Periconception Diet does not Vary by Duration of US Residence for Mexican Immigrant Women

Published:March 07, 2013DOI:


      This cross-sectional study assessed the influence of duration of residence in the United States on periconception dietary intake of pregnant Mexican immigrant women, using baseline data from Healthy Mothers on the Move, a randomized control trial conducted with 234 women from 2004 to 2006 in Detroit, MI. Average maternal age was 27.3±5.2 years (range=18 to 41 years) with 5.99±4.76 years of US residence (range=0 to 36 years). Women's usual dietary intake during the past 12 months was recorded on a validated food frequency questionnaire (17.3 weeks average gestation). Intakes of selected micronutrients, macronutrients, and food groups were compared by US residence categories (≤5, 6 to 10, or ≥11 years) using analysis of covariance. The percent of women with intakes below the Estimated Average Requirement and the percent not meeting US dietary guidelines were calculated. There was no association between dietary intake and duration of US residence in this population. Percentages of women with dietary intake below the Estimated Average Requirement were: 12.0% for folate, 7.7% for vitamin C, 23.9% for calcium, 11.2% for protein, and 5.1% for carbohydrates. US dietary guidelines were not met for fruit by 17.5% and for vegetables by 74.8% of women. Typical diets were high in saturated fat and cholesterol. Of the 2,195 kcal average daily energy intake, >25% came from saturated fats, trans fats, and added sugars that may replace nutrients important for healthy fetal growth and development and women's health. Interventions to improve intake before, during, and after pregnancy are important in this population, regardless of duration of US residence.


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        • Gardiner P.M.
        • Nelson L.
        • Shellhaas C.S.
        • et al.
        The clinical content of preconception care: Nutrition and dietary supplements.
        Am J Obstet Gynecol. 2008; 199: S345-S356
        • Wu G.
        • Bazer F.W.
        • Cudd T.A.
        • Meininger C.J.
        • Spencer T.E.
        Maternal nutrition and fetal development.
        J Nutr. 2004; 134: 2169-2172
        • Mikkelsen T.B.
        • Osler M.
        • Orozova-Bekkevold I.
        • Knudsen V.K.
        • Olsen S.F.
        Association between fruit and vegetable consumption and birth weight: A prospective study among 43,585 Danish women.
        Scand J Public Health. 2006; 34: 616-622
        • Suarez L.
        • Hendricks K.
        • Felkner M.
        • Gunter E.
        Maternal serum B12 levels and risk for neural tube defects in a Texas-Mexico border population.
        Ann Epidemiol. 2003; 13: 81-88
        • Hromi-Fiedler A.
        • Bermudez-Millan A.
        • Segura-Pérez S.
        • Pérez-Escamilla R.
        Household food insecurity is associated with depressive symptoms among low-income pregnant Latinas.
        Matern Child Health J. 2011; 7: 421-430
        • Tovar A.
        • Must A.
        • Bermudez O.I.
        • Hyatt R.R.
        • Chasan-Taber L.
        The impact of gestational weight gain and diet on abnormal glucose tolerance during pregnancy in Hispanic women.
        Matern Child Health J. 2009; 13: 520-530
        • Ley S.H.
        • Hanley A.J.
        • Retnakaran R.
        • Sermer M.
        • Zinman B.
        • O'Connor D.L.
        Effect of macronutrient intake during the second trimester on glucose metabolism later in pregnancy.
        Am J Clin Nutr. 2011; 94: 1232-1240
        • Fung T.T.
        • McCullough M.
        • Van Dam R.M.
        • Hu F.B.
        A prospective study of overall diet quality and risk of type 2 diabetes in women.
        Diabetes Care. 2007; 30: 1753-1757
        • Ford E.S.
        • Giles W.H.
        • Dietz W.H.
        Prevalence of the metabolic syndrome among US adults—Findings from the Third National Health and Nutrition Examination Survey.
        JAMA. 2002; 287: 356-359
        • Kieffer E.C.
        • Carman W.J.
        • Gillespie B.W.
        • Nolan G.H.
        • Worley S.E.
        • Guzmán J.R.
        Obesity and gestational diabetes among African-American women and Latinas in Detroit: Implications for disparities in women's health.
        J Am Med Womens Assoc. 2001; 56 (196): 181-187
        • Caughey A.B.
        • Cheng Y.W.
        • Stotland N.E.
        • Washington A.E.
        • Escobar G.J.
        Maternal and paternal race/ethnicity are both associated with gestational diabetes.
        Am J Obstet Gynecol. 2010; 202: e611-e615
        • Centers for Disease Control and Prevention
        Age-adjusted percentage of civilian, noninstitutionalized population with diagnosed diabetes, by Hispanic origin and sex, United States, 1997–2010.
        (Updated December 27, 2011. Accessed May 30, 2012)
        • Hackley B.
        • Fennie K.
        • Applebaum J.
        • Berry D.
        • D'Eramo Melkus G.
        The effect of language preference on prenatal weight gain and postpartum weight retention in urban Hispanic women.
        Ethn Dis. 2010; 20: 162-168
        • Ogden C.L.
        • Carroll M.D.
        • Curtin L.R.
        • McDowell M.A.
        • Tabak C.J.
        • Flegal K.M.
        Prevalence of overweight and obesity in the United States, 1999-2004.
        JAMA. 2006; 295: 1549-1555
        • Harley K.
        • Eskenazi B.
        • Block G.
        The association of time in the US and diet during pregnancy in low-income women of Mexican descent.
        Paediatr Perinat Epidemiol. 2005; 19: 125-134
        • Schaffer D.M.
        • Velie E.M.
        • Shaw G.M.
        • Todoroff K.P.
        Energy and nutrient intakes and health practices of Latinas and white non-Latinas in the 3 months before pregnancy.
        J Am Diet Assoc. 1998; 98: 876-884
        • Cohen G.R.
        • Curet L.B.
        • Levine R.J.
        • et al.
        Ethnicity, nutrition, and birth outcomes in nulliparous women.
        Am J Obstet Gynecol. 2001; 185: 660-667
        • Gutierrez Y.M.
        Cultural factors affecting diet and pregnancy outcomes of Mexican American adolescents.
        J Adolesc Health. 1999; 25: 227-237
        • Martin J.A.
        • Hamilton B.E.
        • Ventura S.J.
        • et al.
        Births: Final data for 2009.
        Natl Vital Stat Rep. 2011; 60
        • Ennis S.R.
        • Rios-Vargas M.
        • Albert N.G.
        The Hispanic Population: 2010.
        United States Census Bureau, Washington, DC2011
        • Kieffer E.C.
        • Salabarría-Peña Y.
        • Odoms-Young A.M.
        • Willis S.K.
        • Palmisano G.
        • Guzmán J.R.
        The application of focus group methodologies to community-based participatory research.
        in: Israel B.A. Eng E. Schulz A.J. Parker E.A. Methods for Community-Based Participatory Research for Health. 2nd ed. Jossey-Bass, San Francisco, CA2013: 249-276
        • Kieffer E.C.
        • Caldwell C.H.
        • Welmerink D.B.
        • Welch K.B.
        • Sinco B.R.
        • Guzmán J.R.
        Effect of the Healthy MOMs lifestyle intervention on reducing depressive symptoms among pregnant Latinas.
        Am J Community Psychol. 2012; 50: 1-14
        • Kieffer E.
        • Welmerink D.
        • Welch K.
        • Sinco B.
        • Rees Clayton E.
        • Schumann C.
        • et al.
        Dietary outcomes of Healthy MOMs/Madres Saludables: A randomized controlled diabetes prevention trial with pregnant Latina women.
        Am J Public Health. 2013; (In press)
        • Patterson R.E.
        • Kristal A.R.
        • Tinker L.F.
        • Carter R.A.
        • Bolton M.P.
        • Agurs-Collins T.
        Measurement characteristics of the Women's Health Initiative food frequency questionnaire.
        Ann Epidemiol. 1999; 9: 178-187
        • Kristal A.R.
        • Feng Z.
        • Coates R.J.
        • Oberman A.
        • George V.
        Associations of race/ethnicity, education, and dietary intervention with the validity and reliability of a food frequency questionnaire: The Women's Health Trial Feasibility Study in Minority Populations.
        Am J Epidemiol. 1997; 146: 856-869
        • Institute of Medicine Food and Nutrition Board
        Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline.
        National Academies Press, Washington, DC1998
        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids.
        National Academies Press, Washington, DC2000
        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc.
        National Academies Press, Washington, DC2001
        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids.
        National Academies Press, Washington, DC2005
        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference Intakes for Calcium and Vitamin D.
        National Academies Press, Washington, DC2011
        • Murphy S.P.
        • Barr S.I.
        Practice paper of The American Dietetic Association: Using the Dietary Reference Intakes.
        J Am Diet Assoc. 2011; 111: 762-770
      1. Nutrition and Your Health: Dietary Guidelines for Americans, 2010.
        US Government Printing Office, Washington, DC2010 (Home and Garden Bulletin No. 232)
      2. Nutrition and Your Health: Dietary Guidelines for Americans, 2005.
        US Government Printing Office, Washington, DC2005 (Home and Garden Bulletin No. 232)
        • Casagrande S.S.
        • Wang Y.
        • Anderson C.
        • Gary T.L.
        Have Americans increased their fruit and vegetable intake? The trends between 1988 and 2002.
        Am J Prev Med. 2007; 32: 257-263
        • Dubowitz T.
        • Smith-Warner S.A.
        • Acevedo-Garcia D.
        • Subramanian S.V.
        • Peterson K.E.
        Nativity and duration of time in the United States: Differences in fruit and vegetable intake among low-income postpartum women.
        Am J Public Health. 2007; 97: 1787-1790
        • Wright J.D.
        • Wang C.Y.
        • Kennedy-Stephenson J.
        • Ervin R.B.
        Dietary intake of ten key nutrients for public health, United States: 1999-2000.
        Adv Data. 2003; : 1-4
        • Batis C.
        • Hernandez-Barrera L.
        • Barquera S.
        • Rivera J.A.
        • Popkin B.M.
        Food acculturation drives dietary differences among Mexican Americans, and non-Hispanic whites.
        J Nutr. 2011; 141: 1898-1906
        • Dubowitz T.
        • Heron M.
        • Bird C.E.
        • et al.
        Neighborhood socioeconomic status and fruit and vegetable intake among whites, blacks, and Mexican Americans in the United States.
        Am J Clin Nutr. 2008; 87: 1883-1891
        • Guendelman S.
        • Siega-Riz A.M.
        Infant feeding practices and maternal dietary intake among Latino immigrants in California.
        J Immigr Health. 2002; 4: 137-146
        • Montez J.K.
        • Eschbach K.
        Country of birth and language are uniquely associated with intakes of fat, fiber, and fruits and vegetables among Mexican-American women in the United States.
        J Am Diet Assoc. 2008; 108: 473-480
        • Sharkey J.R.
        • Johnson C.M.
        • Dean W.R.
        Nativity is associated with sugar-sweetened beverage and fast-food meal consumption among Mexican-origin women in Texas border colonias.
        Nutr J. 2011; 10: 101
        • Satia-Abouta J.
        • Patterson R.E.
        • Neuhouser M.L.
        • Elder J.
        Dietary acculturaltion: Applications to nutrition research and dietetics.
        J Am Diet Assoc. 2002; 102: 1105-1118
        • Perez-Escamilla R.
        Dietary quality among Latinos: Is acculturation making us sick?.
        J Am Diet Assoc. 2009; 109: 988-991
        • Perez-Escamilla R.
        Acculturation, nutrition, and health disparities in Latinos.
        Am J Clin Nutr. 2011; 93: 1163S-1167S
        • Rivera J.A.
        • Barquera S.
        • González-Cossío T.
        • Olaiz G.
        • Sepulveda J.
        Nutrition transition in Mexico and in other Latin American countries.
        Nutr Rev. 2004; 62: S149-S157
        • Thornton P.L.
        • Kieffer E.C.
        • Salabarría-Peña Y.
        • et al.
        Weight, diet, and physical activity-related beliefs and practices among pregnant and postpartum Latino women: The role of social support.
        Matern Child Health J. 2006; 10: 95-104
        • Harley K.
        • Eskenazi B.
        Time in the United States, social support and health behaviors during pregnancy among women of Mexican descent.
        Soc Sci Med. 2006; 62: 3048-3061
        • Suitor C.W.
        • Bailey L.B.
        Dietary folate equivalents: Interpretation and application.
        J Am Diet Assoc. 2001; 100: 88-94
        • Willett W.C.
        • Lenart E.
        Reproducibility and validity of food frequency questionnaires.
        in: Willett W.C. Nutritional Epidemiology. 2nd ed. Oxford University Press, New York, NY1998: 101-147
        • Wei E.K.
        • Gardner J.
        • Field A.E.
        • Rosner B.A.
        • Colditz G.A.
        • Suitor C.W.
        Validity of a food frequency questionnaire in assessing nutrient intakes of low-income pregnant women.
        Matern Child Health J. 1999; 3: 241-246
        • Thompson F.E.
        • Subar A.F.
        Dietary assessment methodology.
        in: Coulston A.M. Boushey C.J. Ferruzzi E.R. Nutrition in the Prevention and Treatment of Disease. 3rd ed. Academic Press, San Diego, CA2013: 5-46
        • Carroll R.
        • Midthune D.
        • Subar A.
        • Shumakovich M.
        • et al.
        Taking advantage of the strengths of 2 different dietary assessment instruments to improve intake estimates for nutritional epidemiology.
        Am J Epidemiol. 2012; 175: 340-347
        • Ayala G.X.
        • Baquero B.
        • Klinger S.
        A systematic review of the relationship between acculturation and diet among Latinos in the United States: Implications for future research.
        J Am Diet Assoc. 2008; 108: 1330-1344
        • Benavides-Vaello S.
        Cultural influences on the dietary practices of Mexican Americans: A review of the literature.
        Hispanic Health Care Intl. 2005; 3: 27-35


      E. C. Kieffer is an associate professor, School of Social Work, University of Michigan, Ann Arbor.


      B. R. Sinco is a research associate, School of Social Work, University of Michigan, Ann Arbor.


      K. B. Welch is a statistician specialist, Center for Statistical Consulting and Research, University of Michigan, Ann Arbor.


      D. B. Welmerink was a research associate, School of Social Work, University of Michigan, Ann Arbor.


      C. Y. Schumann was a supervising nutritionist, Community Health and Social Services Center, Inc, Detroit, MI.


      V. Uhley is an assistant professor, William Beaumont School of Medicine, Oakland University, Rochester, MI; at the time of the study, she was a medical education and research lab specialist associate, Department of Internal Medicine, Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor.