Eating down or simply eating less? The diet and health implications of these practices during pregnancy and postpartum in rural Bangladesh

Abstract

Objective: To: (i) determine the prevalence of self-reported eating less and eating down during early and late pregnancy and postpartum, and explore risk factors associated with eating less; (ii) examine the association between eating less and diet quality; and (iii) determine the association between eating less and weight gain during pregnancy.

Design: Data were collected longitudinally from a cohort of women participating in a community health programme. Diet was assessed at three time points (≤20 weeks' gestation, 36 weeks' gestation, 6 months' postpartum), body weight was measured during study enrolment (≤20 weeks' gestation) and at 36 weeks' gestation, and information about the woman and her household was collected at enrolment.

Setting: The Rang-Din Nutrition Study in the Rangpur and Dinajpur districts of Bangladesh.

Subjects: Women (n 4011).

Results: The prevalence of self-reported eating less differed by time point (75·9 % in early pregnancy, 38·8 % in late pregnancy, 7·4 % postpartum; P<0·001). The most common reason for eating less across all time periods was food aversion or loss of appetite. Women who reported eating less in late pregnancy had consumed animal-source foods less frequently in the preceding week than women who reported eating more (mean (sd): 11·7 (7·4) v. 14·8 (9·2) times/week; P<0·001) and had lower weekly weight gain than women who reported eating more (mean (se): 0·27 (0·004) v. 0·33 (0·004) kg/week; P<0·001).

Conclusions: Eating less has negative implications with respect to diet quality and pregnancy weight gain in this context.

Keywords: Bangladesh; Diet; Eating down; Postpartum; Pregnancy.

Fig. 1

Flowchart of participants (CHW, community health worker; GA, gestational age; SDU, safe delivery unit)

Fig. 2

Weekly weight gain during pregnancy (mean values with their standard errors represented by vertical bars) among rural Bangladeshi women (n 4011) who reported consuming less (), the same () or more () food relative to their pre-pregnancy pattern, Rang-Din Nutrition Study, September 2011–August 2012. Means in model 1 were calculated using mixed-model ANOVA including the random effect of cluster and adjusted for multiple comparisons. Model 2 further adjusted for maternal age, BMI and gestational age at enrolment, parity, and season of interview at 36 weeks’ gestation. ^a,b,cMean values with unlike superscript letters were significantly different (P<0·05)