Food desert residence and prenatal diet quality

Area of Science:

• Maternal-Child Health
• Nutritional Epidemiology
• Public Health Nutrition

Background:

• Suboptimal prenatal nutrition is linked to adverse pregnancy outcomes.
• The impact of the food environment on prenatal diet quality is not fully understood.
• Food deserts (FDs) may influence dietary patterns during pregnancy.

Purpose of the Study:

• To compare prenatal macro- and micronutrient intake, glycemic and lipid patterns, and dietary quality indices in pregnant individuals residing in food deserts (FDs) versus non-FD areas.
• To evaluate the association between FD residence and dietary intake and quality in an urban Black/African American cohort.

Main Methods:

• Secondary analysis of an urban maternal-child cohort (2014-2024) including 543 pregnant individuals (aged 18-40).
• Dietary intake assessed via Block-Bodnar food frequency questionnaires (FFQs).
• FD exposure determined by geocoding residential addresses to US Department of Agriculture FD classifications; multivariable linear regression adjusted for covariates.

Main Results:

• 45% of participants resided in FDs; no significant differences in macronutrient, micronutrient, glycemic, or lipid intake between FD and non-FD groups.
• FD residence was associated with higher pro-inflammatory Dietary Inflammatory Index (DII) scores (p=0.04).
• Both groups exhibited insufficient intake of protein, iron, folic acid, and vitamin D, with high sugar/saturated fat intake and low adherence to guidelines.

Conclusions:

• Prenatal dietary quality was suboptimal irrespective of FD residence in this cohort.
• Insufficient intake of key nutrients and pro-inflammatory dietary patterns were prevalent.
• Nutrition strategies must address broader determinants of diet beyond geographic food access.