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Pregnancy stage, dietary intake and health outcomes

I am writing to make a comment on the article by Ogawa and co. [1] Published in the February 2018 issue. Titled “Maternal vegetable intake during early pregnancy and wheeze in offspring under 2 years”. The authors examine the relationship between wheeze and vegetables consumed by mothers during the early and mid-to-late-pregnancy stages. The authors use food frequency questionnaires (FFQs) to determine if wheeze is present in children. The incidence of wheeze in children aged 2 years old was significantly lower in mothers who ate the most folate-rich and cruciferous vegetables at the beginning of their pregnancy than in those in the lowest intake group. The mother’s vegetable intake was a significant factor in the inverse relationship between wheeze and the amount of vegetables consumed. A significant association was not found for the intake during mid- to late-pregnancy.

Ogawa et al. Ogawa et al. While the study’s primary purpose is to compare dietary intakes at different stages of pregnancy, it is not possible to validate the FFQ for mothers in mid-to-late-stage pregnancy. This is why the limitations of the study do not address this. Mid-to-late-stage prenatal mothers, due to the changing nature of dietary recommendations as well as patterns of consumption across different stages/trimesters of pregnancy are an independent population that deserves independent validation.

The American College of Obstetricians and Gynecologists [2] suggests that women of normal weight who exercise less than 30 minutes per day increase their intake of fruits, vegetables, and oils (but not milk) during each trimester of pregnancy. Calorie recommendations go up from 1800 calories per person in the first trimester to 2400 calories for the third. The patterns of consumption change throughout pregnancy. McGowan [3] and McAuliffe [3] examine dietary patterns using food diaries that are kept for each trimester. The authors concluded that healthy and unhealthy diets are likely to continue throughout pregnancy. However, 56.6% mothers who were assigned to the “Unhealthy dietary pattern” at baseline were moved to the other group in the third trimester. These changes could be caused by changes in appetite or nausea, as well as contact with educators and care professionals from the beginning of pregnancy. Future research could help to improve the prevention literature on maternal-infant dysphoria by mapping the dietary requirements for different stages of pregnancy development.


  1. Ogawa K, Morisaki N, Kobayashi M, Jwa S, Tani Y, Sago H, et al. Maternal vegetable intake during pregnancy and wheeze in children after 2 years. Eur J Clin Nutr. 2018;72:761-71.
  2. Article Google Scholar
  3. American College of Obstetricians and Gynecologists. Nutrition during pregnancy. In: Your pregnancy, childbirth and beyond: Month by month. Chapter 17, 6th edition. Washington, DC: American College of Obstetricians and Gynecologists, 2016. p. 313-27.
  4. McGowan, C. McAuliffe, F. Maternal dietary patterns during pregnancy and their associated nutrient intakes. Public Health Nutr. 2013 Jan;16:97-107


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