{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T12:36:55Z","timestamp":1785155815242,"version":"3.55.0"},"reference-count":50,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"unspecified","delay-in-days":222,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1368980025100815_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>To describe the nutritional intake and status of pregnant women in Bloemfontein and compare across different household food security categories.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1368980025100815_as2\">\n\t    <jats:title>Design:<\/jats:title>\n\t    <jats:p>Cross-sectional.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1368980025100815_as3\">\n\t    <jats:title>Setting:<\/jats:title>\n\t    <jats:p>Pelonomi Tertiary Hospital.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1368980025100815_as4\">\n\t    <jats:title>Participants:<\/jats:title>\n\t    <jats:p>427 pregnant women were interviewed using a standard questionnaire and a quantitative FFQ to collect socio-demographic, HIV status, household food security, supplement and dietary intake data. Weight and height were measured using standard anthropometric techniques and capillary blood taken by finger-prick for anaemia, Fe and inflammation status assessment.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1368980025100815_as5\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>26\u00b77 % of participants were food secure, while 11\u00b75 %, 32\u00b71 % and 29\u00b75 % experienced mild, moderate and severe food insecurity, respectively. 54\u00b75 %, 41\u00b77 % and 31\u00b71 % were obese, anaemic and Fe deficient. Median energy intake was 8808 (6978\u20139223) KJ\/d, with no significant differences between the food security groups (<jats:italic>P<\/jats:italic> = 0\u00b7517). Based on the dietary reference intakes, 98\u00b71 % met the estimated average requirement (EAR) for carbohydrates, but the majority had sub-optimal intake of protein (58\u00b73 %), fibre (60\u00b79 %), pantothenic acid (67\u00b70 %), vitamins C (65\u00b76 %), D (68\u00b74 %), E (59\u00b70 %) and K (61\u00b78 %), potassium (99\u00b78 %), dietary Ca (95\u00b78 %) and Fe (80\u00b78 %). Compared with the moderately and severely food-insecure counterparts, food-secure participants had a higher intake of animal protein (<jats:italic>P<\/jats:italic> &lt; 0\u00b7001), total fat (<jats:italic>P<\/jats:italic> = 0\u00b7014), monounsaturated fat (<jats:italic>P<\/jats:italic> = 0\u00b7002), vitamins B<jats:sub>12<\/jats:sub> (<jats:italic>P<\/jats:italic> = 0\u00b7014), C (<jats:italic>P<\/jats:italic> &lt; 0\u00b7001) and D (<jats:italic>P<\/jats:italic> = 0\u00b7003) and dietary Ca (<jats:italic>P<\/jats:italic> = 0\u00b7001). Dietary folate intake was below the EAR in 69\u00b79 %, but was higher among severely food-insecure participants (463\u00b794 (327\u00b739, 609\u00b771) \u00b5g than food secure (378\u00b749 (265\u00b799, 496\u00b715) \u00b5g, <jats:italic>P<\/jats:italic> = 0\u00b7007)).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1368980025100815_as6\">\n\t    <jats:title>Conclusion:<\/jats:title>\n\t    <jats:p>The findings show widespread inadequate nutrient intake among pregnant women in Bloemfontein, with food-insecure women showing significantly lower intake of specific nutrients.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1368980025100815","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T04:59:41Z","timestamp":1754888381000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Nutritional status and household food security of pregnant women: insights from the Nutritional Status of Expectant Mothers and their Newborn Infants (NuEMI) study in South Africa"],"prefix":"10.1017","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7435-4520","authenticated-orcid":false,"given":"Janet Adede","family":"Carboo","sequence":"first","affiliation":[{"name":"University of the Free State"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Ngounda","sequence":"additional","affiliation":[{"name":"University of the Free State"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liska","family":"Robb","sequence":"additional","affiliation":[{"name":"University of the Free State"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marizeth","family":"Jordaan","sequence":"additional","affiliation":[{"name":"University of the Free State"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5578-9246","authenticated-orcid":false,"given":"Corinna May","family":"Walsh","sequence":"additional","affiliation":[{"name":"University of the Free State"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"S1368980025100815_ref16","first-page":"143","article-title":"Using different approaches to assess the reproducibility of a culturally sensitive quantified food frequency questionnaire","volume":"24","author":"Wentzel-Viljoen","year":"2011","journal-title":"S Afr J Clin Nutr"},{"key":"S1368980025100815_ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06845-w"},{"key":"S1368980025100815_ref29","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-05437-4"},{"key":"S1368980025100815_ref34","unstructured":"34. World Health Organization (2023) Increasing Fruit and Vegetable Consumption to Reduce the Risk of Noncommunicable Diseases. Available at https:\/\/www.who.int\/tools\/elena\/interventions\/fruit-vegetables-ncds (accessed January 2025)."},{"key":"S1368980025100815_ref42","doi-asserted-by":"publisher","DOI":"10.51745\/najfnr.8.18.165-175"},{"key":"S1368980025100815_ref19","volume-title":"Household Food Insecurity Access Scale (HFIAS) for Measurement of Household Food Access: Indicator Guide","author":"Coates","year":"2007"},{"key":"S1368980025100815_ref5","doi-asserted-by":"publisher","DOI":"10.3390\/nu14122407"},{"key":"S1368980025100815_ref24","first-page":"72","volume-title":"South African Child Gauge 2020: Food and Nutrition Security","author":"Symington","year":"2020"},{"key":"S1368980025100815_ref35","unstructured":"35. Department of Health (2005) Amendment of Regulations Relating to the Fortification of Certain Foodstuffs. Available at https:\/\/www.gov.za\/sites\/default\/files\/gcis_document\/201409\/28012a0.pdf (accessed January 2025)."},{"key":"S1368980025100815_ref22","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/134.11.3127"},{"key":"S1368980025100815_ref25","doi-asserted-by":"publisher","DOI":"10.4102\/hsag.v24i0.1114"},{"key":"S1368980025100815_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980020001275"},{"key":"S1368980025100815_ref44","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14951"},{"key":"S1368980025100815_ref17","doi-asserted-by":"publisher","DOI":"10.1080\/20786204.2014.936663"},{"key":"S1368980025100815_ref32","doi-asserted-by":"publisher","DOI":"10.1177\/03795721241298377"},{"key":"S1368980025100815_ref49","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2021.101469"},{"key":"S1368980025100815_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-02917-9"},{"key":"S1368980025100815_ref48","volume-title":"Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act 54 of 1972). Regulations Relating to the Reduction of Sodium in Certain Foodstuffs and Related Matters","year":"2013"},{"key":"S1368980025100815_ref20","volume-title":"Nutritional Anaemias: Tools for Effective Prevention","year":"2017"},{"key":"S1368980025100815_ref26","doi-asserted-by":"publisher","DOI":"10.1080\/03670244.2019.1690999"},{"key":"S1368980025100815_ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2004.06.027"},{"key":"S1368980025100815_ref45","first-page":"e51213","article-title":"A case of recurrent gestational hypokalemia due to an exaggerated physiological response to pregnancy: the importance of using pregnancy-specific reference ranges","volume":"15","author":"Sarfo-Adu","year":"2023","journal-title":"Cureus"},{"key":"S1368980025100815_ref30","doi-asserted-by":"publisher","DOI":"10.3945\/jn.114.198622"},{"key":"S1368980025100815_ref50","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.101166"},{"key":"S1368980025100815_ref2","unstructured":"2. Food and Agriculture Organization (2024) Hunger and Food Insecurity. Available at https:\/\/www.fao.org\/hunger\/en\/ (accessed June 2024)."},{"key":"S1368980025100815_ref9","first-page":"100091","article-title":"Maternal food insecurity in low-income countries: revisiting its causes and consequences for maternal and neonatal health","volume":"3","author":"Iqbal","year":"2021","journal-title":"J Agric Food Res"},{"key":"S1368980025100815_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzac118"},{"key":"S1368980025100815_ref10","volume-title":"Assessing Food Inadequacy and Hunger in South Africa in 2021 Using the General Household Survey (GHS)","year":"2023"},{"key":"S1368980025100815_ref37","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.21-0627"},{"key":"S1368980025100815_ref39","doi-asserted-by":"publisher","DOI":"10.1067\/S0002-9378(03)00363-6"},{"key":"S1368980025100815_ref46","first-page":"9","article-title":"Salt intake in South Africa: a current perspective","volume":"20","author":"Eksteen","year":"2015","journal-title":"J Endocrinol Metab Diabetes S Afr"},{"key":"S1368980025100815_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.09.002"},{"key":"S1368980025100815_ref1","doi-asserted-by":"publisher","DOI":"10.1002\/cl2.1150"},{"key":"S1368980025100815_ref28","doi-asserted-by":"publisher","DOI":"10.3390\/nu11112668"},{"key":"S1368980025100815_ref31","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-S3-S17"},{"key":"S1368980025100815_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2010.05.013"},{"key":"S1368980025100815_ref12","doi-asserted-by":"publisher","DOI":"10.1080\/03670244.2014.964230"},{"key":"S1368980025100815_ref21","volume-title":"Serum Ferritin Concentrations for the Assessment of Iron Status and Iron Deficiency in Populations. Vitamin and Mineral Nutrition Information System","year":"2011"},{"key":"S1368980025100815_ref33","doi-asserted-by":"publisher","DOI":"10.3390\/nu10091183"},{"key":"S1368980025100815_ref18","volume-title":"Dietary Reference Intakes: The Essential Guide to Nutrient Requirements","year":"2006"},{"key":"S1368980025100815_ref38","volume-title":"Guidelines for Maternity Care in South Africa","year":"2015"},{"key":"S1368980025100815_ref14","first-page":"116","article-title":"An investigation into utilising gestational body mass index as a screening tool for adverse birth outcomes and maternal morbidities in a group of pregnant women in Khayelitsha","volume":"26","author":"Davies","year":"2013","journal-title":"S Afr J Clin Nutr"},{"key":"S1368980025100815_ref6","doi-asserted-by":"publisher","DOI":"10.3390\/nu13020565"},{"key":"S1368980025100815_ref47","volume-title":"WHO Global Report on Sodium Intake Reduction","year":"2023"},{"key":"S1368980025100815_ref15","first-page":"4019","article-title":"Evaluation of energy and macronutrient intake of black women in Bloemfontein: a cross-sectional study","volume":"7","author":"Hattingh","year":"2008","journal-title":"Afr J Biotechnol"},{"key":"S1368980025100815_ref11","first-page":"227","article-title":"Twin versus singleton pregnancies: the incidence, pregnancy complications, and obstetric outcomes in a Nigerian tertiary hospital","volume":"3","author":"Obiechina","year":"2011","journal-title":"Int J Womens Health"},{"key":"S1368980025100815_ref7","doi-asserted-by":"publisher","DOI":"10.3390\/nu9101096"},{"key":"S1368980025100815_ref13","volume-title":"International Standards for Anthropometric Assessment","author":"Stewart","year":"2011"},{"key":"S1368980025100815_ref3","volume-title":"Africa \u2013 Regional Overview of Food Security and Nutrition 2023: Statistics and Trends","year":"2023"},{"key":"S1368980025100815_ref43","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14733"}],"container-title":["Public Health Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1368980025100815","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T16:12:42Z","timestamp":1759853562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1368980025100815\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"alternative-id":["S1368980025100815"],"URL":"https:\/\/doi.org\/10.1017\/s1368980025100815","relation":{},"ISSN":["1368-9800","1475-2727"],"issn-type":[{"value":"1368-9800","type":"print"},{"value":"1475-2727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e137"}}