Preconception Dietary Patterns and Their Sociodemographic and Lifestyle Correlates in a Multi-Country Cohort: The NiPPeR Study

Abstract Objectives There are few studies of preconception diets despite their potentially far-reaching implications for maternal and offspring health. In a three-country trial (Nutritional Intervention Preconception and during Pregnancy to maintain healthy glucosE metabolism and OffspRing health–NiPPeR), we derived preconception dietary patterns and examined their sociodemographic and lifestyle correlates. Methods Women planning pregnancy (N = 1720) in the United Kingdom (UK, n = 460), Singapore (SG, n = 660) and New Zealand (NZ, n = 600) completed interviewer-administered lifestyle and pre-harmonised food-frequency questionnaires prior to randomisation. Dietary patterns for the whole cohort were derived (factor analysis on 44 food groups common to the three countries), alongside sensitivity analyses of country-specific dietary patterns. Correlates of each dietary pattern were assessed using multivariable linear regression. Results Three dietary patterns were identified: ‘Vegetables, Fruits and Wholegrain bread (VFW)’, ‘Processed meat, Confectionery and Sweetened beverages (PmCS)’ and ‘Fish, Poultry, Noodles and rice (FPN)’. The VFW and PmCS patterns were observed in UK and NZ women; the FPN pattern was principally observed in SG women. Women who were older, multiparous, had higher educational attainment, higher household income and engaged in vigorous physical activity tended to adhere to the VFW pattern; the converse was observed for the PmCS pattern. Country-specific analyses revealed similar trends. In the UK, sociodemographic factors influenced adherence to dietary patterns to a greater extent than in SG and NZ, where lifestyle behaviours appeared to have stronger influences. Conclusions Despite differences in geographic locations and variations in ethnicity and food availability, similarities in preconception dietary patterns were identified. Across locations, there were both similarities and dissimilarities in the correlates of these patterns. While harmonised dietary patterns form the basis for informing international recommendations, targets for diet behavioural change may need to be population-specific. Funding Sources This study is funded by the UK Medical Research Council, Singapore Government, New Zealand Government and under a research agreement with Nestec SA.