Food Security and Diet Quality in Postpartum Women

Abstract Objectives Food insecurity has been associated with poor diet-related health in women, but few prior studies focused on the postpartum period—a particularly important time for the health of women and children. We examined associations between food security and maternal diet quality in a racially diverse cohort of postpartum women. We further assessed whether participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or the Supplemental Nutrition Assistance Program (SNAP) modified this potential relation. Methods We examined 363 women in central North Carolina from the Nurture study (2013–2017). We computed maternal food security status using the 10-item USDA food security survey module at 3 months postpartum. We calculated Alternate Healthy Eating Index-2010 (AHEI) scores (range of 0 to 100) and component scores from food frequency questionnaires completed at 6 months postpartum. We conducted multiple linear regression examining associations between food security status (high, marginal, low, and very low) and AHEI, adjusting for age, race, education, marital status, number of children, breastfeeding, and total calories. We assessed WIC and SNAP as potential effect modifiers. Results Among women, 64.4% were Black and had a mean (standard deviation, SD) age of 28.2 (5.9) years. Nearly half (45.7%) had a high school diploma or less. Of women, 21.3% had low or very low food security. Mean (SD) AHEI score was 41.5 (11.3). We found no evidence of an interaction between food security and WIC or SNAP so we adjusted for both. In adjusted models, food security status at 3 months postpartum was not associated with AHEI (data not shown) at 6 months postpartum. However, low (ß: −0.64; 95% CI: −1.15, −0.13; P = 0.01) and very low (ß: −0.57; 95% CI: −1.02, −0.13; P = 0.01) food security were associated with a less healthy score for trans fat intake. Conclusions Food security status was not associated with overall diet quality in postpartum women. However, food insecure women showed higher consumption of trans fats. Future research should evaluate interventions to alleviate food insecurity in postpartum women, and assess whether these interventions lead to improved diet quality. Funding Sources National Institutes of Health.