Nutrition and diet myths, knowledge and practice during pregnancy and lactation among a sample of Egyptian pregnant women: a cross-sectional study

An observational cross-sectional analytical study.

Convenient sample (easy access).

The sample size was 460, calculated using www.​openepi.​com, in view of a study performed in which 46% of the pregnant women had a myth score less than the mean [8]. The confidence interval was 95%, and the nonresponse rate was assumed to be 20% with a power of 80%. We used the following equation: Sample size n = [DEFF*Np(1-p)]/ [(d2/Z21-α/2*(N-1) + p*(1-p)].

A pretested 2-page interview questionnaire was used to collect data from the study participants. It included four sections:

The questions were translated by two language experts into Arabic and back translated to English by another two independent language experts. Pilot testing of the final questionnaire was performed on 15 participants to ensure the clarity of the questions. The results of the pilot study were not added to the results. The Cronbach’s alpha reliability test was performed for the knowledge and myths question scales. The scales were internally consistent, with Cronbach’s alpha values of 0.819 and 0.745, respectively.

Obstetrics and gynecology experts collected the data from pregnant females who agreed to participate after written informed consent was obtained from them after clarification of the study’s aim in a private clinic and university hospital ANC clinic in Cairo, Egypt. The private clinic was open three days a week from 1 pm to 7 pm and served females of high socioeconomic level. The public ANC clinic of the university hospital was opened every day from 9 am to 3 pm except Friday and served females of middle and low socioeconomic levels. Five hundred pregnant women were assessed for eligibility, and 32 pregnant women were excluded: 14 did not meet the inclusion criteria, 6 did not consent and 12 refused to complete the questionnaire. Finally, 468 pregnant women were included in the study and completed the questionnaire.

All the collected data were revised for completeness and logical consistency. The data were extracted from Google Forms to Microsoft Office Excel Software Program, 2019, and then transferred and analyzed into the Statistical Package of Social Science Software program, version 26 (SPSS) for statistical analysis. Mean, SD, median, and IQR were calculated for knowledge score and myths score, and then participants were categorized into 2 groups according to the median score for knowledge and for myths into above and below median score [8]. Comparisons between categories and sociodemographic charterers of the participants were performed using chi-square and Mann‒Whitney U tests accordingly, where a significant p value was p ≤ 0.05.

The present study is one of the first to provide information on the myths and knowledge of pregnant Egyptians regarding nutrition and diet during pregnancy and lactation. We found that more than half of the participants held at least one myth about nutrition and diet during pregnancy and breastfeeding. 44% believed that not satisfying cravings leave a mark on the body of the newborn during pregnancy, and 40% of our participants would act upon this myth regardless of their educational level, while another study on pregnant Mexicans found that, lower educational attainment was associated with.

holding and acting upon myth [8]. This study also found that younger participants, The belief that “a frightened or angry mother should not nurse a baby” was most prevalent among women with the lowest levels of education, the lowest socioeconomic status, and fewer prior pregnancies, whereas in our study, 40% of the participants believed that, but only 25.9% believed that [8]. Weir.

Z. et al. performed a qualitative study of the myths of overweight and obese pregnant women and reported that the myth “you cannot exercise during pregnancy” was associated with a low socioeconomic level while our study revealed that, 37.4% believed that and 23.1% indeed were not practicing exercise regardless of their socioeconomic level [15]. According to Marshall et al., pregnant women in a rural community in the southeast United States typically do not engage in physical activity because they feel that their everyday activities provide enough exercise. While some felt that physical exercise puts both mother and child at risk for injury, others felt that rest is more vital than physical activity [16]. In contrast to pregnant Maasai women in Tanzania, during the second and third trimesters, they will gradually increase the amount of daily chores they have to perform until they become exhausted. They will also neglect their prenatal checkups in order to prepare for their postnatal period, during which they will remain in their homes for three months [17]. Nonetheless, Atif et al. found that 76.4% of respondents in Pakistan thought that light to moderate weight lifting was a cause of miscarriage [18].

During lactation, 53.2% thought that drinking moghat and helba could increase the breast milk supply and 44.9% were already practicing that.

In our study, participants with older age and with enough family income showed significantly higher knowledge scores than others, and the reason may be due.

to the fact that older women have more experience. Generalized Egyptian beliefs were prevalent among our study population, which included the idea that the fetus receives vitamins, proteins, and minerals from the mother’s diet and that breast milk is the only nourishment a baby needs during the first six months of life. However, in a community-based qualitative cross-sectional study, that was conducted between April and May 2022 among the rural Acholi communities in Northern Uganda or newborns, they found that most mothers believed that breast milk is given exclusively in the first two months. However, some mothers, introduce sugar solution, black tea, and soup immediately after birth [19].

We also want to draw attention to the fact that, although two-thirds of study women from the Middle East used folic acid, only 47% of our participants took it before or throughout pregnancy [20].

In January/February 2022, a cross-sectional questionnaire-based real-world research was carried out in Vietnam with 200 pregnant women and 100 preconception women. Out of 300 respondents, 62% had scores indicating a high likelihood of limited health literacy, 33% had scores indicating possibly limited health literacy, and only 5% (16 respondents) had adequate health literacy. Only 23% of respondents with limited health literacy were currently using folic acid/folate supplements, whereas 39% of those with possibly limited health literacy were using folic acid/folate supplements (p < 0.05). This indicates that folic acid administration before and during pregnancy is insufficient even in other countries [21].

Other studies reported that most women know that they should take folic acid but do not know exactly how folic acid could benefit them and their babies (e.g., prevention of neural tube defects) [22].

We did notice and would like to highlight, that only 31% of our participants knew that gestational diabetes increases the future risk of type 2 diabetes. Another study showed that 80% of their study participants knew about this increased risk [8], which reflects the magnitude of the lack of knowledge among Egyptian women. We think that this lack of knowledge may prevent women from seeking professional advice for improving their diet and lifestyle on time to delay or prevent the onset of type 2 diabetes mellitus.

Our research revealed that the participants’ most frequent sources of information about pregnancy and lactation were advice from family and friends (60%) and others (doctors, previous education in school or university) (45%) respectively.

However, according to a different Vietnamese survey, healthcare professionals (77%), family or friends (47%), and websites (36%), were the most reliable sources of information about nutrition [21].

Generally, pregnant, and lactating women tend to modify their diet according to myths and knowledge transmitted from their family and friends, who were the main source of knowledge among our participants to improve their health and that of their children. However, they often implement these modifications without the guidance of a nutrition or health specialist, as reported by Pinheiro [23]. This circumstance offers perinatal healthcare providers an opportunity to enhance the nutrition and gestational weight gain of their patients, particularly younger patients with less expertise, by implementing appropriate intervention programs. It is crucial that dieticians and other medical experts take on the responsibility of dispelling misconceptions about nutrition and diet during pregnancy and lactation. Finally, it is essential to highlight that nutritional guidance for pregnant women will require not only the transmission of knowledge but also the interpretation of information within the context of certain.

culturally rooted beliefs [24].

Our study’s limitations were its convenient sample and that it is a single-center study, so a randomized study that includes different areas in Egypt with large is needed for a better assessment of nutritional knowledge, myths, and practices among Egyptian women during pregnancy and lactation.