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The Relationship Between Perceived Discrimination and Reported Nutrient Intake Among Pregnant Individuals of Minoritized Racial and Ethnic Groups - 19/06/25

Doi : 10.1016/j.jand.2024.11.007 
Tatyana Johnson, MD 1, Ann K. Kan, MS 2, Lauren B. Bonner, PhD 2, Linda Van Horn, PhD, RDN 2, Kiarri N. Kershaw, PhD, MPH 2, William A. Grobman, MD, MBA 3, Karen L. Lindsay, PhD, RDN 4, 5, Michelle P. Debbink, MD, PhD 6, Brian M. Mercer, MD 7, David M. Haas, MD, MS 8, George R. Saade, MD 9, Uma Reddy, MD, MPH 10, Samuel Parry, MD 11, Hy Simhan, MD, MS 12, Daniel T. Robinson, MD, MSc 1, 13,
1 Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois 
2 Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 
3 Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio 
4 Department of Pediatrics, School of Medicine, University of California, Irvine, California 
5 Susan Samueli Integrative Health Institute, College of Health Sciences, University of California, Irvine, California 
6 University of Utah Health Academic Medical Center, Salt Lake City, Utah 
7 Case Western Reserve University - The MetroHealth System, Cleveland, Ohio 
8 Indiana University School of Medicine, Indianapolis, Indiana 
9 Eastern Virginia Medical School, Norfolk, Virginia 
10 Columbia University, New York, New York 
11 University of Pennsylvania, Philadelphia, Pennsylvania 
12 University of Pittsburgh, Pittsburgh, Pennsylvania 
13 Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois 

Address correspondence to: Daniel T. Robinson, MD, MSc, Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E Chicago Ave, Box 45, Chicago, IL 60611.Department of PediatricsNorthwestern University Feinberg School of MedicineMD225 E Chicago AveBox 45ChicagoIL60611

Abstract

Background

Implications of lifelong, perceived discrimination on nutrient intake during the preconception period are unclear.

Objective

The objective was to identify associations between perceived discrimination and consumption of specific nutrients associated with risk of adverse pregnancy outcomes.

Design

This is a secondary data analysis of the prospective Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort. Participants completed a Block food frequency questionnaire assessing diet during the 3 months before pregnancy and a Krieger Experiences of Discrimination Scale assessing personal encounters of discrimination.

Participants and setting

Participants were recruited from 8 clinical centers across the United States between 2010 and 2013. Each participant completed the food frequency and Krieger questionnaires and self-identified as belonging to a minoritized racial or ethnic group for this analysis (n = 2457).

Main outcome measures

Main outcomes include reported total energy and macronutrient intake, percent of energy from macronutrients, saturated and unsaturated fatty acids, added sugar, sodium, dietary fiber, and Healthy Eating Index-2010 Seafood and Plant Proteins component score.

Statistical analyses performed

Participants were grouped as reporting fewer (< 3) or more (≥ 3) circumstances of discrimination on the Krieger scale. Multivariable regression models examined associations between discrimination group and nutrient intake. Variables with nonnormal distributions were log transformed. Associations were adjusted for total energy intake. Primary outcomes underwent false discovery rate correction.

Results

Those reporting 3 or more circumstances of discrimination had higher reported energy intake (P = .002) and higher reported intake of total fat, saturated fat, unsaturated fats, protein, added sugar, and sodium after false discovery rate correction (all P values < .05) compared with those reporting fewer circumstances. After adjustment for total energy intake, reporting 3 or more circumstances was associated with greater reported intake of saturated fat and n-3 polyunsaturated fatty acids, and lower reported intake of dietary fiber (all P values < .05).

Conclusions

Reporting 3 or more circumstances of discrimination was associated with higher reported total energy intake. After adjustment for total energy, reporting 3 or more circumstances of perceived discrimination was associated with less nutritious intake for some (higher saturated fat and lower dietary fiber) but not all (higher eicosapentaenoic and docosahexaenoic acids) nutrients.

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Keywords : Pregnancy, Diet quality, Fatty acids, Racism, Racial discrimination


Plan


 STATEMENT OF POTENTIAL CONFLICT OF INTEREST D. T. Robinson previously received research funding for a clinical investigation sponsored by Fresenius Kabi, was a speaker and consultant for Baxter pharmaceutical, and currently serves as institutional principal investigators, with no salary funding, for a consortium database sponsored by Mead Johnson Nutrition.
 FUNDING/SUPPORT The original Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be study was supported by grant funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), grant U10 HD063036 from RTI International, grant U10 HD063072 for Case Western Reserve University, grant U10 HD063047 from Columbia University, grant U10 HD063037 from Indiana University, grant U10 HD063041 from University of Pittsburgh, grant U10 HD063020 from Northwestern University, grant U10 HD063046 from University of California Irvine, grant U10 HD063048 from University of Pennsylvania, and grant U10 HD063053 from University of Utah. M. P. Debbink receives salary support from the March of Dimes and American Board of Obstetrics and Gynecology as part of the Reproductive Scientist Development Program, as well as NICHD grants 1U54HD113169 and NIMHD 1R21MD019175-01A1. Biostatistical analysis for this study was supported by D. T. Robinson’s Founders’ Board Neonatology Young Research Scholar Fund through Lurie Children’s Hospital.
 DATA AVAILABILITY The de-identified data contributing to these findings are available on the National Institute of Child Health and Human Development Data and Specimen Hub: 226675.
 AUTHOR CONTRIBUTIONS D. T. Robinson, L. Van Horn, L. Bonner, K. Kershaw, W. A. Grobman designed the research for this study; W. A. Grobman, B. M. Mercer, D. M. Hass, G. R. Saade, S. Parry, U. Reddy, and H. Simhan conducted the initial Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be research; A. Kan and L. Bonner analyzed the dataset; T. Johnson, A. Kan, L. Bonner, L. Van Horn, K. N. Kershaw, W. A. Grobman, and D. T. Robinson interpreted the data analysis; T. Johnson and D. T. Robinson wrote the first draft of the manuscript and had primary responsibility for final content; all authors read and approved the final manuscript.


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Vol 125 - N° 7

P. 1024-1036 - juillet 2025 Retour au numéro
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