Abstract Body: Background: Nutrient needs increase during pregnancy, and diet quality may predict maternal and infant health outcomes.
Objective: To assess diet quality and select nutrients during pregnancy among mothers who followed different diet patterns in the FeFiFo-MOMS study.
Methods: Pregnant women randomized to one of four diets (high fiber, high fermented foods, both, or control) completed three 24-hour dietary recalls at baseline (12-22 weeks of gestation), mid-pregnancy (26-30 weeks), and late pregnancy (34-38 weeks) collected using Nutrition Data System for Research. Healthy Eating Index-2015 (HEI-2015) scores, macronutrient distribution, and key micronutrients of interest during pregnancy (folate, calcium, iron, zinc, DHA, choline, vitamin D) were evaluated at each timepoint. Linear mixed models compared intake levels across diet groups.
Results: Of 122 participants, mean nutrient intake levels at baseline without supplementation were below recommendations for iron (15.8 mg), folate (437 mcg), DHA (0.17 g), choline (376 mg), and vitamin D (5.3 mcg). Overall, participants reported increases in calcium (+10.8%) and vitamin D (+13.7%) throughout pregnancy, both p<0.05. Comparing baseline to late pregnancy, the combined fiber and fermented foods group reported greatest increases in daily calcium (mean+SEM 997.5+59.4 --> 1199.2+71.7 mg), iron (14.6+1.1 --> 18.4+1.2 mg), folate (433.5+36.0 --> 476.5+28.8 mcg), and zinc (10.8+0.7 --> 13.0+0.7 mg), with significant detection of time x group interactions (all p<0.01). HEI-2015 scores were highest at mid-pregnancy and in the high fiber and combined groups (69.6+2.0 and 70.3+1.5 points), respectively representing +14.6% and +9.6% increases from baseline, which were greater than the control and fermented foods only groups showing minimal change (p<0.001). Only the high fiber group sustained this improvement through late pregnancy (70.1+2.0), while the fermented foods only group showed the lowest diet quality throughout (58.5+1.7 at late pregnancy).
Conclusions: A combined high fiber and fermented foods diet provided greatest increases in key nutrients during pregnancy, while high fiber alone yielded most sustained diet quality improvements. Dietary fiber intake remains a key component of optimal diet quality during pregnancy.