Practitioners beware: regional differences in beliefs about nutrition during pregnancy

We surveyed 1,771 members of The American Dietetic Association, who worked in general nutrition, pediatrics, and public health nutrition, about their clients' beliefs about nutrition during pregnancy. The practitioners were chosen because they likely served pregnant women and/or women with young children. Items for the belief inventory were generated by surveying the beliefs of pregnant and nonpregnant adolescents and their families, teachers, and peers as well as by collecting beliefs heard from clients of social workers, nurses, and dietitians residing in the state of Tennessee. Using a modified q-sort, 26 statements were developed to survey dietitians practicing nationwide. Results indicate that beliefs about physiological needs during pregnancy, practices related to a healthy baby, and beverage recommendations were not significantly different across the regions designated by US Public Health Services (Standard Federal Administrative Regions). However, beliefs about cravings and folklore showed strong regional differences, with the Southeast regions and adjacent states differing significantly from other regions. The majority of beliefs are not supported by scientific information, and results support the need for each region to identify beliefs that could influence dietary patterns (eg, eating for two, eating only a few selected foods, restricting salt, taking vitamins to overcome an inadequate diet, and deciding pregnancy is a good time to lose weight). We recommend that dietetic practitioners become aware of clients' beliefs, support beliefs that are accurate according to current recommendations for pregnancy, and counsel clients about beliefs that are potentially detrimental to good nutrition during pregnancy.