Application of the Nutrient-Rich Food Index 9.3 and the Dietary Inflammatory Index for Assessing Maternal Dietary Quality in Japan: A Single-Center Birth Cohort Study

Nutrients. 2021 Aug 19;13(8):2854. doi: 10.3390/nu13082854.


The maternal diet can potentially influence the life-course health of the child. A poor-quality maternal diet creates nutrient deficiencies and affects immune-metabolic regulation during pregnancy. The nutrient-based overall dietary quality can be assessed using the Nutrient-Rich Food Index 9.3 (NRF9.3), which measures adherence to the national reference daily values of nutrient intake. Pro- and anti-inflammatory nutrient intake can be assessed using the energy-adjusted dietary inflammatory index (E-DII), a comprehensive index of diet-derived inflammatory capacity. Using these indices, we assessed the overall dietary quality and inflammatory potential of pregnant women during mid-gestation in an urban area of Japan (n = 108) and found that there was a strong inverse correlation between the NRF9.3 and E-DII scores. Comparison of the scores among the tertiles of NRF9.3 or E-DII indicated that dietary fiber, vitamin C, vitamin A, and magnesium mainly contributed to the variability of both indices. Intake of vegetables and fruits was positively associated with high NRF9.3 scores and negatively associated with high E-DII scores, after adjustment for maternal age, pre-pregnancy body mass index, and educational level. Consistent with the previous studies that used dietary pattern analysis, this study also demonstrated that vegetables and fruits were the food groups chiefly associated with high dietary quality and low inflammatory potential among pregnant Japanese women.

Keywords: DII; DOHaD; NRF9.3; maternal dietary quality; pregnancy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Diet Records
  • Diet, Healthy* / adverse effects
  • Energy Intake
  • Female
  • Fruit
  • Humans
  • Inflammation / etiology
  • Inflammation / physiopathology
  • Inflammation / prevention & control*
  • Maternal Nutritional Physiological Phenomena*
  • Nutrition Assessment*
  • Nutritional Status*
  • Nutritive Value*
  • Prospective Studies
  • Protective Factors
  • Recommended Dietary Allowances*
  • Risk Assessment
  • Risk Factors
  • Tokyo
  • Vegetables