Dietary Intake Patterns and Lifestyle Behaviors of Pregnant Women Living in a Manitoba First Nations Community: Implications for Fetal Alcohol Spectrum Disorder

Abstract

The information on the nutrition status of women at-risk of carrying a child with fetal alcohol spectrum disorder (FASD) is scarce, particularly in the First Nations population living on reserve. This study examined and compared nutrition status, dietary intake, and lifestyle patterns of pregnant at-risk, defined as those who consume alcoholic drink during the current pregnancy, and non-at-risk women living in northern Manitoban community. Thirty-seven pregnant, First Nations women (at-risk n = 15; non-at-risk, n = 22) were recruited to participate in the study. A questionnaire, presented in paper and iPad formats, collected information on participants' demographics, dietary intake, lifestyle, pregnancy outcomes, and maternal health. A food frequency questionnaire and 24-h recall were used to determine nutrient intake. Nutrient values were assessed using Dietary Reference Intakes (DRI). At-risk and non-at-risk women were below the Canada Food Guide serving size recommended for Vegetable and Fruit, Grain, and Milk Products with 93%, 92%, and 93% of participants not meeting the recommendations, respectively. Women met the recommendations for vitamins A, B1, B12, C, niacin, choline, as well as calcium, and zinc. Sixty eight percentage (%) of participants did not meet the recommendations for folate and iron, and 97% for docosahexaenoic acid (DHA). Significant differences were observed between non-at-risk and at-risk women for mean % DRI intakes of vitamin C (313 ± 224 vs. 172 ± 81 mg/day), niacin (281 ± 123 vs. 198 ± 80 mg/day), folate (70 ± 38 vs. 10 ± 22 mcg/day), and iron (101 ± 74 vs. 74 ± 30 mg/day). The findings of this study lay a fundamental premise for the development of community nutrition programs, nutrition education, and nutrition intervention, such as community specific prenatal supplementation. These will assist in ensuring adequate maternal nutrient intake and benefit families and communities in Northern Manitoba with and without alcohol insult.

Keywords: FASD; First Nations; alcohol; macronutrients; maternal nutrition; micronutrients.

Figure 1

Proportion of participants and 95% CIs for not meeting CFG recommendations: (a) all women (n = 37); (b) non-at-risk (n = 22) and at-risk (n = 15). No significant difference was identified between the non-risk and at-risk groups. Reference intakes were adopted from CFG (2007) [20]. F/V, Vegetable and Fruit; Grain, Grain Products; Milk, Milk and Alternatives; Meat, Meat and Alternatives [20]. CI, confidence interval; CFG, Canada’s Food Guide.

Figure 2

Energy intake (%) from macro-nutrients for (a) all women (n = 37); (b) non-at-risk (n = 22) and at-risk (n = 15). * significant difference (p < 0.05) between non-at-risk and at-risk groups. Total CHO includes added sugar. CHO, carbohydrates.

Figure 3

Proportion of participants not meeting DRI recommendations (a) all women (n = 37); (b) non-at-risk (n = 22) and at-risk (n = 15). Bars represent proportions and 95% CI. * significant difference (p < 0.05) between non-at-risk and at-risk groups. DRI: estimated average requirement (EAR) for pregnant women aged 14–18, 19–30, and 31–50 for vitamins A, C, B1, B12, folate, niacin, zinc, calcium, iron; adequate intake (AI) for choline [1]. Recommendations for DHA (C22:6n−3) were obtained from International Society for the Study of Fatty Acids and Lipids [24].