Dietary intakes, diet quality and physical activity levels from preconception to late pregnancy: Prospective assessment of changes and adherence to recommendations.

Abstract

Background: Prospective nutritional and physical activity data are lacking throughout preconception and pregnancy.

Objectives: To evaluate (1) intakes of energy, macronutrients and micronutrients, diet quality and physical activity levels in preconception and in each trimester of pregnancy and (2) adherence to recommendations.

Design: Prospective study.

Methods: Ninety individuals planning a pregnancy in the next year (Quebec, Canada) took part in four online assessments that occurred before conception and during each trimester of pregnancy (T1, T2 and T3). At each assessment, dietary intakes were derived from at least two web-based 24-h recalls, and supplements use was obtained from a web questionnaire. Diet quality was measured via the Healthy Eating Food Index 2019. Physical activity levels were evaluated with the International Physical Activity Questionnaire and the Pregnancy Physical Activity Questionnaire.

Results: Preconceptionally, participants (30.5 ± 3.6 years) had a mean body mass index of 23.5 ± 3.4 kg/m². Energy intakes (kcal/day) increased over time (preconception: 2172 ± 457; T1: 2284 ± 557; T2: 2382 ± 501; T3: 2434 ± 549; p < 0.0001), while Healthy Eating Food Index 2019 total score remained stable (p = 0.10). Although dietary fiber intake (g/day) increased from preconception to T3 (preconception: 23 ± 9; T1: 25 ± 9; T2: 26 ± 10; T3: 27 ± 9; p < 0.0001), more than 80% of individuals had daily dietary fiber intakes below 14 g/1000 kcal at each assessment. From preconception to T3, total intakes (foods + supplements) increased for iron, folate and vitamin D (p < 0.01), especially from preconception to T1. These intakes came mainly from dietary supplements and met recommendations for most individuals (>52%) at each assessment. Physical activity levels (METs - min/week) decreased from preconception to T3 (preconception: 1754 ± 1431; T1: 1518 ± 1124; T2: 1562 ± 1214; T3: 1258 ± 1218; p < 0.0001), whereas most individuals (64%-82%) complied with the physical activity recommendations at each assessment.

Conclusion: Changes in dietary intakes and physical activity levels are observed from preconception to the end of pregnancy. The recommendations are met for most individuals, except for dietary fiber intakes. These results need to be confirmed in a larger, more heterogeneous sample.