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Cited by 40Public Health and NutritionNutrition, Health and Food BehaviorChild Nutrition and Water Access

The DOI matches its Crossref record; 59 of the 62 references it cites were found in a registry or an index.

What stops us from eating: a qualitative investigation of dietary barriers during pregnancy in Punjab, Pakistan

Open access
Asim, Muhammad, Ahmed, Zarak H, Nichols, Amy R, Rickman, Rachel, Neiterman, Elena, Mahmood, Anita, Widen, Elizabeth M·2022·Public Health Nutrition
DOI 10.1017/s1368980021001737PMC PMC8523588
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Abstract

Objective: Adequate dietary intake during pregnancy is vital for the health and nutritional status of both mother and fetus. The nutritional status of reproductive age women in Pakistan is poor, with 14 % being underweight (BMI < 18·5) and 42 % experiencing Fe deficiency anaemia. This may stem from beliefs, practices and other barriers influencing dietary intake. This qualitative study seeks to determine which factors impact dietary intake during pregnancy in rural Punjab. Design: In-depth interviews and focus group discussions were conducted and then analysed using thematic analysis. Setting: Three purposively selected rural districts (Sahiwal, Okara and Pakpatan) with the highest prevalence of maternal and child malnutrition in the province of Punjab, Pakistan Participants: Mothers with children under age two (n 29) and healthcare providers with at least 5 years of experience working in the district (n 12). Results: We identified a combination of physiological, socio-cultural and structural barriers that inhibited healthful dietary intake during pregnancy. The primary physiological barriers to optimal dietary intake and dietary practices included food aversions and food cravings. Food classification, fear of a difficult childbirth, fear of high blood pressure and household food politics were the principal socio-cultural barriers. Additionally, two structural barriers, inadequate antenatal counseling and a lack of affordable food options, were identified. Conclusions: Our study demonstrates that complex barriers prevent pregnant women in the Punjab area from consuming adequate dietary intake and that antenatal health education programmes and structural interventions are needed to support healthful dietary practices during this critical period.

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Fig. 1 Socio-ecological model highlighting major food intake barriers identified in the current study
Fig. 1 Socio-ecological model highlighting major food intake barriers identified in the current studyCC BY · PubMed Central

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Show all 62 references

Research works printed but not linked: 5

  1. Nag, 1994, Beliefs and practices about food during pregnancy: implications for maternal nutrition, Eco Poli Weekly, 29, 2427
  2. Hisam, 2014, Knowledge, attitude and practice regarding folic acid deficiency; A hidden hunger, Pak J Med Sci, 30, 583
  3. Lakshmi, 2013, Food preferences and taboos during ante-natal period among the tribal women of north coastal Andhra Pradesh, J Com Nutr Health, 2, 32
  4. Wegrzyniak, 2012, Treatment of hyperemesis gravidarum, Rev Obstet Gynecol, 5, 78
  5. 2019, Pakistan Demographic and Health Survey 2017–18

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Metadata

Authors
Asim, M., Ahmed, Z. H., Nichols, A. R., Rickman, R., Neiterman, E., Mahmood, A., & Widen, E. M.
Affiliations
  • Aga Khan University (PK)
  • The University of Texas at Austin (US)
  • University of Waterloo (CA)
Corresponding author
Widen, Elizabeth M
ORCID
Widen, Elizabeth M
Venue
Public Health Nutrition
Publisher
Cambridge University Press (CUP)
Published
2021-04-19
Volume
25
Issue
3
Pages
760-769
ISSN
  • 1368-9800 (ISSN-L)
  • 1475-2727
DOI
10.1017/s1368980021001737
PMC
PMC8523588
OpenAlex
W3152897503
Cited by
22
References
62
Citations by year
2025: 5 · 2024: 10 · 2023: 5 · 2022: 2
FWCI
4.20
Type
journal article
Language
en
Open access
Licence
Locations
  • Public Health Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R00HD086304, P2CHD042849)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Keywords
dietary intake during pregnancy, barriers to healthy eating, food aversion, food cravings, food classification, fear of childbirth, antenatal counseling, maternal nutrition, rural Punjab, food affordability
MeSH terms
Child, Child, Preschool, Diet, Female, Humans, Nutritional Status, Pakistan, Pregnancy, Rural Population, Pregnant People, Pregnant Women

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