Elsevier

The Journal of Nutrition

Volume 131, Issue 4, April 2001, Pages 1217-1224
The Journal of Nutrition

Intake of Micronutrient-Rich Foods in Rural Indian Mothers Is Associated with the Size of Their Babies at Birth: Pune Maternal Nutrition Study1

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One third of the Indian babies are of low birth weight (<2.5 kg), and this is attributed to maternal undernutrition. We therefore examined the relationship between maternal nutrition and birth size in a prospective study of 797 rural Indian women, focusing on macronutrient intakes, dietary quality and micronutrient status. Maternal intakes (24-h recall and food frequency questionnaire) and erythrocyte folate, serum ferritin and vitamin C concentrations were measured at 18 ± 2 and 28 ± 2 wk gestation. Mothers were short (151.9 ± 5.1 cm) and underweight (41.7 ± 5.1 kg) and had low energy and protein intakes at 18 wk (7.4 ± 2.1 MJ and 45.4 ± 14.1 g) and 28 wk (7.0 ± 2.0 MJ and 43.5 ± 13.5 g) of gestation. Mean birth weight and length of term babies were also low (2665 ± 358 g and 47.8 ± 2.0 cm, respectively). Energy and protein intakes were not associated with birth size, but higher fat intake at wk 18 was associated with neonatal length (P < 0.001), birth weight (P < 0.05) and triceps skinfold thickness (P < 0.05) when adjusted for sex, parity and gestation. However, birth size was strongly associated with the consumption of milk at wk 18 (P < 0.05) and of green leafy vegetables (P < 0.001) and fruits (P < 0.01) at wk 28 of gestation even after adjustment for potentially confounding variables. Erythrocyte folate at 28 wk gestation was positively associated with birth weight (P < 0.001). The lack of association between size at birth and maternal energy and protein intake but strong associations with folate status and with intakes of foods rich in micronutrients suggest that micronutrients may be important limiting factors for fetal growth in this undernourished community.

Key words:

India
maternal intake
food frequency questionnaire
green leafy vegetables
birth size

Abbreviations:

BMI
body mass index
FFQ
food frequency questionnaire
GLV
green leafy vegetables
ICMR
Indian Council of Medical Research
MUAC
mid-upper arm circumference

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1

Supported by the Wellcome Trust, London, U.K., and the Medical Research Council, U.K.