Adequate micronutrients intakes in pregnancy requires major changes in the quality of the diet

International audienceIntroduction: Maternal nutrition is critical to the health of bothmother and offspring. Intakes of micronutrients such as iodine, calcium,iron, folate and vitamin D play an important role in preventingadverse pregnancy and birth outcomes, however there is a paucity ofdata on the nutritional adequacy of diets during pregnancy.Objectives: Our objective was to identify to what extent pregnancyreduces the nutritional adequacy of the expecting mother’s dietand if this nutritional gap can be resolved by simple quantitative orqualitative changes in the diet.Method / Design: Using a comprehensive probabilistic approach,the PANDiet scoring system, we evaluated the observed nutritionaladequacy of diets of French and American women of childbearingage (n=344 and n=563) participating in ENNS and NHANES and wesimulated the changes in adequacy in all nutrients and the final overallPANDiet scores of women of childbearing age who would remain ontheir diet during pregnancy. Then, by either increasing the quantityof consumed foods or using snacks recommended during pregnancy,we simulated the effect of a 150-kcal increase in the energy intake ofFrench women of childbearing age.Results: Simulation of pregnancy in women of childbearing agelowered the probabilities of adequacy for the intake of some nutrients(8 out of 34 in France including folate, vitamin D and iodine, and 9out of 30 in the US including folate), resulting in a decrease in theoverall PANDiet score, which was similar in both countries. Simulated150-kcal increases in energy intake, with an increase in the quantity offood consumed or using recommended snacks only partially correctedthis decrease. Indeed, those snacks failed to address the decrease inadequacy related to some of critical micronutrients during pregnancy.Conclusions: Pregnancy induces an important nutritional gap,which is not efficiently addressed with simple generic dietary advice