Nutritional Status and Household Food Security of Pregnant Women: Insights from the NuEMI Study in South Africa.

To describe the nutritional intake and status of pregnant women in Bloemfontein, and compare across different household food security categories. Cross-sectional. Pelonomi Tertiary Hospital. 427 pregnant women were interviewed using a standard questionnaire and a quantitative food frequency questionnaire to collect sociodemographic, HIV status, household food security, supplement and dietary intake data. Weight and height were measured using standard anthropometric techniques, and capillary blood taken by finger-prick for anemia, iron and inflammation status assessment. 26.7% of participants were food-secure, while 11.5%, 32.1% and 29.5% experienced mild, moderate and severe food insecurity, respectively. 54.5%, 41.7% and 31.1% were obese, anemic, and iron deficient. Median energy intake was 8,808 (6,978-9,223)KJ/day, with no significant differences between the food security groups (p=0.517). Based on the DRI, 98.1% met the estimated average requirement (EAR) for carbohydrates, but the majority had sub-optimal intake of protein (58.3%), fiber (60.9%), pantothenic acid (67.0%), vitamins C (65.6%), D(68.4%), E(59.0%) and K(61.8%), potassium (99.8%), dietary calcium (95.8%) and iron (80.8%). Compared to the moderately and severely food-insecure counterparts, food-secure participants had a higher intake of animal protein (p<0.001), total fat (p=0.014), monounsaturated fat (p=0.002), vitamins B12 (p=0.014), C (p<0.001) and D (p=0.003) and dietary calcium (p=0.001). Dietary folate intake was below the EAR in 69.9%, but was higher among severely food-insecure participants (463.94 (327.39, 609.71)µg than food-secure [378.49 (265.99, 496.15)µg, p=0.007)]. The findings show widespread inadequate nutrient intake among pregnant women in Bloemfontein, with food-insecure women showing significantly lower intake of specific nutrients.