Food Nutr Res. 2017 Apr 11;61(1):1311185. doi: 10.1080/16546628.2017.1311185. eCollection 2017.
Lander RL1,
Hambidge KM1,
Krebs NF1,
Westcott JE1,
Garces A2,
Figueroa L2,
Tejeda G2,
Lokangaka A3,
Diba TS3,
Somannavar MS4,
Honnayya R4,
Ali SA5,
Khan US5,
McClure EM6,
Thorsten VR6,
Stolka KB6;
Women First Preconception Nutrition Trial Group.
- 1
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO, USA.
- 2
- Department of Planning, INCAP (Institute of Nutrition of Central America and Panama), Guatemala City, Guatemala.
- 3
- Department of Community Health, Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
- 4
- Women's and Children's Health Research Unit, KLE University's Jawaharlal Nehru Medical College, Belagavi, India.
- 5
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
- 6
- RTI International, Durham, NC, USA.
Abstract
Background:
Our aim was to utilize a feasible quantitative methodology to estimate
the dietary adequacy of >900 first-trimester pregnant women in poor
rural areas of the Democratic Republic of the Congo, Guatemala, India
and Pakistan. This paper outlines the dietary methods used. Methods:
Local nutritionists were trained at the sites by the lead study
nutritionist and received ongoing mentoring throughout the study.
Training topics focused on the standardized conduct of repeat
multiple-pass 24-hr dietary recalls, including interview techniques,
estimation of portion sizes, and construction of a unique site-specific
food composition database (FCDB). Each FCDB was based on 13 food groups
and included values for moisture, energy, 20 nutrients (i.e. macro- and
micronutrients), and phytate (an anti-nutrient). Nutrient values for
individual foods or beverages were taken from recently developed
FAO-supported regional food composition tables or the USDA national
nutrient database. Appropriate adjustments for differences in moisture
and application of nutrient retention and yield factors after cooking
were applied, as needed. Generic recipes
for mixed dishes consumed by the study population were compiled at each
site, followed by calculation of a median recipe per 100 g. Each
recipe's nutrient values were included in the FCDB. Final site FCDB
checks were planned according to FAO/INFOODS guidelines. Discussion:
This dietary strategy provides the opportunity to assess estimated mean
group usual energy and nutrient intakes and estimated prevalence of the
population 'at risk' of inadequate intakes in first-trimester pregnant
women living in four low- and middle-income countries. While challenges
and limitations exist, this methodology demonstrates the practical
application of a quantitative dietary strategy for a large international
multi-site nutrition trial, providing within- and between-site
comparisons. Moreover, it provides an excellent opportunity for local
capacity building and each site FCDB can be easily modified for
additional research activities conducted in other populations living in
the same area.
KEYWORDS:
Dietary assessment; low- and middle-income countries; nutrition; pregnant women
