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. 2019 Jan 29;11(2):288.
doi: 10.3390/nu11020288.

Dietary Intake Patterns among Lactating and Non-Lactating Women of Reproductive Age in Rural Zambia

Chisela Kaliwile  1 , Charles Michelo  2   3 , Tyler J Titcomb  4 , Mourad Moursi  5 , Moira Donahue Angel  6 , Chelsea Reinberg  7 , Pheobe Bwembya  8 , Robyn Alders  9   10   11 , Sherry A Tanumihardjo  12
Affiliations

Dietary Intake Patterns among Lactating and Non-Lactating Women of Reproductive Age in Rural Zambia

Chisela Kaliwile et al. Nutrients. .

Abstract

Insufficient dietary intake, micronutrient deficiencies, and infection may result in malnutrition. In Zambia, an estimated 14% of women are vitamin A-deficient, ~50% are anemic, 10% are underweight, and 23% are overweight/obese. A cross-sectional survey determined food and nutrient intakes of randomly selected Zambian women (n = 530) of reproductive age (15⁻49 years). Dietary intake data were collected using interactive multiple-pass 24-h recalls. Carbohydrate, fat, protein, and selected micronutrient intakes were estimated. Prevalence of adequate intakes were determined using the estimated average requirement (EAR) cut-point method and comparisons between lactating and non-lactating women were made by two-sample t-tests. The response rate was 98.7%. Overweight/obesity occurred in 20.7% (95% confidence interval (CI: 17.2, 24.5)). Almost all micronutrient intakes were inadequate, with values between 22.3% and 99.9%. Mean iron intake was >EAR, and 8.2% of women tested (12/146, 95% CI: 4.1, 13.0) were anemic (hemoglobin <115 g/L). Calcium intake was higher in lactating than non-lactating women (p = 0.004), but all intakes need improvement. Vitamin intakes in rural Zambian women are inadequate, suggesting a need for health promotion messages to encourage intake of locally available micronutrient-dense foods as well as supplementation, fortification, and biofortification initiatives. Nutritional support is important because maternal nutrition directly impacts child health.

Keywords: body mass index; dietary diversity scores; dietary intake; estimated average requirements; nutritional status; vitamin A.

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Conflict of interest statement

The authors declare no conflict of interest with the exception that M.M., M.D.A. and C.R. are employees of HarvestPlus, which partially funded this study. However, the funders had no role in the design of the study; in the collection or interpretation of data; and in the decision to publish the results.

Figures

Figure 1
Figure 1
Subject flow through the study and reasons for withdrawal or loss to follow-up.
Figure 2
Figure 2
Overlaid mineral intake distributions from lactating (dashed curved line) and non-lactating (solid curved line) women assessed by 24-h dietary recall for minerals with estimated average requirements (EARs). Vertical lines represent EARs for minerals for lactating women (dashed line) and non-lactating women (solid line), the dotted vertical line represents EARs that do not differ with lactation in the case of calcium. Two-sample t-tests were used to compare mean intake differences for each mineral: (A) calcium (p = 0.004), (B) iron (p = 0.54), and (C) zinc (p = 0.89).
Figure 3
Figure 3
Overlaid vitamin intake distributions from lactating (n = 180, dashed curved line) and non-lactating (n = 342; solid curved line) women assessed by 24-h dietary recall for vitamins of interest in comparison with the estimated average requirements (EARs). Two-sample t-tests were used to compare mean intake differences for each vitamin: (A) vitamin A (p = 0.62), (B) thiamin (p = 0.69), (C) riboflavin (p = 0.42), (D) niacin (p = 0.65), (E) vitamin C (p = 0.06), (F) vitamin B6 (p = 0.65), (G) folate (p = 0.29), and (H) vitamin B12 (p = 0.38). Vertical lines represent EARs for vitamins for lactating women (dashed line) and non-lactating women (solid line).
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