When entering her first pregnancy, Jasna Twynstra was determined to make the best nutrition choices for her own health, and her baby's. Although, when she dove into the latest research on the topic, she found herself with more questions than answers.
"I noticed there wasn't a lot of research in Canada on how health-care providers are trained, or how much they know about giving nutrition advice to pregnant people."
Twynstra, now a professor and graduate chair in the Brescia School of Food and Nutritional Sciences in the Faculty of Health Sciences, and associate scientist with the Children's Health Research Institute, began her career as a postdoc exploring how blood delivers nutrients throughout the body. But when she began to face growing questions about her own pregnancy, she decided to take a new path within her research.
"Because I was so driven to make the best decisions for myself and my baby, I jumped two feet into the field and started to figure out: what is the best way to educate pregnant people on what they should be eating so they can make their own, informed choices?"
Nutrition is incredibly important during pregnancy for the short-term and long-term health of the pregnant person and their baby. Inadequate nutrition increases the risk of numerous complications, including low or large birth weight baby, preterm birth, cardiovascular disease, obesity and more.
Twynstra is dedicated to improving the field of prenatal nutrition so that every pregnant person has the proper resources from the start, helping them feel confident in making dietary choices throughout pregnancy, and beyond.
Currently, a pregnant person's first source of nutrition guidance is often their family doctor. But the problem, Twynstra says, is that "despite having up-to-date recommendations, health-care providers don't necessarily receive a lot of education on nutrition. And pregnant people report they would like more information from them."
Figuring out how to satisfy what the pregnant person is searching for, and bridge that knowledge gap, is the ultimate goal.
The starting point, she says, is training health-care providers.
Inconsistent nutrition training, patchwork prenatal advice
Twynstra's current research project tackles the issue of incomplete or inconsistent nutrition education by exploring what health-care trainees learn about the topic in medical school, placements or other settings. By starting at this foundational level, Twynstra can identify what's being taught and what's missing, helping to ensure the next generation of health-care providers will be able to fully support pregnant people throughout their journey.
So far, Twynstra has discovered time is a major limitation. The amount of time a health-care provider can spend with a pregnant person is dependent on the setting. For instance, she has found midwives are able to explore a wider breadth and depth of nutrition topics, due to longer appointments. Twynstra believes referrals to nutrition experts, such as registered dieticians, and exploring a multidisciplinary approach to care would enable pregnant people to receive the necessary nutrition information no matter what health-care environment they're in.
She hopes this research will inspire better prenatal nutrition training for health-care professionals. There are ways to empower health-care workers to provide high-quality information to their pregnant patients, Twynstra says, but right now, it's a patchwork system. What health-care providers can offer their patients depends on the nutrition information they've learned in their own training.
"This can be boiled down to their own education, their awareness of nutrition experts such as registered dietitians, as well as understanding how much time they have with the pregnant person in their appointment and how to best utilize that time to ensure the necessary topics are covered."
Twynstra sees the lack of consistency in prenatal nutrition across the field as one of its biggest challenges. Depending on whether a pregnant person sees a family doctor, midwife, obstetrician or another provider, the guidance they receive can vary widely. Without a standardized approach, it's difficult to ensure everyone has access to the essential information they need, she said.
"The questions I had during my own pregnancy are driving my research. I believe they are common questions asked by many pregnant people," Twynstra said. "I want to ensure they receive answers supported by research, and are consistent no matter their health-care provider."
