MATERNAL NUTRITION: A CROSS-CULTURAL SURVEY OF FOOD HABITS OF PREGNANT WOMEN IN THE UNITED STATES A THESIS SUBMITTED TO THE GRADUATE SCHOOL IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE MASTER OF ARTS BY JAMIE COCHRAN-SMITH ADVISOR: DR. EVELYN J. BOWERS BALL STATE UNIVERSITY MUNCIE, INDIANA DECEMBER, 2011 MATERNAL NUTRITION: A CROSS-CULTURAL SURVEY OF FOOD HABITS OF PREGNANT WOMEN IN THE UNITED STATES A THESIS SUBMITTED TO THE GRADUATE SCHOOL IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE MASTER OF ARTS BY JAMIE COCHRAN-SMITH ADVISOR: DR. EVELYN J. BOWERS Committee Approval: ___________________________________ ___________________________ Committee Chairperson Date ___________________________________ ___________________________ Committee Member Date ___________________________________ ___________________________ Committee Member Date Departmental Approval: ___________________________________ ___________________________ Departmental Chairperson Date ___________________________________ ___________________________ Dean of Graduate School Date BALL STATE UNIVERSITY MUNCIE, INDIANA DECEMBER, 2011 Acknowledgements I would like to give special thanks to my committee for their encouragement and guidance throughout the process of writing this thesis. First and foremost, I would like to say thank you to Dr. Bowers for sparking an interest in me by introducing me to the Fetal Origins of Adult Disease Hypothesis. Thank you, Dr. Hicks, for encouraging all of us graduate students to choose a thesis topic that we found interesting. Thank you, Dr. Wohlt, for your class discussions on nutrition and culture. I would also like to thank my family for their support throughout this process. I would like to give a special thank you to my husband, Andy, who encouraged me to keep going when I felt like giving up. Thank you to my parents, my grandmother, and my siblings for continually believing in me at times when I did not. Table of Contents Table of Contents ................................................................................................................. i Table of Tables ................................................................................................................... ii Chapter 1: Introduction .......................................................................................................1 Background ..............................................................................................................1 Fetal Origins Hypothesis..........................................................................................5 Current Findings ......................................................................................................9 Previous Studies ...........................................................................................9 Organ Development ...................................................................................11 DNA Methylation ......................................................................................12 Glucocorticoid Exposure ...........................................................................14 Chapter 2: Methodology ....................................................................................................18 Chapter 3: Nutritional Value of Foods ...............................................................................23 Macronutrients ...........................................................................................24 Macrominerals ...........................................................................................27 Microminerals ............................................................................................30 Vitamins .....................................................................................................33 Milk Products .............................................................................................41 Meat Products ............................................................................................42 Legumes .....................................................................................................43 Nuts and Seeds ...........................................................................................44 Fats and Oils ..............................................................................................44 Sugars and Sweets......................................................................................44 Beverages ...................................................................................................45 Vegetables ..................................................................................................45 Fruits ..........................................................................................................46 Grains .........................................................................................................47 Chapter 4: Results ..............................................................................................................49 Section A: Micronutrients and Macronutrients ......................................................49 Section B: Foods ....................................................................................................55 Mexican-American Diet.............................................................................63 Non-Hispanic White Diet ..........................................................................64 Non-Hispanic Black Diet ...........................................................................65 Mexican-American versus Non-Hispanic White Comparison ..................66 Mexican-American versus Non-Hispanic Black Comparison ...................67 Non-Hispanic White versus Non-Hispanic Black Comparison .................68 Chapter 5: Analysis ............................................................................................................70 Section A: Discussion of Micronutrients and Macronutrients ...............................70 Section B: Discussion of Foods .............................................................................76 Section C: General Discussion...............................................................................79 Chapter 6: Conclusion........................................................................................................83 Appendix A: .....................................................................................................................110 i Table of Tables Table 1.1 Weights and Percentiles for Infants at Full-Term in Kilograms ..........................8 Table 2.1 2006 Low Birth Weight for Date for U.S. Born Singletons at 37+ Weeks Gestation (<2500 Grams) ...................................................................................................19 Table 2.2 2006 Percent of U.S. Born Singletons Born at 20+ Weeks Gestation (<2500 Grams) ............................................................................................................................................19 Table 3.1 Amino Acids ......................................................................................................27 Table 3.2 Maternal Macromineral Consumption and Fetal Outcome ...............................28 Table 3.3 Maternal Micromineral Consumption and Fetal Outcome ................................31 Table 3.4 Maternal Vitamin Consumption and Fetal Outcome .........................................34 Table 4.1 Average Daily Intake Per Person by Ethnic Group, Dietary Reference Intakes and Tolerable Upper Intake Levels for Macronutrients .....................................................49 Table 4.2 Average Daily Intake Per Person by Ethnic Group, Dietary Reference Intakes and Tolerable Upper Intake Levels for Minerals and Vitamins ........................................50 Table 4.3 Macronutrients and Micronutrients Consumed Similarly by All Groups ..........51 Table 4.4 Macronutrients and Micronutrients with Significant F-Ratios ..........................52 Table 4.5 Scheffe Post-Test Results ..................................................................................53 Table 4.6 Average Daily Intake Per Individual by Ethnic Group......................................55 Table 4.7 Foods Consumed Similarly by All Ethnic Groups ............................................57 Table 4.8 Food Categories with Significant F-Ratios .......................................................60 Table 4.9 Scheffe Post-Test Results ..................................................................................62 Table 4.10 Consumed Significantly More by Mexican American Pregnant Women When Compared to Non-Hispanic White and Non-Hispanic Black Women ..............................63 Table 4.11 Foods Consumed in Significantly Lesser Amounts by Mexican American Pregnant Women When Compared to Non-Hispanic White and Non-Hispanic Black Pregnant Women ................................................................................................................64 Table 4.12 Foods Consumed Significantly More by Non-Hispanic White Pregnant Women When Compared to Mexican-American and Non-Hispanic Black Women ........64 Table 4.13 Foods Consumed Significantly Less by Non-Hispanic White Pregnant Women When Compared to Mexican-American and Non-Hispanic Black Women ........65 Table 4.14 Foods Consumed Significantly More by Non-Hispanic Black Pregnant Women When Compared to Mexican-American and Non-Hispanic White Women ........65 Table 4.15 Significant Foods Consumed