Dataset Information

Racial or Ethnic and Socioeconomic Inequalities in Adherence to National Dietary Guidance in a Large Cohort of US Pregnant Women.

ABSTRACT: The significance of periconceptional nutrition for optimizing offspring and maternal health and reducing social inequalities warrants greater understanding of diet quality among US women.Our objective was to evaluate racial or ethnic and education inequalities in periconceptional diet quality and sources of energy and micronutrients.Cross-sectional analysis of data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort.Nulliparous women (N=7,511) were enrolled across eight US medical centers from 2010 to 2013.A semiquantitative food frequency questionnaire assessing usual dietary intake during the 3 months around conception was self-administered during the first trimester. Diet quality, measured using the Healthy Eating Index-2010 (HEI-2010), and sources of energy and micronutrients were the outcomes.Differences in diet quality were tested across maternal racial or ethnic and education groups using F tests associated with analysis of variance and ?2 tests.HEI-2010 score increased with higher education, but the increase among non-Hispanic black women was smaller than among non-Hispanic whites and Hispanics (interaction P value <0.0001). For all groups, average scores for HEI-2010 components were below recommendations. Top sources of energy were sugar-sweetened beverages, pasta dishes, and grain desserts, but sources varied by race or ethnicity and education. Approximately 34% of energy consumed was from empty calories (the sum of energy from added sugars, solid fats, and alcohol beyond moderate levels). The primary sources of iron, folate, and vitamin C were juices and enriched breads.Diet quality is suboptimal around conception, particularly among women who are non-Hispanic black, Hispanic, or who had less than a college degree. Diet quality could be improved by substituting intakes of refined grains and foods empty in calories with vegetables, peas and beans (legumes), seafood, and whole grains.

SUBMITTER: Bodnar LM

PROVIDER: S-EPMC5446928 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Racial or Ethnic and Socioeconomic Inequalities in Adherence to National Dietary Guidance in a Large Cohort of US Pregnant Women.

Bodnar Lisa M LM Simhan Hyagriv N HN Parker Corette B CB Meier Heather H Mercer Brian M BM Grobman William A WA Haas David M DM Wing Deborah A DA Hoffman Matthew K MK Parry Samuel S Silver Robert M RM Saade George R GR Wapner Ronald R Iams Jay D JD Wadhwa Pathik D PD Elovitz Michal M Peaceman Alan M AM Esplin Sean S Barnes Shannon S Reddy Uma M UM

Journal of the Academy of Nutrition and Dietetics 20170317 6

<h4>Background</h4>The significance of periconceptional nutrition for optimizing offspring and maternal health and reducing social inequalities warrants greater understanding of diet quality among US women.<h4>Objective</h4>Our objective was to evaluate racial or ethnic and education inequalities in periconceptional diet quality and sources of energy and micronutrients.<h4>Design</h4>Cross-sectional analysis of data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort.< ...[more]

PMID: 28320597

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Project description:Importance:The overall prevalence of chronic kidney disease (CKD) has stabilized in the United States in recent years. However, it is unclear whether all major sociodemographic groups experienced this trend. Objective:To examine trends in CKD prevalence across major sociodemographic groups as defined by race/ethnicity and socioeconomic status. Design, Setting, and Participants:This repeated cross-sectional study used data from the National Health and Nutrition Examination Surveys for 1988 to 1994 and every 2 years from 1999 to 2016 on individuals 20 years or older with information on race/ethnicity, socioeconomic status, and serum creatinine levels. Statistical analysis was conducted from May 1, 2017, to April 6, 2020. Exposures:Race/ethnicity and socioeconomic status. Main Outcomes and Measures:Prevalence of CKD was defined as an estimated glomerular filtration rate of 15 to 59 mL/min/1.73 m2. Results:A total of 54?554 participants (mean [SE] age, 46.2 [0.2] years; 51.7% female) were examined. The age-, sex- and race/ethnicity-adjusted overall prevalence of stage 3 and 4 CKD increased from 3.9% in 1988-1994 to 5.2% in 2003-2004 (difference, 1.3%; 95% CI, 0.9%-1.7%; P?<?.001 for change) and remained relatively stable thereafter at 5.1% in 2015-2016 (difference, -0.1%; 95% CI, -0.7% to 0.4%; P?=?.61 for change). The trend in adjusted CKD prevalence differed significantly by race/ethnicity (P?=?.009 for interaction). In non-Hispanic white and non-Hispanic black persons, CKD prevalence increased between 1988-1994 and 2003-2004 and remained stable thereafter. Among Mexican American persons, CKD prevalence was lower than in other racial/ethnic groups and remained stable between 1988-1994 and 2003-2004 but nearly doubled (difference, 2.1%; 95% CI, 0.9%-3.3%; P?=?.001 for change) between 2003-2004 and 2015-2016 to rates similar to those in other racial/ethnic groups. There were higher rates of CKD prevalence among groups with lower educational level and income (eg, 5.8% vs 4.3% and 4.3% vs 3.1% in low vs high education and income, respectively, in 1988-1994), but trends in CKD prevalence mirrored those for the overall population. The higher CKD prevalence among individuals with lower educational level and income remained largely consistent throughout the entire period. Results were similar in most subgroups when including albuminuria to define CKD. Conclusions and Relevance:The prevalence of CKD in the United States has stabilized overall in recent years but has increased among Mexican American persons. More important, gaps in CKD prevalence across racial/ethnic groups and levels of socioeconomic status largely persisted over 28 years. There is a need to identify and address causes of increasing CKD prevalence among Mexican American persons and a need to renew efforts to effectively mitigate persistent disparities in CKD prevalence.

Project description:BackgroundNeonatal and infant mortality rates are among the most significant indicators for assessing a country's healthcare and social development. This study examined the trends in neonatal, post-neonatal, and infant mortality in Italy from 2016 to 2020 and analysed differences between children of Italian and foreign parents based on areas of residence, as well as the leading causes of death. Special attention was given to the analysis of mortality in 2020, the first year of the Covid-19 pandemic, and its comparison with previous years.MethodsData from 2016 to 2020 were collected by the Italian National Institute of Statistics and extracted from two national databases, the Causes of Death register and Live births registered in the population register. Neonatal, post-neonatal, and infant mortality rates were calculated using conventional definitions. The main analyses were conducted by comparing Italian citizens to foreigners and contrasting residents of the North with those of the South. Group comparisons were made using mortality rate ratios. The main causes of death were examined, and Poisson log-linear regression models were employed to investigate the relationships between mortality rate ratios for each cause of death and citizenship, place of residence and calendar year.ResultsIn Italy, in 2020, the neonatal mortality rate was 1.76 deaths per thousand live births and it was 55% higher in foreign children than in Italian children. Foreign children had a higher mortality rate than Italians for almost all significant causes of death. Children born in the South of Italy, both Italian and foreign, had an infant mortality rate about 70% higher than residents in the North. Regions with higher infant mortality were Calabria, Sicily, Campania, and Apulia. In the South, mortality from neonatal respiratory distress and prematurity was higher. In the first months of 2020, between March and June, the first Covid-19 wave, Italy experienced an increase in neonatal and infant mortality compared to the same period in 2016-2019, not directly related to SARS-CoV-19 infection. The primary cause was neonatal respiratory distress.ConclusionsThe neonatal and infant mortality rates indicate the persistence of profound inequalities in Italy between the North and the South and between Italian and foreign children.

Dataset Information

Racial or Ethnic and Socioeconomic Inequalities in Adherence to National Dietary Guidance in a Large Cohort of US Pregnant Women.

Publications

Racial or Ethnic and Socioeconomic Inequalities in Adherence to National Dietary Guidance in a Large Cohort of US Pregnant Women.

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