Progress of Eastern Mediterranean Countries towards Meeting USDA Dietary Guidelines for Pregnant Women: A Focused Review.

Abstract

Purpose of review: Pregnant women across the globe, in the Eastern Mediterranean Region (EMR), face various dietary obstacles during their pregnancy. In this region, characterized by diverse cultural preferences and traditions, emergencies such as conflicts, natural disasters, epidemics, and displacement continue to exist. This influences food insecurity in the region, particularly among pregnant women. This review aims to enhance maternal and fetal health by analyzing these nutritional challenges and assessing women's nutrient consumption in accordance with the USDA's 2020-2025 Nutritional Guidelines for Pregnant Women, with particular attention to significant nutrient deficiencies. It provides a comprehensive examination of the existing literature and data regarding maternal nutrition in the EMR, highlights deficiencies in data collection and analysis, calls for national surveys, and emphasizes the necessity of raising awareness about the adequate nutrition to improve health outcomes for mothers and their infants in the region. The USDA guidelines were selected for comparisons as they are internationally recognized standards. To enhance the analysis, WHO regional standards were also used, offering context-specific insights that complement the USDA framework.

Recent findings: Pregnant women in the EMR commonly experience nutrient inadequacies, particularly in carbohydrates, fruits, and vegetables. A healthy nutritious diet during pregnancy contributes to optimal fetal growth and increases the potential for long-term health for mothers and their offspring. Many antioxidants (vitamin A, C, and E, carotenoids and flavonoids) are derived from the inclusion of vegetables and fruits in pregnant women's diets. Additionally, they also provide folates, potassium and fiber. Starchy carbohydrates and fiber containing whole grain cereals and vegetables are the fundamentals of a healthy diet allowing for good body's functioning and providing energy as a primary source. Whole grain cereal products are particularly rich in minerals, vitamins, and dietary fibers. The study highlights lack of intake in milk and dairy products, sources of iodine, essential for cognitive fetal growth, in addition to an insufficient amount of vitamin D, which is protective against gestational diabetes, as well as vitamin C, essential for immunity and antioxidant properties. The findings emphasize the importance of conducting national surveys among pregnant women in the EMR Region countries to gain a clearer understanding of their food intake and inform the development of targeted interventions. The study focuses on significant nutrient deficiencies and dietary challenges faced by pregnant women in EMR, emphasizing the need for targeted surveys and educational initiatives.