Abstract P1165: Dietary Quality Among Pregnant People With Overweight/Obesity: Comparison Between Randomized Controlled Trial Participants in Early Pregnancy With Non-Pregnant NHANES Matched Participants

Background: Poor dietary quality is associated with perinatal obesity, including excess gestational weight gain, a risk factor for future cardiometabolic disease. Despite the need to assess and intervene on dietary quality in pregnancy, few studies have identified screeners that are easy to use and have comparable performance in research as well as the general population. We sought to describe the dietary patterns of participants in early pregnancy using the Dietary Screener Questionnaire (DSQ) and compare the results with a matched non-pregnant sample from the 2009-2010 wave of the National Health and Nutrition Examination Survey (NHANES) who also completed the screener to demonstrate the external validity of our DSQ results. Methods: We compared the baseline dietary quality data from an ongoing randomized controlled trial (RCT) to assess the effectiveness of a remote lifestyle intervention targeting dietary quality on gestational weight gain with matched controls from non-pregnant NHANES participants. Baseline DSQ responses were collected from the RCT participants at ≤ 15 weeks of gestation. We selected a non-pregnant NHANES sample matched for age (20-44), sex (female), BMI (≥ 25), and complete DSQ data. We estimated daily intake of added sugar (total and from sweetened beverages), fiber, fruits and vegetables, and dairy using the standard scoring procedures and compared the samples using the Mann-Whitney U test. Results: At baseline, 383 RCT participants completed the DSQ with a mean age of 34.2 years (SD = 5.0). The NHANES sample included 651 people (mean age = 32.9 years, SD = 7.4 years). Pregnant RCT participants had a significantly lower consumption of daily total sugar (median = 13.2 tsp, IQR = [11.6, 15.0]) and sugar from beverages (median = 4.5 tsp, IQR = [3.9, 6.1]) compared to matched NHANES non-pregnant participants (total: median = 15.3 tsp, IQR = [12.9, 19.8]; beverages: median = 6.6 tsp, IQR = [4.4, 11.0]; both p < 0.001). Other dietary quality measures were comparable between samples (Figure 1). Conclusion: Dietary patterns of RCT participants in early pregnancy and matched non-pregnant NHANES 2009-2010 participants were similar, except for sugar intake, indicating that the DSQ results may be generalizable to a broader population like people in NHANES. The lower intake of added sugar, particularly from sweetened beverages, may reflect decreased intake in early pregnancy or secular changes in the last 15 years.