Abstract
BACKGROUND: During lactation, maternal requirements for many nutrients increase due to the physiological demands of breast milk production, reflected in dietary recommendations. BMI is negatively associated with dietary quality postpartum, and 40% of women in Norway have pre-pregnancy overweight and obesity. Currently, there is limited data on dietary intake among lactating women in Norway and whether they meet nutritional requirements. We aimed to evaluate the nutrient intake in a study sample of lactating women with overweight and obesity, compared with the Nordic Nutrition Recommendations (NNR 2023). METHODS: In this cross-sectional analysis, we included baseline data from 112 lactating women with a pre-pregnancy BMI of 25-35 kg/m(2), participating in a weight loss and breastfeeding promotion intervention trial in Oslo, Norway. Data were collected at 2 weeks postpartum (subject characteristics, anthropometry and dietary supplement use), at 7 weeks postpartum (dietary assessment) and post-weaning (retrospective dietary supplement use). Dietary data were obtained from a 4-day dietary record before randomisation to dietary treatment for weight loss. Nutrient intake was compared to the dietary reference values for lactating women in NNR 2023. Increased risk of inadequate intake of micronutrients was assessed as the proportion of women with intakes below the average requirement (AR), with and without dietary supplements. RESULTS: Mean ± SD BMI at 2 weeks postpartum was 30.7 ± 2.5 kg/m(2). At 7 weeks postpartum the women reported a mean energy intake of 9.2 ± 2.0 MJ/day, with a higher intake of saturated fat and a lower intake of carbohydrate, dietary fibre and docosahexaenoic acid than recommended. The majority had an increased risk of inadequate intake of vitamin A (92%), folate (92%), vitamin D (84%), selenium (87%) and iodine (71%) from the diet alone. When dietary supplements were taken into account, ≥ 50% of the women still had an increased risk of inadequate intake of vitamin A, folate and selenium. CONCLUSIONS: The high proportion of lactating women with overweight and obesity failing to meet the newly updated Nordic Nutrition Recommendations highlights the need to raise awareness among new mothers and healthcare professionals about the increased maternal nutritional demands during lactation and hence, the importance of nutrient-dense diets.