-hour recall data from the 2011-12 Bangladesh Integrated Household survey (n=4044) to quantify dietary intake of energy, proteins, calcium, iron, vitamin A, and women’s dietary diversity score (WDDS) for NPNL women, PW and LW. Multivariable regression models assessed the association between reproductive status and nutrient intakes. Equivalence test, that looks for proof of similarity, rather than proof of difference, assessed statistically significant similarity in nutrient intakes of PW vs. NPNL women, and LW vs. NPNL women at alpha equals 0.05 and a pre-specified equivalence margin or ‘delta’, defined as ±60% of the additional nutrient intakes recommended for PW and LW. If the 95% CI of the difference between means lied completely within ±delta, then the null hypothesis of ‘no equivalence’ was rejected, and similarity between the two groups claimed.
Results : PW and LW had suboptimal intakes for all nutrients. Compared to NPNL group, mean energy intakes of PW and LW were greater by 100 Kcal/d and 80 Kcal/d, respectively. Mean WDDS was 3.7±1 across all three groups. Significant and positive relationship was found only for lactation status and energy intake. In both group comparisons, the null of ‘no equivalence’ was rejected at alpha equals 0.05 for all nutrients.
Conclusions : Dietary intakes of PW and LW are similar to NPNL women in rural Bangladesh. There is a need to enhance women’s diets, especially during pregnancy and lactation when demand for macronutrients and micronutrients is elevated.
Funding Sources : N/A