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Diet and Nutritional Quality in Indonesian Pregnant Women

High prevalence of malnutrition in pregnant women can still be found in developing countries, like Indonesia. According to the Indonesian Ministry of Health of a large number pregnant women were at risk of suffering from Chronic Energy Deficiency (CED), with being anemic and deficient in iodine1. This situation necessitates for special attention; since nutrition plays an important role during pregnancy. Poor nutritional status during pregnancy can lead to preterm pregnancy, low birth weight and other adverse outcomes2.

Diet plays a major role in determining the nutritional status of pregnant women. Dietary quality often better reflects whether or not the diet is good3. Previous studies had showed that the quality of a diet was as important as its quantity. The study found that poor dietary quality would lead to poor nutritional status. Furthermore, one study showed that the risk of malnutrition in pregnant women decreased by 53% when their dietary quality was improved4.

In this regard a new study was carried out which focused on analyzing the relationship between dietary quality and nutritional status in pregnant women especially in Indonesia. This study was also the first study to analyze dietary quality of pregnant women in Indonesia using AHEI-P (Alternate Healthy Eating Index for Pregnancy) and the first to adapt the AHEI-P based on Indonesian dietary guidelines5.

The majority of subjects in the study were found to have inadequate Gestational Weight Gain. Furthermore, mean un-adapted and adapted AHEI-P scores in all Gestational Weight Gain categories were classified as needs improvement. The result was due to the majority of subjects being classified in the needs improvement category for their dietary quality distribution. Moreover, subjects who had inadequate GWGs had the lowest un-adapted and adapted AHEI-P scores.

The study implied that the dietary quality of pregnant women especially in rural area of Indonesia is still problematic and needs to be improved. Supports from government and other related sectors are needed to solve this matter. Finding of this study is still preliminary but it showed that adapted AHEI-P is applicable. It can be an alternative instrument to assess the dietary quality of pregnant women although further improvement and analysis needed. Present study has some limitations.

First, the trans fat data is not provided in Indonesian Food Composition Table. In order to attain the trans fat data we must borrow Food Composition Table from other countries.

Second, the present study was conducted only in rural area, assessment on urban area is needed to justify whether the adapted instrument is also applicable to be used in both areas.

All subjects needed to improve the quality of their diet. Although there was no correlation between nutritional status and dietary quality via AHEI-P, more effort to raise awareness of the importance of dietary quality for pregnant women is needed. In addition, further analysis on how dietary quality affects pregnancy outcomes is also needed.


Alternate healthy eating index for pregnancy, dietary quality, gestational weight gain, nutritional status, pregnant women, importance of dietary quality, Food Composition Table, inadequate GWGs, Alternate Healthy Eating Index for Pregnancy.


  1. Ministry of Health, 2013. National health research 2013. National Institute of Health Research and Development, Ministry of Health, Indonesia.
  2. Scholl, T.O., 2011. Maternal iron status: Relation to fetal growth, length of gestation and iron endowment of the neonate. Nutr. Rev., 69: S23-S29.
  3. Rifas-Shiman, S.L., J.W. Rich-Edwards, K.P. Kleinman, E. Oken and M.W. Gillman, 2009. Dietary quality during pregnancy varies by maternal characteristics in Project Viva: A US cohort. J. Am. Diet. Assoc., 6: 1004-1011.
  4. Kedir, H., Y. Berhane and A. Worku, 2016. Magnitude and determinants of malnutrition among pregnant women in eastern Ethiopia: Evidence from rural, community‐based setting. Matern. Child Nutr., 12: 51-63.
  5. Dewi, R.K., Khomsan, A., Riyadi, H. and Diana, R., 2018. Dietary Quality and Nutritional Status of Pregnant Women in Sumenep Regency, Madura, Indonesia. Pak. J. Nutr., 17: 530-534.

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