1. The document discusses assessing diet and choline intake through egg consumption among women in early pregnancy. It provides background on nutrition during pregnancy and importance of diet. 2. The aims are to assess choline intake among women in early pregnancy, determine the percentage consuming recommended amounts, and differences in consumption patterns. 3. Poor nutrition during pregnancy can lead to health issues, and diet plays a key role in fetal development. Assessing nutrient intake is complex due to physiological changes during pregnancy.

1. Assessing the diet of women in early pregnancy/egg consumption/choline
intake
Chapter 1: Background to the Study1.1 IntroductionThis chapter forms the basis of the
research by providing a background to the study with respect to the diet of women during
early pregnancy. The chapter also discusses the research aims and objectives as well as the
research hypotheses. In aIDition, the rational for the study is provided together with the
overall organization of the dissertation.1.1 BackgroundNutrition among pregnant women is
a significant public health issue; this is because poor nourishment can result in a number of
health issues such as obesity, overweight, cancer, diabetes and cardiovascular disease
(Signore et al. 2008; Cheng et al. 2008; Shaw et al. 2004; Ueland 2010). Malnourishment
during pregnancy plays a pivotal role in the causing stillbirths before commencement of
labor. Cheng et al. (2008) points out that pregnancy is often typified by supplementary
energy requirements of about 300 kcals on a daily basis (1256 Kilojoules), with changes in
energy metabolism during pregnancy together with significant variations among women. As
a result, health dietary intake during pregnancy is vital to for the health outcomes of both
mothers as well as their infants. Cho et al. (2010) emphasizes that the most demanding
period during human growth and development takes place in the course of the 9 months of
pregnancy. Evaluating the nutrient and food intake during pregnancy is complicated since
conception usually sets off a myriad of sequential and complex physiological changes that
are likely to have an impact on maternal nutrient metabolism and absorption, meal
patterns, appetite and nutrient and energy needs (Allen 2006). Individual behavioral
physiological responses with regard to the stress of reproduction usually vary considerably,
and that both the amount and type of food intake changes in accordance with the pregnancy
period (Meck & Williams 2003). Nausea, which is prevalent in about 50-80% of
pregnancies, is likely to commence as early as 4-6 weeks of gestation and peaks during 8-12
weeks, after which it declines. Constipation and heartburns are also known to prompt
changes in the eating habits (Bidulescu et al. 2009; Leslie et al. 2010). Cho et al. (2010)
reports that women are likely to develop food preferences during pregnancy because of the
changes with respect to smell and taste. Another food disorder, Pica, is typified by the urge
to eat non-food substances, and usually affects at least 50% of pregnant women in the
United Kingdom. Maternal concerns regarding parenting, weight gain and fetal growth and
development is likely to increase the maternal awareness regarding nutrition and increase
the focus of the healthcare provider towards food habits as well as supplement

2. consumption (Wen et al. 2010).Wen et al. (2010) reported that nutrition during pregnancy
has a considerable impact on infant growth and development. For instance, high intake of
folic acid prior to and throughout pregnancy has been established to hamper the
development of defects in the neural tube (King 2000). Similarly, excessive intake of vitamin
A during early pregnancy is teratogenic to the fetus. Innis & Elias (2003) conducted an
extensive data review regarding pregnancy and recommended nutrient supplementation,
dietary intake and weight gain. The authors inferred that pregnant women ought to gain
body weight depending on their pregravid body mass index (BMI), be counseled about the
required healthy diet needed to gain weight, and examined on a regular basis in order to
determine any potential problems. In aIDition, the study also recommended pregnant
women to undertake regular dietary intake assessment in the course of the pregnancy.
Evidence suggests that maternal nutrition prior to and during pregnancy have a significant
on the fetus during and after birth (Innis & Elias 2003). In aIDition, most women often
become interested in their heath following the confirmation of pregnancy. Meck & Williams
(2003) reported that pregnant are more apprehensive about their body image and weight;
however, most women usually enter pregnancy with relatively lower levels of calcium
intakes than the recommended 100 mg per day. A study by Innis & Elias (2003) reported
that, after pregnancy confirmation, most women usually attempt to increase the intake of
calcium. In aIDition, Innis & Elias (2003) reported that pregnant women usually eat better
during the early phases of the pregnancy; nonetheless, this trend does not necessarily
continue with the changes taking place in the course of the pregnancy.Malnutrition during
pregnancy is caused by insufficient dietary intake, which is linked to a number of socio-
cultural and economic variables. Innis & Elias (2003) proposed a measure of poor nutrition
during pregnancy: less intake of vegetables and fruits than the recommended intake. A
study by Wen et al. (2010) reported that only 10% of the population consumes the
recommended 5 or more serves of vegetables on a daily basis, and about 50 percent
reported to consume the recommended 2 or more serves of fruits on a daily basis. There is
no doubt that social economic status plays a pivotal role with regard to nutritional intake by
pregnant women. Innis & Elias (2003) reports that individuals with higher socio-economic
status are closer to the nutritional recommendations that their counterparts from lower
socio-economic status.However, to date, there is a limited prevalence data with respect to
diet related health behaviors exhibited by pregnant women. This poses the need to explore
the trends in dietary intake among pregnant women, especially those in the early phases of
their pregnancy (Albright et al. 2005; Allen 2006; Bidulescu et al. 2009). In this regard, the
focus of this study is to assess choline intake, through egg consumption, among women in
their early pregnancy phases. Cho et al. (2010) reported that choline consumption is a
prerequisite for a healthy body. Choline helps in the production of constructional
components found in the cell membranes of the human body (Zeisel 2006; Xu, Gammon &
Zeisel 2009). Regardless of its potential benefits associated with choline intake, nutritional
recommendations do not encourage the consumption of particular high-choline food
substances such as fatty meats and eggs. A survey by Innis & Elias (2003) reported that only
2 percent of women in post menopause eat the recommended choline-intake. In this regard,
this study will assess the trends in choline intake among women in early pregnancy.1.2

3. Aims and Objectives The primary objective of this study is to assess choline intake
among women in early pregnancy. In this regard, the study seeks to determine the
percentage of women in early pregnancy consuming the recommended choline intake as
well as the differences between the patterns of consumption. The following are the specific
discussion objectives of this study: