Health literacy of pregnant women and its association with methyl-group donor intake and folic acid supplementation: a cross-sectional study

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BACKGROUND: Adequate health literacy (HL) can be particularly important among pregnant women, as it can have an impact on maternal and fetal health. Deliberate intake of folate through food and folic acid supplementation (FAs) is essential for women in reproductive age. Dietary intake of methyl-group donors (MGDs) via maternal nutrition may influence the infant's health and may affect reproductive outcomes through epigenetic mechanisms. OBJECTIVE: The aim of our study was to assess HL in relation to (MGD) intake among pregnant women, and to assess health knowledge as part of health literacy. METHODS: 124 pregnant women were involved in this cross-sectional study. Data were collected using two validated HL questionnaires, and a food frequency questionnaire (FFQ) to estimate MGD intake. Statistical analyses included the calculation of means, correlation coefficients, and multiple linear regression analysis. RESULTS: The HL of pregnant women was found problematic (50.8% Newest Vital Sign Test, NVS; 46.7% Brief Health Literacy Screening Tool, BRIEF). The estimated intake of dietary folate, methionine, choline and betaine were 264.7 ± 134.6 µg/d; 2303 ± 1209 mg/d; 248.1 ± 110.8 mg/d, and 127.1 ± 65.8 mg/d (mean ± standard deviation, SD), respectively. Before pregnancy 58.87% of respondents did not take FAs; during pregnancy, this decreased to 31.45%. CONCLUSION: Pregnant women did not reach adequate HL. Further evaluation of health literacy, MGD intake, is required to formulate suitable nutritional intake for pregnant women in Hungary. It is suggested that providing better information to pregnant women could improve their adherence to folic acid supplementation recommendations.

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