a1 Department of Public Health, Sports and Nutrition, University of Agder, Serviceboks 422, 4604 Kristiansand, Norway
a2 Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo, Norway
Objective To construct a diet score for assessing degree of adherence to a healthy and environmentally friendly New Nordic Diet (NND) and to investigate its association with adequacy of gestational weight gain and fetal growth in a large prospective birth cohort.
Design Main exposure was NND adherence, categorized as low, medium or high adherence. Main outcomes were adequacy of gestational weight gain, described as inadequate, optimal or excessive according to the 2009 Institute of Medicine guidelines, and fetal growth, categorized as being small, appropriate or large for gestational age. Associations of NND adherence with gestational weight gain and fetal growth were estimated with multinomial logistic regression in crude and adjusted models.
Subjects Women (n 66 597) from the Norwegian Mother and Child Cohort Study (MoBa).
Results Higher NND adherence implied higher energy and nutrient intakes, higher nutrient density and a healthier macronutrient distribution. Normal-weight women with high as compared with low NND adherence had lower adjusted odds of excessive gestational weight gain (OR=0·93; 95 % CI 0·87, 0·99; P=0·024). High as compared with low NND adherence was associated with reduced odds of the infant being born small for gestational age (OR=0·92; 95 % CI 0·86, 0·99; P=0·025) and with higher odds of the baby being born large for gestational age (OR=1·07; 95 % CI 1·00, 1·15; P=0·048).
Conclusions The NND score captures diet quality. Adherence to a regional diet including a large representation of fruits and vegetables, whole grains, potatoes, fish, game, milk and drinking water during pregnancy may facilitate optimal gestational weight gain in normal-weight women and improve fetal growth in general.
(Received August 20 2013)
(Revised January 16 2014)
(Accepted February 13 2014)
(Online publication March 31 2014)