Is carbohydrate, protein, fat, and energy intake adequate among lactating women in Northwest Ethiopia?

backgroundMaternal nutrition is an important factor in the health of lactating women and their children. Due to increased energy and nutrient needs during lactation, women in middle- and low-income nations are more nutritionally vulnerable than other women of reproductive age. Inadequate energy and macronutrient intake can also contribute to stunting, muscle wasting, edema, loss of bone density, anemia, and increased susceptibility to infections and nutritional deficiencies in women and babies. Some previous studies reported only the descriptive results of energy and macronutrient intake. But the current study assessed both the prevalence and associated factors. Therefore, this study aimed to assess energy and macronutrient intake inadequacy and its associated factors among lactating women in Bahir Dar City, Northwest Ethiopia.

methodsA study was conducted in Bahir Dar city from February 27 to March 21, 2021. A systematic random sampling technique was used to select 318 respondents. Data were collected by interviewer-administered, semi-structured questionnaires after the pilot survey had been completed. A single 24-hour multi-step dietary recall was used to collect the respondent's dietary data. Data entry and analysis were performed using EpiData version 3.1 and SPSS version 24, respectively. Energy and macronutrient intake values were calculated from the ESHA Food Processor and the Ethiopian and World Food Composition Tables. The macronutrient intake was evaluated by the Acceptable Macronutrient Distribution Range (AMDR). Bivariable and multivariable binary logistic regression were used to declare the significant variables.

resultsThe prevalence of energy, carbohydrate, protein, and fat intake inadequacy among respondents was 52%, 66.2%, 17%, and 90.4%, respectively. The percentage of energy derived from carbohydrates, protein, and fat was 74%, 16%, and 10%, respectively. The median energy intake was 2416.8 kcal. Approximately 55%, 84%, and 90% of the respondents had carbohydrate, protein, and fat intakes above, within, and below the acceptable macronutrient distribution range, respectively. Not receiving nutrition education (AOR = 1.32, 95% CI (1.01, 2.83)) and being categorized as medium wealth (AOR = 2.04, 95% CI (1.03, 6.03)) were significantly associated with inadequate energy intake. Having a primary educational level (AOR = 2.56, 95% CI (1.07, 7.17)) and a secondary school educational level (AOR = 0.47, 95% CI (0.24, 0.93)) were associated with inadequacies in carbohydrate intake. Being a merchant (AOR = 2.01, 95% CI (1.12, 6.52)), daily laborer (AOR = 9.28, 95% CI (1.61, 43.65)), or private employee (AOR = 2.12, 95% CI (1.11, 8.07)) was associated with protein intake inadequacy. Due to the low prevalence outcome (< 10% adequacy) of fat intake, regression was not performed. CONCLUSION AND RECOMMENDATION: More than half of lactating women's energy intake was lower than recommended. Most of the respondent's carbohydrate, protein, and fat intakes were above, within, and below the acceptable macronutrient distribution range, respectively. Wealth index and nutrition education were associated with energy intake inadequacy. The educational status of the respondents' husbands was associated with carbohydrate intake inadequacy, and the occupational status of the respondents and their husbands was associated with protein intake inadequacy. Therefore, lactating women should receive nutrition education and counseling to consume a diversified diet and enhance their dietary intake through healthcare practice.