(41) Impact of living in a food desert on prenatal macro- and micronutrient intake

Objective: Nutritional deficiencies and associated adverse pregnancy outcomes are emerging threats to public health. Little is known about the impact of the lived food environment on prenatal diet quality. This study aimed to explore the impact of living in a food desert (FD) on macro- and micro-nutrient intake in pregnancy.

Study Design: We performed a single-center prospective pregnancy cohort study from 2014-2024. Participants were a subset of those enrolled in the Atlanta African American Maternal-Child Cohort, which included pregnant people ages 18-40 with a singleton 8-14 weeks’ gestation who identified as Black/African American. Block-Bodnar food frequency questionnaires (FFQ) were administered at 8-14 or 24-30 weeks’ gestation.  Responses were used to estimate dietary intake of macro/micronutrients. Address of primary residence was assigned to a census tract; FD status was assigned to low-income & low-access tracts according to U.S. Department of Agriculture (USDA) definitions. Descriptive and bivariate statistics were utilized.

Results: Of n=543 pregnancies, n=242 (45%) lived in a FD. Median BMI was 28.3 and 27.1 in FD and non-FD, respectively (p=0.321). FD census tracts had more housing units that utilized Supplemental Nutrition Assistance Program (SNAP) benefits: 586 vs 362 (p< 0.0001). Living in a FD was not associated with significant differences in macro/micronutrient intake (Table 1). However, a large proportion of FD & non-FD cohorts had insufficient micronutrient intake. Rates of insufficient intake were highest for vitamin D, magnesium, folic acid, & iron (Table 2).

Conclusion: Interestingly, our data demonstrates no difference in prenatal intake of macro/micronutrients according to residence in a FD. Both groups had high rates of insufficient micronutrient intake regardless of living in a FD or non-FD. These findings highlight the current prenatal nutritional crisis and support a shift in policy focus to nutrition education, food prescription programs, and diet culture to optimize maternal nutrition status in pregnancy and beyond.