Pregnant women are vulnerable to malnutrition. Based on basic health research in 2013, one in four pregnant women in Indonesia experienced chronic energy deficiency (KEK) such as 37.1% due to anemia, and 24.3% for iodine deficiency. This condition requires special attention from all elements because low nutritional state of pregnant women can cause born prematurely, low birth weight, and other dangerous outcomes.
Most pregnant women in Indonesia still focus on the quantity of diet compared to the quality of their food. The diet quantity shows how much is consumed, while the quality of the diet shows how well the consumption is seen from the diversity and balance of nutrients. Therefore, pregnant women now need to also focus on the quality of their diet. Assessing the diet quality of pregnant women can be done using the Alternate Healthy Eating Index for Pregnancy (AHEI-P). Keep in mind, AHEI-P is an assessment of diet quality developed in America by considering balanced nutrition guidelines in the country. In Indonesia, there is no assessment of diet quality, especially for pregnant women. In this study, researchers conducted an AHEI-P adaptation based on the balanced nutrition guidelines that apply in Indonesia.
Data on diet quality using AHEI-P was obtained from semi-quantitative food frequency (SQ-FFQ) data. AHEI-P consists of 9 indicators, and each indicator has a maximum score of 10, so the maximum total score is 90. Indicators that have been adjusted to synchronize with Indonesia’s balanced nutrition guidelines are the maximum score criteria for fiber, iron, energy and protein. Adapted AHEI-P has a maximum score of 110. Diet quality is categorized into 4, namely Poor quality (unadapted, <45; adapted, <55), needs improvement (unadapted, 45-72; adapted, 55-88) and high quality (unadapted,> 72; adapted,> 88). Meanwhile, the nutritional state data of pregnant women are seen from the increasing body weight of pregnant women.
The research conducted on 145 pregnant women in Sumenep Regency showed that most pregnant women did not have sufficient weight gain, the low quantity and quality of diet of pregnant women were in needs improvement category. The low nutritional state of pregnant women is in line with the quality of the diet that is still lacking.
Based on the results of SQ-FFQ, consumption of white meat compared to red meat was the highest, while consumption of vegetables had the lowest score. It also showed that fish consumption is quite high compared to consumption of red meat such as beef, buffalo, goats, and sheep, which was very low. On average, pregnant women only consume red meat twice a year, during certain holidays or events. The low amount of vegetable consumption is the same as most pregnant women in Indonesia. Pregnant women always eat vegetables every meal, but the amount is still below the recommended amount.
The results of this study showed that participants with insufficient weight gain had lower diet quality scores, both using unadapted AHEI-P and adapted AHEI-P. The results of Pearson correlation analysis showed that the adapted AHEI-P had higher validity values than the unadapted AHEI-P.
There is a tendency for pregnant women with a low-quality diet to have low nutritional state and poor quality diet. However, statistically, there was no significant relationship between diet quality (AHEI-P and AHEI-P adapted) to the nutritional state of pregnant women. It can be caused by many factors that affect the nutritional state of pregnant women. Quality of diet is related to diet quantity. Therefore, it will be difficult to maintain an ideal weight gain if the diet quantity is not enough.
All participants involved in the study need to improve the quality of their diet. Awareness regarding the importance of maintaining the quantity and quality of proper food for pregnant women needs to be encouraged, so the nutritional needs of pregnant women are met to avoid the unfavorable birth outcome.
Author: Rian Diana, SP., M.Si.
Detailed information from this study can be seen in our article in the Pakistan Journal of Nutrition. https://scialert.net/abstract/?doi=pjn.2018.530.534
Dewi RK, Khomsan A, Riyadi H, Diana R. (2019). Dietary Quality and Nutritional Status of Pregnant Women in Sumenep Regency, Madura, Indonesia. Pakistan Journal of Nutrition., 17 (11): 530-534, 2018. DOI Number: 10.3923/pjn.2018.530.534