We assessed women’s prenatal diet during pregnancy using both three-day food diaries (TFD) and FFQ. At the enrollment visit, we asked pregnant women to complete a TFD over two consecutive weekdays and one weekend day. We trained pregnant women to record their food and drink consumption, with a detailed list of all ingredients and their portions (in grams). We provided participants with visual-aid booklets with colored photographs of 200 local food items with standard portion sizes to help them better identify the type and amount of food. We collected the handwritten TFDs before 24 weeks of gestation and summarized all food items into 21 non-overlapping food groups. We averaged the daily consumption for each food group over three days and derived daily calorie and nutrient intakes according to the China Food Composition Database [22]. We also asked participants to report their dietary intake frequency from pregnancy to enrollment visit (mean gestational age 22 weeks, SD 1.2) using a semiquantitative FFQ. The FFQ contained 25 food items and beverages with nine consumption frequency categories: “almost never”, “<1 time per month”, “1–3 times per month”, “1–2 times per week”, ”3–4 times per week”, “5–6 times per week”, “1 time per day”, “2 time per day” and “≥3 times per day”. We did not collect data on the amount consumed in the FFQ, thus we calculated only the daily consumption frequency for each food group. To be comparable with the TFD, we further combined the 25 FFQ food groups into the 21 TFD food groups based on their similarity in nutrient profiles (e.g., combined pork, beef, and lamb as a red meat group). To evaluate the reproducibility of the FFQ, we invited a subset of 401 pregnancies without gestational diabetes mellitus (GDM) to recomplete the FFQ at the third trimester (mean gestational age 33 weeks, SD 1.1). We chose pregnancies without GDM for the reproducibility study because GDM participants may take doctors’ dietary advice and change their diet habits after the diagnosis. The Spearman correlation coefficients of consumption frequencies ranged from 0.80 (vegetables) to 0.43 (tubers) between the two FFQs, and ranged from 0.60 (vegetables) to 0.25 (whole grains) between FFQ (the first time) and TFD.

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