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Review
. 2023 Jul 7;15(13):3071.
doi: 10.3390/nu15133071.

An Evaluation of Food and Nutrient Intake among Pregnant Women in The Netherlands: A Systematic Review

Sovianne Ter Borg  1 , Nynke Koopman  1 , Janneke Verkaik-Kloosterman  1
Affiliations
Review

An Evaluation of Food and Nutrient Intake among Pregnant Women in The Netherlands: A Systematic Review

Sovianne Ter Borg et al. Nutrients. .

Abstract

Nutritional deficiencies during pregnancy can have serious consequences for the health of the (unborn) child. This systematic review provides an updated overview of the available food and nutrient intake data for pregnant women in The Netherlands and an evaluation based on the current recommendations. Embase, MEDLINE, and national institute databases were used. Articles were selected if they had been published since 2008 and contained data on food consumption, nutrient intake, or the status of healthy pregnant women. A qualitative comparison was made with the 2021 Dutch Health Council recommendations and reference values. A total of 218 reports were included, representing 54 individual studies. Dietary assessments were primarily performed via food frequency questionnaires. Protein, vitamin A, thiamin, riboflavin, vitamin B6, folate, vitamin B12, vitamin C, iron, calcium, and magnesium intakes seemed to be adequate. For folate and vitamin D, supplements were needed to reach the recommended intake. The reasons for concern are the low intakes of fruits, vegetables, and (fatty) fish, and the intakes of alcohol, sugary drinks, and salt. For several foods and nutrients, no or limited intake data were found. High-quality, representative, and recent data are needed to evaluate the nutrient intake of pregnant women in order to make accurate assessments and evaluations, supporting scientific-based advice and national nutritional policies.

Keywords: dietary assessment; early life; nutritional status; pregnancy; recommendations.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram for updated systematic reviews [15]. ‡ Reports from Dutch institutes and non-peer-reviewed Dutch articles. * Studies that were already included in the previous review [14].
Figure 2
Figure 2
Vegetable consumption by pregnant women. Squares indicate vegetable intake. The dotted vertical line represents recommended intake (200 g/d). a = median with interquartile range (IQR); b = mean with standard deviation; c = mean. Generation R study [39]. KOALA [32]. Merkx et al. [33].
Figure 3
Figure 3
(Fatty) fish consumption by pregnant women. Squares indicate fish intake; dots indicate fatty fish intake. The dotted vertical line represents recommended intakes for fish (2 servings/week) and fatty fish (1 serving/week). a = median with interquartile range (IQR); b = median; c = mean. n.s. = not stated. ABCD study, Generation R study, KOALA, LucKi, PIAMA [20]. Doornbos et al. [40].
Figure 4
Figure 4
Protein intake of pregnant women. Squares indicate protein intake. The dotted lines represent the estimated average requirement (EAR: 43.5 g/d, 50 g/d) and recommended dietary allowance (RDA: 54.6 g/d, 62.6 g/d) for the first trimester (in gray) and second trimester (in blue). T0 = preconception; T1 = first trimester; T2 = second trimester. a = mean; b = median; c = median with 90% range. Generation R study [55]. GLIMP2 study [50]. Hernia study [56]. Voortman et al. [57].
Figure 5
Figure 5
Folic acid intake of pregnant women. Squares indicate the dietary folate intake; dots indicate the intake via supplements. The dotted vertical lines represent the adequate intake (AI: 400 µg DFE/d) and the recommended intake from supplements (400 µg DFE/d one month before till the 10th week of pregnancy). T0 = preconception; T1 = first trimester; T2 = second trimester. a = mean with standard error of the mean (SEM); b = median with 5th and 95th percentiles; c = median with 90% range. GLIMP2 study [50]. HAVEN study [43]. Voortman et al. [57].
Figure 6
Figure 6
Folate status of pregnant women. Squares indicate the status of non-supplement users; dots indicate the status of supplement users; triangles indicate the status of the total study population. The dotted vertical line represents the reference value. T0 = preconception; T1 = first trimester; T2 = second trimester. a = median with interquartile range (IQR); b = mean with standard deviation (SD); c = mean with standard error of the means (SEM); d = median with minimum and maximum value. ABCD study [78]. Generation R study [70]. GLIMP2 study [50]. Rotterdam Predict study [80]. Voortman et al. [57]. Hogeveen et al. [61].
Figure 7
Figure 7
Vitamin B12 intake of pregnant women. Squares indicate the dietary folate intake; dots indicate the intake via supplements; triangles indicate the total intake. The dotted vertical lines represents the estimated average requirement (EAR: 2.4 μg/d) and the recommended dietary allowance (RDA: 3.3 μg/d). T0 = preconception; T1 = first trimester; T2 = second trimester. a = mean with standard error of the mean (SEM); b = median with interquartile range (IQR); c = median with 90% range. GLIMP2 study [50]. KOALA [81]. Voortman et al. [57].
Figure 8
Figure 8
Calcium intake of pregnant women. Squares indicate the dietary folate intake; triangles indicate the total intake. The dotted vertical lines represent the estimated average requirement (EAR: 750 mg/d) and recommended daily allowance (RDA: 950 mg/d) for women aged 25 year and older. a = mean with standard deviation (SD); b = median with 90% range. Expect study I [83]. Generation R study [84]. Voortman et al. [57].
Figure 9
Figure 9
Vitamin B6 intake of pregnant women. Squares indicate the dietary folate intake; dots indicate the intake via supplements; triangles indicate the total intake. The dotted vertical lines represent the estimated average requirement (EAR: 1.3 mg/d) and recommended daily allowance (RDA: 1.8 mg/d). T0 = preconception; T1 = first trimester; T2 = second trimester. a = mean with standard error of the mean (SEM); b = median with 90% range. GLIMP2 study [50]. Voortman et al. [57].
Figure 10
Figure 10
Vitamin D intake of pregnant women. Squares indicate the dietary folate intake; dots indicate the intake via supplements; triangles indicate the total intake. The dotted vertical line represents the adequate intake (AI: 10 μg/d). T0 = preconception; T1 = first trimester; T2 = second trimester. a = mean with standard error of the mean (SEM). GLIMP2 study [50].
Figure 11
Figure 11
Vitamin D status of pregnant women. Dots indicate the vitamin D status. The dotted vertical line represents the reference value. T0 = preconception; T1 = first trimester; T2 = second trimester. a = mean with standard deviation (SD); b = median with 95% range; c = mean with standard error of the means (SEM); d = median with minimum and maximum value. ABCD study [93]. Generation R study [92]. GLIMP2 study [50]. KOALA [91]. ZOOG [88].
Figure 12
Figure 12
Iron intake of pregnant women. Squares indicate the dietary folate intake; dots indicate the intake via supplements; and triangles indicate the total intake. The dotted vertical lines represent the estimated average requirement (EAR: 7 mg/d) and recommended daily allowance (RDA: 16 mg/d). T0 = preconception; T1 = first trimester; T2 = second trimester. a = median with 25th and 75th percentiles; b = mean with standard deviation (SD); c = median with 90% range. Generation R study [94]. GLIMP2 study [50]. Voortman et al. [57].
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References

    1. Tuncalp Ö., Rogers L.M., Lawrie T.A., Barreix M., Peña-Rosas J.P., Bucagu M., Neilson J., Oladapo O.T. WHO recommendations on antenatal nutrition: An update on multiple micronutrient supplements. BMJ Glob. Health. 2020;5:e003375. doi: 10.1136/bmjgh-2020-003375. - DOI - PMC - PubMed
    1. Jouanne M., Oddoux S., Noël A., Voisin-Chiret A.S. Nutrient Requirements during Pregnancy and Lactation. Nutrients. 2021;13:692. doi: 10.3390/nu13020692. - DOI - PMC - PubMed
    1. World Health Organization (WHO) Good Maternal Nutrition. The Best Start in Life. WHO; Geneva, Switzerland: 2016.
    1. Raghavan R., Dreibelbis C., Kingshipp B.L., Wong Y.P., Abrams B., Gernand A.D., Rasmussen K.M., Siega-Riz A.M., Stang J., Casavale K.O., et al. Dietary patterns before and during pregnancy and birth outcomes: A systematic review. Am. J. Clin. Nutr. 2019;109:729S–756S. doi: 10.1093/ajcn/nqy353. - DOI - PubMed
    1. Bailey R.L., Pac S.G., Fulgoni V.L., 3rd, Reidy K.C., Catalano P.M. Estimation of Total Usual Dietary Intakes of Pregnant Women in the United States. JAMA Netw. Open. 2019;2:e195967. doi: 10.1001/jamanetworkopen.2019.5967. - DOI - PMC - PubMed

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