The secondary micronutrient analysis that Dr. Phelan reported documented the high prevalence of micronutrient deficiencies among the study participants at baseline. More than 90% had deficient intake of vitamin D and fiber, more than 80% had inadequate dietary levels of iron, vitamin E, and choline, and more than half had too little dietary magnesium, vitamin K, and folate. There were additional deficiencies for other micronutrients in lesser proportions of study participants.
The analysis also showed how the behavioral and diet intervention through the end of the third trimester normalized many of these deficiencies, compared with the placebo arm. For example, the prevalence of a magnesium dietary deficiency in the intervention arm dropped from 69% at baseline to 37% at follow-up, compared with hardly any change in the control arm, so that women in the intervention group had a 64% reduced rate of magnesium deficiency compared with the controls, a statistically significant difference.
Other micronutrients that had significant drops in deficiency rate included calcium, with a 63% relative reduction in the deficiency prevalence, vitamin A with a 61% cut, vitamin E with an 83% relative reduction, and vitamin K with a 51% relative drop. Other micronutrient intake levels that showed statistically significant increases during the study compared with controls included vitamin D and copper, but choline showed an inexplicable drop in consumption in the intervention group, a “potential concern,” Dr. Phelan said. The intervention also significantly reduced sodium intake. Dr. Phelan and her associates published these findings (Nutrients. 2019 May 14;11[5]:1071; doi: 10.3390/nu11051071).
Mitchel L. Zoler/MDedge News
Dr. Leanne M. Redman
“The diet quality of many of the pregnant women we have studied was poor, often eating less than half the recommended amounts of fruits and vegetables,” said Leanne M. Redman, PhD, a professor at Louisiana State University and director of the Reproductive Endocrinology and Women’s Health Laboratory at the university’s Pennington Biomedical Research Center in Baton Rouge. “Meal replacement with bars and shakes will be really important for future efforts at improving diet quality” in pregnant women with obesity, predicted Dr. Redman, who did not collaborate on the study Dr. Phelan reported.
SOURCE: Phelan S et al. Obesity Week 2019. Abstract T-OR-2081.