Data_Sheet_2_Food Intake and Diet Quality of Pregnant Women in China During the COVID-19 Pandemic: A National Cross-Sectional Study.ZIP

Background:Between January and April 2020, China implemented differentiated prevention and control strategies across the country, based on the severity of the COVID-19 epidemic/pandemic in different regions. These strategies included lockdowns, social distancing, and the closure of public places. These measures may have affected dietary intake to varying degrees. This study aimed to assess variations in food intake and diet quality among pregnant women according to regional severity and related control measures during the most severe period of COVID-19 restrictions in 2020.
MethodsA total of 3,678 pregnant women from 19 provinces/municipalities in mainland China were analyzed in this nationwide, multi-center study. Food intake data were obtained and assessed using a validated food frequency questionnaire (FFQ). Diet quality was quantified using the Diet Balance Index for Pregnancy (DBI-P), which included high bound score (HBS, excessive dietary intake), low bound score (LBS, insufficient dietary intake), and diet quality distance (DQD, dietary imbalance). Linear trend tests and multivariable regression analyses were performed to examine the association between food intake, DBI-P and the severity of pandemic.
ResultsThe median daily intake of vegetables, fruit, livestock/poultry meat, dairy, and nuts decreased (p < 0.05) according to low, moderate, and high severity of the pandemic, while no significant differences in cereals/potatoes, eggs, and fish/shrimp intake. The median daily intake of cereals/potatoes exceeded the recommended ranges, and the daily intake of eggs and fish/shrimp was below recommended ranges regardless of the pandemic severity (p < 0.05). Regarding diet quality, HBS decreased (lower excessive consumption) (p = 0.047) and LBS increased (greater insufficient consumption) (p = 0.046) with increased severity of the pandemic. On multivariable analyses, moderate and high pandemic severity were related to lower HBS risk (OR = 0.687, OR = 0.537) and higher LBS risk (β = 1.517, β = 3.020) when compared to low pandemic severity.
ConclusionsUnder more severe COVID-19 pandemic conditions, pregnant women consumed less quality food, characterized by reduced consumption of vegetables, fruit, livestock/poultry meat, dairy and nuts, while the quality of the foods that pregnant women consumed in excess tended to improve, but the overconsumption of cereals/potatoes was a problem.

背景：2020年1月至4月，中国依据不同地区新型冠状病毒肺炎（COVID-19）疫情严重程度，在全国范围内实施差异化防控策略，包括封控、保持社交距离及关停公共场所。此类措施可能对膳食摄入产生不同程度的影响。本研究旨在评估2020年新冠疫情管控最严格时期，不同疫情严重程度及相关防控措施下，孕妇的食物摄入与膳食质量变化情况。
方法：本项全国多中心研究共纳入来自中国大陆19个省/直辖市的3678名孕妇进行分析。研究采用经过验证的食物频率问卷（food frequency questionnaire, FFQ）收集并评估食物摄入数据；使用孕期膳食平衡指数（Diet Balance Index for Pregnancy, DBI-P）量化膳食质量，该指数包含高上限得分（high bound score, HBS，指膳食摄入过量）、低上限得分（low bound score, LBS，指膳食摄入不足）以及膳食质量距离（diet quality distance, DQD，指膳食不均衡程度）。本研究通过线性趋势检验与多变量回归分析，探究食物摄入、DBI-P与疫情严重程度之间的关联。
结果：随着疫情严重程度由低到中、再到高等级别，孕妇每日蔬菜、水果、畜禽肉、乳制品及坚果的摄入中位数均显著下降（p < 0.05）；而谷物/薯类、蛋类及鱼/虾的摄入未出现显著差异。无论疫情严重程度如何，孕妇每日谷物/薯类摄入均超出推荐范围，蛋类与鱼/虾摄入均低于推荐范围（p < 0.05）。在膳食质量方面，随着疫情严重程度升高，HBS呈下降趋势（即过量摄入情况减少，p = 0.047），LBS呈上升趋势（即摄入不足情况增多，p = 0.046）。多变量分析结果显示，与低疫情严重程度组相比，中、高疫情严重程度组的HBS风险更低（OR=0.687、OR=0.537），LBS风险更高（β=1.517、β=3.020）。
结论：在疫情更严峻的新冠疫情管控环境下，孕妇的优质食物摄入减少，具体表现为蔬菜、水果、畜禽肉、乳制品及坚果的摄入量降低；尽管孕妇过量摄入的膳食质量有所改善，但谷物/薯类的过量摄入仍是一项突出问题。