Chrononutrition and anemia in pregnant adults and adolescents: A systematic review

IF 0.3 Q4 NUTRITION & DIETETICS

CAHIERS DE NUTRITION ET DE DIETETIQUE Pub Date : 2026-08-01 Epub Date: 2026-09-24 DOI:10.1016/j.cnd.2026.08.063

Karina Neves da Silva Telles, Laura Lima Camelo, Luiza Jurado Piay, Yasmin Ferreira Riera, Clara Lima Cardoso, Letícia Barbosa Gabriel da Silva, Ana Sophia Soares Pessoa Nobre de Lacerda, Cláudia Saunders

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The population includes adolescent (10-19 years) and adult (=20 years) pregnant women, in any gestational trimester, with a singleton pregnancy. Exposure corresponds to consuming up to three meals per day, while the comparison group comprises pregnant women who consume more than five meals per day. The primary outcome is the presence of anemia, defined by hemoglobin levels below 11g/dL, and the secondary outcome refers to its severity, classified as mild (hemoglobin between 10.0 and 10.9g/dL), moderate (7.0 and 10.0g/dL), or severe (hemoglobin below 7.0g/dL). Observational studies and clinical trials published between 2000 and 2025 in Portuguese, English, and Spanish are included. Searches are being conducted in the PubMed, LILACS, Scopus, Embase, and Food Science and Technology Abstracts databases. 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Observational studies and clinical trials published between 2000 and 2025 in Portuguese, English, and Spanish are included. Searches are being conducted in the PubMed, LILACS, Scopus, Embase, and Food Science and Technology Abstracts databases. Methodological quality is assessed using the GRADE system and tools from the National Heart, Lung, and Blood Institute.</div><div><h3>Results</h3><div>To date, four studies identified as potentially eligible indicate an association between lower meal frequency and a higher incidence of gestational anemia. Preliminary findings suggest that pregnant women with a meal frequency of fewer than three meals per day had a higher risk of anemia, even after adjusting for potential confounding factors. Among pregnant women with moderate anemia, a higher proportion had a maternal age under 18 years, lower educational attainment, and lower meal frequency compared to pregnant women with mild anemia.</div></div><div>To date, four studies identified as potentially eligible indicate an association between lower meal frequency and a higher incidence of gestational anemia. Preliminary findings suggest that pregnant women with a meal frequency of fewer than three meals per day had a higher risk of anemia, even after adjusting for potential confounding factors. 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引用次数: 0

Abstract

Objective

This study aims to evaluate the association between the number of daily meals and the presence and severity of anemia in adult and adolescent pregnant women.

Methods

This is a systematic review conducted according to the PRISMA guidelines and registered in PROSPERO (CRD420251047844). The research question was structured using the PECO strategy. The population includes adolescent (10-19 years) and adult (=20 years) pregnant women, in any gestational trimester, with a singleton pregnancy. Exposure corresponds to consuming up to three meals per day, while the comparison group comprises pregnant women who consume more than five meals per day. The primary outcome is the presence of anemia, defined by hemoglobin levels below 11 g/dL, and the secondary outcome refers to its severity, classified as mild (hemoglobin between 10.0 and 10.9 g/dL), moderate (7.0 and 10.0 g/dL), or severe (hemoglobin below 7.0 g/dL). Observational studies and clinical trials published between 2000 and 2025 in Portuguese, English, and Spanish are included. Searches are being conducted in the PubMed, LILACS, Scopus, Embase, and Food Science and Technology Abstracts databases. Methodological quality is assessed using the GRADE system and tools from the National Heart, Lung, and Blood Institute.

Results

To date, four studies identified as potentially eligible indicate an association between lower meal frequency and a higher incidence of gestational anemia. Preliminary findings suggest that pregnant women with a meal frequency of fewer than three meals per day had a higher risk of anemia, even after adjusting for potential confounding factors. Among pregnant women with moderate anemia, a higher proportion had a maternal age under 18 years, lower educational attainment, and lower meal frequency compared to pregnant women with mild anemia.

Conclusion

This review is expected to enhance understanding of the relationship between meal frequency and gestational anemia, contributing to evidence-based nutritional recommendations for prenatal care.

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怀孕成人和青少年的时间营养与贫血：一项系统综述

目的本研究旨在评估成人和青少年孕妇每日膳食数量与贫血的存在和严重程度之间的关系。本研究旨在评估成人和青少年孕妇每日膳食数量与贫血的存在和严重程度之间的关系。方法这是一项根据PRISMA指南进行的系统评价，在PROSPERO注册（CRD420251047844）。研究问题是使用PECO策略构建的。人口包括青春期（10-19岁）和成年（=20岁）孕妇，在任何妊娠三个月，单胎妊娠。接触相当于每天吃三顿饭，而对照组包括每天吃五顿饭以上的孕妇。主要结局是贫血，定义为血红蛋白水平低于11g /dL，次要结局是其严重程度，分为轻度（血红蛋白在10.0至10.9 g/dL），中度（7.0至10.0 g/dL）或重度（血红蛋白低于7.0 g/dL）。2000年至2025年间以葡萄牙语、英语和西班牙语发表的观察性研究和临床试验纳入其中。检索正在PubMed、LILACS、Scopus、Embase和Food Science and Technology Abstracts数据库中进行。使用GRADE系统和国家心脏、肺和血液研究所的工具评估方法学质量。这是一项根据PRISMA指南进行的系统评价，并在PROSPERO注册（CRD420251047844）。研究问题是使用PECO策略构建的。人口包括青春期（10-19岁）和成年（=20岁）孕妇，在任何妊娠三个月，单胎妊娠。接触相当于每天吃三顿饭，而对照组包括每天吃五顿饭以上的孕妇。主要结局是贫血，定义为血红蛋白水平低于11g /dL，次要结局是其严重程度，分为轻度（血红蛋白在10.0至10.9 g/dL），中度（7.0至10.0 g/dL）或重度（血红蛋白低于7.0 g/dL）。2000年至2025年间以葡萄牙语、英语和西班牙语发表的观察性研究和临床试验纳入其中。检索正在PubMed、LILACS、Scopus、Embase和Food Science and Technology Abstracts数据库中进行。使用GRADE系统和国家心脏、肺和血液研究所的工具评估方法学质量。结果迄今为止，有四项研究表明较低的进餐频率和较高的妊娠贫血发生率之间存在关联。初步研究结果表明，即使在调整了潜在的混杂因素后，每天进餐频率少于三餐的孕妇患贫血的风险也更高。在中度贫血孕妇中，与轻度贫血孕妇相比，母亲年龄在18岁以下、受教育程度较低、进餐频率较低的比例更高。迄今为止，有四项研究表明较低的进餐频率和较高的妊娠贫血发生率之间存在关联。初步研究结果表明，即使在调整了潜在的混杂因素后，每天进餐频率少于三餐的孕妇患贫血的风险也更高。在中度贫血孕妇中，与轻度贫血孕妇相比，母亲年龄在18岁以下、受教育程度较低、进餐频率较低的比例更高。结论本综述旨在加深对进餐频率与妊娠贫血之间关系的了解，为产前护理提供循证营养建议。本综述有望增进对膳食频率与妊娠贫血之间关系的理解，为产前护理提供循证营养建议。

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来源期刊

CAHIERS DE NUTRITION ET DE DIETETIQUE NUTRITION & DIETETICS-

CiteScore

0.60

自引率

33.30%

发文量

审稿时长

65 days

期刊介绍： Les Cahiers de nutrition et de diététique sont le lieu de communication reconnu pour les médecins spécialistes de la nutrition, les diététiciens, les professionnels et les chercheurs de agro-alimentaire, les enseignants et les étudiants. Les Cahiers de nutrition et de diététique abordent les sujets se rapportant à la biologie générale, à la médecine et à la nutrition, aux aliments, aux comportements alimentaires, à la diététique pratique, ainsi que des thèmes variés : activité physique, apports nutritionnels conseillés, dénutrition, alcool, obésité de enfant, aliments à effet santé, plaisir alimentaire, restauration collective, goûters et collations, allergies alimentaires...