Assessment of nutritional status in a pregnant women cohort examining health effects of air pollution: Preliminary results from the SICAPHE study

摘要

Background: Few efforts have been undertaken to objectively assess nutritional status in pregnant women, especially within environmental health studies in developing countries. We report preliminary results from nutritional assessments in the newly established South Indian Cohort for Air Pollution and Health Effects (SICAPHE) study aimed at generating exposure-response relationships for air pollution and select birth/early childhood outcomes. Aim: Development and validation of a food frequency questionnaire (FFQ) for nutritional assessments in a pregnant mother cohort in south India. Methodology: We administered a 24-hr dietary recall questionnaire to sub-set of pregnant women enrolled in the SICAPHE study (n=100 out of total cohort enrollment of 1200) to develop a food list, conducted a market survey to seasonality in availability and developed standardized instrument for assessing portion size. Based on these food frequency questionnaire was developed assess macro and micro-nutrient intakes against recommended nutritional requirements (developed by the Indian National Institute of Nutrition).. Results: Initial analyses (n= 156) indicates inadequate intake of milk and milk products among all rural and most urban subjects. Majority of the rural subjects also reported inadequate cereal (carbohydrate) intake (84.3%), pulses/legumes (protein) intake (71.8%) & fats/ oils (68.7%). More than half of the subjects reported inadequate fruit (59.3%) and vegetable (53.1%) intake. These results are being used in conjunction with total calorie requirements and measurements of body mass index to develop an integrated index of nutritional status. Conclusion: FFQs allow more precise assessments of nutritional status while also providing insights into specific nutritional deficiencies. Inclusion of this information for the SICAPHE subjects would allow an examination of the contributions of nutrition as both a direct determinant of low birth weight and as an effect modifier in the relationship between air pollution exposures and birth weight.