Improving Maternal and Infant Nutrition: A Framework for Action

Chapter 2: Why is Maternal and Infant Nutrition Important?Food, Nutrition and Health2.1 A typical diet in Scotland is one which is too low in fruit and vegetables, fishand complex carbohydrates including dietary fibre, and too high in fat, sugar 1 andsalt. 2 This type of diet is more likely to contain inadequate levels of essentialnutrients and to be energy dense. Poor diet has been linked to the development ofcardiovascular disease, cancer, type 2 diabetes, overweight and obesity 3 – all ofwhich are high in Scotland. Individuals coming to Scotland from other countries andadopting Scottish dietary patterns also tend to have poorer health outcomes, with theincidence of type 2 diabetes in particular high amongst some ethnic groups 4 .2.2 Overweight and obesity (1) are rising across both developed and developingcountries. 5 In 2009 26.8% of men and 26.4% of women in Scotland were obese,66.3% of men and 58.4% of women were overweight (including obese). For childrenthe corresponding rates were 14.4% and 28.2% 6. Overweight occurs when energyintake from food and drink consumption, including alcohol, is greater than the energyrequirements of the body’s metabolism over a prolonged period, resulting in theaccumulation of excess body fat. People who are overweight or obese are more atincreased risk of a range of diseases, in particular cardiovascular disease, cancer,type 2 diabetes, osteoarthritis and gallstones. 5Maternal Nutrition and Foetal Growth and Development2.3 Women are advised to follow general healthy eating advice before, during andafter pregnancy. Healthy eating advice for women during these periods of time isprovided on the Food Standards Agency eatwell website (www.eatwell.gov.uk) andis summarised in Appendix 3.2.4 Survey data suggest that, taken as a whole, women of reproductive ageincluding those who have adequate intakes of energy, have poor dietary intakes ofsome key nutrients including iron, calcium, folate, vitamin D and have low iron andvitamin D status. 7 As chapter 3 highlights, there is very little data on the dietaryintake and nutritional status of pregnant women.2.5 During pregnancy there is increased demand for several key nutrients such asvitamin D, folate, iron and calcium. 8, 9 This increased demand for iron and calciumfor example can be met by consumption of foods rich in these nutrients and bynormal physiological adaptations which increase absorption. Provided maternalstores of iron and calcium are adequate at the onset of pregnancy, there is norecommendation to increase intake of these nutrients over and above the RNI fornon pregnant women. (2) However, for vitamin D and folate the increased amountrequired cannot be met from food sources alone, therefore, it is recommended thatall pregnant women take a daily supplement of each, in addition to increasing their