Poster Topical Area: Global Nutrition
Location: Hall D
Poster Board Number: 606
Objectives: The present study aimed to assess dietary intakes among pregnant women in Zinder, Niger, develop food-based recommendations (FBR) based on women's current food consumption patterns to improve the macro- and micronutrient (MN) adequacy of their diets and identify any shortfalls requiring nutrient supplementation.
Methods: Dietary data were collected by 24h recall among pregnant women (n=99). Linear Programming (LP) analyses, using Optifood software, were performed to identify nutrient gaps in women's diets, develop and evaluate FBR, and model various supplementation strategies. FBRs were considered sufficient for ensuring dietary adequacy for vitamins A, B1, B2,B3,B6, B9,B12,A, C, iron, zinc and calcium if the modeled worst-case scenario for each nutrient provided > 65% of the MN-specific RDA (IOM).
Results: The median (IQR) reported energy intake was 1759 (1475, 2101) kcal/d, which is below the estimated energy requirement of 2675 kcal/d. LP analyses indicated that it was difficult to select a diet that achieved RDAs for modeled MNs, except for B6, iron and zinc. The inclusion of prenatal iron and folic acid (IFA) supplements increased this number to 4 MN. Further LP analyses indicated that a low percentage of women would be at risk of inadequate intakes of 8 MN, if they consumed one additional meal per day, plus the following daily FBR: 3 servings of dark green leafy vegetables, 2 servings of milk, 2 servings of millet, 2 servings of pulses and 3 servings of vitamin A fortified oil. This FBR doubled the cost of the diet (0.22 to 0.51 USD). None of the FBRs tested ensured a low percentage of women would be at risk of inadequate intakes of vitamins B3, B12 and C. Recommendations to consume an additional meal per day, including one of the following: 1) UNIMMAP supplement, 2) Supercereal (CSB+) or 3) small quantity lipid-based nutrient supplement resulted in a low percentage of women at risk of inadequate intakes for 10 modeled MN; additional FBR were necessary to achieve adequate calcium intake.
Conclusions: Providing IFA supplements as the standard-of-care in this population and the promotion of realistic FBRs likely will not adequately address MN deficiencies and may be cost-prohibitive. Thus, multiple micronutrient supplementation or nutrient dense food-based interventions should be prioritized.
K. Ryan Wessells
Assistant Project Scientist
University of California, Davis