A clear trade-off exists between the theoretical efficiency and acceptability of dietary changes that improve nutrient adequacy during early pregnancy in French women: Combined data from simulated changes modeling and online assessment survey

BackgroundDuring pregnancy, the diet of a mother-to-be should be adapted to meet increases in nutrient requirements. We analyzed the theoretical efficiency and acceptability of different types of tailored dietary changes for pregnant women.MethodsThe nutrient adequacy of the diet was evaluated using the PANDiet score, by comparing the nutrient intakes of 344 non-pregnant premenopausal women (18–44y) with dietary reference intakes for the first trimester of pregnancy. Simulations were performed to evaluate the theoretical efficiency of three types of ten successive tailored dietary changes in improving nutrient adequacy, with graded difficulty in implementation. The acceptability (declared intention to use in the diet) of most efficient dietary changes was evaluated during an online randomized study including 115 French pregnant women (22–41y).ResultsModifying the amount consumed of foods (type-1) did not modify the food repertoire and resulted in the smallest theoretical efficiency (increase in the PANDiet score of 9.8±0.2 points), but changes were the most acceptable (probability of the intention to use: 0.30–0.78). Conversely, replacing food items by items from the same group or eaten at the same time (type-3) broadened the food repertoire (3.6±1.3 food subgroups added) and resulted in the greatest theoretical efficiency (+23.9±0.3) but changes were the least acceptable (0.07–0.23). Replacing food items within the same subgroup (type-2) slightly broadened the food repertoire (+8.0±1.3 foods) and resulted in moderate theoretical efficiency (+14.8±0.2) and intermediate acceptability (0.11–0.35).ConclusionA clear trade-off exists between the theoretical efficiency and acceptability of dietary changes, with a graded broadening of the food repertoire.【背景】妊娠期间，孕妇的饮食需进行适应性调整以满足其日益增长的营养需求。本研究针对孕妇群体，分析了不同类型定制饮食调整方案的理论有效性与可接受性。 【方法】本研究通过对比344名非妊娠绝经前女性（18~44岁）的营养素摄入数据与妊娠早期膳食参考摄入量，借助PANDiet评分（PANDiet score）评估饮食的营养充足性。随后开展模拟实验，评估三类共10项连续定制饮食调整在改善营养充足性方面的理论有效性，此类调整的实施难度呈梯度分级。此外，本研究纳入115名法国孕妇（22~41岁）开展在线随机对照研究，以此评估优化效果最优的饮食调整方案的可接受性（即受试者声明的饮食采纳意愿）。 【结果】调整食物食用量（类型1）未改变受试者的食物种类库，理论有效性最低（PANDiet评分提升9.8±0.2分），但可接受性最高（采纳意愿概率为0.30~0.78）。与之相反，将食物替换为同类别或同期食用的其他食物（类型3）可拓展食物种类库（新增3.6±1.3个食物亚组），理论有效性最高（提升23.9±0.3分），但可接受性最低（0.07~0.23）。而在同一食物亚组内替换食物（类型2）仅轻微拓展食物种类库（新增8.0±1.3种食物），理论有效性处于中等水平（提升14.8±0.2分），可接受性也处于中间区间（0.11~0.35）。 【结论】饮食调整的理论有效性与可接受性之间存在显著权衡关系，且食物种类库的拓展程度呈梯度差异。