Date of Award


Degree Name

MS in Agriculture - Food Science and Nutrition


Food Science and Nutrition


Peggy Papathakis


Background: Malnutrition can affect the body composition changes that occur in healthy pregnancy, resulting in adverse effects to both the mother and infant. Supplementary foods with high quality protein may result in more favorable changes in lean mass and fat mass in pregnant malnourished women.

Objective: To retrospectively assess changes in body composition in moderately malnourished pregnant Malawian women in response to one of three nutritional interventions.

Methods: Height, weight, MUAC, and TSF were measured in pregnant women with MUAC >20.6 cm and19) were compared using ANOVA. If differences were detected, differences between groups were tested using the Tukey HSD test (continuous) or Chi-squared test (categorical). Longitudinal changes were also measured using mixed model analysis of variance.

Results: At baseline, women had small MUACs and low fat stores, but high muscle mass. Overall, women had significantly larger MUACs at the end of follow up than at baseline, except in adolescents in CSB-IFA and CSB-UNIMMAP. Women overall had significantly larger AMA at the end of enrollment than at baseline, with mature women in the RUSF group experiencing the largest increase compared to adolescents in RUSF and all women in CSB-UNIMMAP and CSB-IFA. On average, AMA was between the 50th-75th percentiles compared to women in the western world, indicating maintenance of muscle mass despite moderate malnutrition. TSF and AFA were both low in all age groups, falling below the 5th percentile for mature women and below the 10th percentile in adolescents compared to women in the Western world. There was no difference in birth weight across intervention groups. Among births that occurred during the rainy season, every cm of MUAC at the end of enrollment resulted in a 0.29 cm greater birth length.

Conclusions: Overall, women improved their nutritional status but did not recover from moderate malnutrition over the course of enrollment. MUAC and BMI were the strongest predictors of birth weight, highlighting the contribution of overall nutritional status to birth outcomes. Women had high muscle mass relative to fat stores, with women in the RUSF group experiencing the largest accrual in muscle. More accurate and objective methods to measure body composition could provide greater detail about changes in body composition over the course of pregnancy in response to supplementary foods.