Cardiometabolic status but not macronutrient intakes differ by pre-pregnancy BMI in women in early pregnancy in Southern Ontario

Introduction:

Introduction: Canadian nutrition recommendations for pregnancy exist but
population-based data on health practices are unavailable as government nutrition surveys do not report on pregnant women. Our objectives were to evaluate dietary intake of macronutrients and cardiometabolic status in early pregnancy and to assess their relationship to pre-pregnancy BMI (pBMI).

Methods:

Methods: Prior to randomization data was obtained from women enrolled in the Be Healthy in Pregnancy RCT (NCT01689961) at 12-17 weeks gestation for 3-d dietary intake (NutritionistPro™). Intakes were compared to the Dietary Reference Intakes (Health Canada, IOM 2005). Estimated Energy Requirement (EER) was derived for each woman from validated equations incorporating age, activity level and body size (IOM, 2005). Fasted plasma and serum samples were analyzed for glucose, insulin, and triglycerides in the hospital laboratory. ANOVA with Dunn’s post-hoc analysis analyzed differences by pBMI (GraphPad Prism 8).

Results:

Results: In 241 women of mainly European descent (31±4 years) (mean±SD), 46% were categorized as overweight/obese by pBMI. Women’s median (IQR) energy intakes (EI) met the individualized EER (2111 kcal/day (667) vs. 2092±185 kcal/day). Protein intake comprised 16.2±3.1% of EI; carbohydrate 51.6% (8.4) and fat 33.8% (7.3) of EI. Macronutrient intake did not differ by pBMI. Median (IQR) triglycerides, glucose and insulin levels were 1.81 mmol/L (0.56), 4.7 mmol/L (0.6), and 33.1 pmol/L (30.7). Overweight women had significantly higher triglycerides (p<0.05) and insulin (p<0.001) values than normal weight women. Obese women had greater triglycerides, insulin, and glucose (p<0.0001).

Conclusion:

Conclusion: Measured energy intake in early pregnancy met recommendations for women in all pBMI categories, with the distribution of macronutrient intake meeting DRIs. While cardiometabolic status differed by pBMI, macronutrient distribution did not. The impact of macronutrient intake and cardiometabolic status on gestational weight gain, and other maternal pregnancy and infant outcomes will be explored in future research. (Supported by CIHR)