RESUMO
BACKGROUND: Dietary intake may be associated with neonatal outcomes, yet little is known about the influence of prepregnancy dietary pattern (DP). OBJECTIVES: To evaluate the association between prepregnancy DPs and perinatal outcomes. DESIGN: Prospective cohort study during pregnancy (baseline between 5 and 13 gestational week and three follow-up visits: 20 to 26 gestational weeks, 30 to 36 gestational weeks, and 30 to 40 days postpartum, respectively). Diet was assessed in the first trimester using a food frequency questionnaire and having prepregnancy as the time frame. PARTICIPANTS/SETTING: Two hundred fifty-three pregnant women met the following eligibility criteria (20 to 40 years of age, 5 to 13 weeks of gestation at baseline, free of chronic [except obesity] or infectious diseases, and with a singleton pregnancy). The final sample was composed of 193 pregnant women attending a public health care center in Rio de Janeiro, Brazil, from 2009 to 2012. MAIN OUTCOME MEASURES: Type of delivery, large for gestational age (LGA), birth length (BL)>90th percentile, Apgar score<7 at 1 minute, and preterm birth. STATISTICAL ANALYSES: Reduced rank regression was used to identify prepregnancy DPs that explain the following response variables: fiber density (daily dietary fiber intake in grams, divided by total daily energy intake in kilocalories), dietary energy density, and percent energy from saturated fat. Statistical analyses included multiple logistic regression models. The following covariates were defined as confounders based on a unique Direct Acyclic Graph for each outcome: maternal age, current smoker, alcohol consumption, years of education, and first-trimester leisure physical activity. RESULTS: The prevalence of normal delivery was 56.7%. LGA occurred in 16%, BL>90th percentile in 24.3%, Apgar score<7 at 1 minute in 14.2%, and preterm birth in 9.5% of the study population. Three DPs were identified: "fast food and candies" was associated with higher odds of LGA (odds ratio [OR]=4.38, 95% CI: 1.32 to 14.48) and BL>90th percentile (OR=4.81, 95% CI: 1.77 to 13.07); "beans, bread, and fat" was inversely associated with Apgar score<7 at 1 minute (OR=0.14, 95% CI: 0.03 to 0.70); and "vegetables and dairy" was inversely associated with preterm birth (OR=0.24, 95% CI: 0.06 to 0.97). There was no association between adherence to DPs and type of delivery. CONCLUSIONS: Higher adherence to fast food and candies prepregnancy DP increased the odds of LGA birth, while a higher adherence to vegetables and dairy DP decreased the odds of preterm birth.
Assuntos
Dieta , Cuidado Pré-Concepcional , Resultado da Gravidez , Adulto , Índice de Apgar , Peso ao Nascer , Brasil/epidemiologia , Doces , Estudos de Coortes , Laticínios , Parto Obstétrico/métodos , Fast Foods , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Razão de Chances , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Prospectivos , VerdurasRESUMO
The aim of this study was to evaluate the association of dietary patterns (DP) with maternal adiposity indicators, leptin, adiponectin and insulin concentrations during pregnancy. A prospective cohort of pregnant women followed up at the 5th-13th, 20th -26th and 30th-36th gestational weeks and 30-40 d postpartum was conducted in Rio de Janeiro. A FFQ was administered in the third trimester (30th-36th gestational weeks). The reduced rank regression procedure was used to identify DP that explain response variables (dietary fibre and total fat) related to indicators of maternal adiposity (postpartum weight retention and gestational weight gain (GWG) adequacy), and plasma leptin, adiponectin and insulin concentrations. The associations between tertiles of DP and the outcomes were determined using logistic regression or longitudinal linear mixed-effect regression models. The mean daily energy intake during pregnancy was 10 104 (sd 3234) kJ (2415 (sd 773) kcal), and GWG was 11·9 (sd 4·2) kg. In all, 40 % of women presented pre-gestational overweight/obesity. Excessive GWG occurred in 34·7 % of pregnant women and 56·6 % were overweight/obese at postpartum. The 'common-Brazilian' DP (characterised by higher intake of beans, rice and lower intake of fast food/snacks, candies/table sugar and processed meats/bacon) was positively associated with adiponectin (ß=1·07; 95 % CI 0·17, 1·98). The 'Western' DP (characterised by higher intake of fast food/snacks and processed meat/bacon and lower intake of noodles/pasta/roots/tubers and sodas) was negatively associated with adiponectin (ß=-1·11; 95 % CI -2·00, -0·22) and positively associated with leptin concentrations (ß=64·9; 95 % CI 22·8, 107·0) throughout pregnancy. It may be suggested that the 'common-Brazilian' is a healthy DP and beneficial for serum concentrations of adiponectin and leptin.
Assuntos
Adiponectina/sangue , Dieta , Leptina/sangue , Adiposidade , Adulto , Brasil , Estudos de Coortes , Dieta/efeitos adversos , Dieta Saudável , Gorduras na Dieta/administração & dosagem , Fibras na Dieta/administração & dosagem , Ingestão de Energia , Feminino , Idade Gestacional , Humanos , Insulina/sangue , Fenômenos Fisiológicos da Nutrição Materna , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Gravidez , Estudos Prospectivos , Aumento de PesoRESUMO
Dietary intake during pregnancy may influence child neurodevelopment and cognitive function. This study aims to investigate the associations between dietary patterns obtained in pregnancy and intelligence quotients (IQ) among offspring at 8 years of age. Pregnant women enrolled in the Avon Longitudinal Study of Parents and Children completed a food frequency questionnaire at 32 weeks' gestation (n = 12,195). Dietary patterns were obtained by cluster analysis. Three clusters best described women's diets during pregnancy: "fruit and vegetables," "meat and potatoes," and "white bread and coffee." The offspring's IQ at 8 years of age was assessed using the Wechsler Intelligence Scale for Children. Models, using variables correlated to IQ data, were performed to impute missing values. Linear regression models were employed to investigate associations between the maternal clusters and IQ in childhood. Children of women who were classified in the meat and potatoes cluster and white bread and coffee cluster during pregnancy had lower average verbal (ß = -1.74; p < .001 and ß = -3.05; p < .001), performance (ß = -1.26; p = .011 and ß = -1.75; p < .001), and full-scale IQ (ß = -1.74; p < .001 and ß = -2.79; p < .001) at 8 years of age when compared to children of mothers in the fruit and vegetables cluster in imputed models of IQ and all confounders, after adjustment for a wide range of known confounders including maternal education. The pregnant women who were classified in the fruit and vegetables cluster had offspring with higher average IQ compared with offspring of mothers in the meat and potatoes cluster and white bread and coffee cluster.
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Dieta , Testes de Inteligência , Efeitos Tardios da Exposição Pré-Natal , Pão , Criança , Café , Dieta/classificação , Registros de Dieta , Feminino , Frutas , Humanos , Inteligência/fisiologia , Estudos Longitudinais , Fenômenos Fisiológicos da Nutrição Materna , Carne , Gravidez , Solanum tuberosum , Inquéritos e Questionários , VerdurasRESUMO
BACKGROUND: Physiologic adaptations lead to an increase in blood lipid levels during pregnancy, yet little is known about the influence of prepregnancy dietary patterns. AIM: To identify whether prepregnancy dietary patterns that explain the consumption of fiber, energy, and saturated fat are associated with blood lipid levels throughout pregnancy. DESIGN: Prospective cohort study, with data collection at gestational weeks 5 to 13, 20 to 26, and 30 to 36. A food frequency questionnaire was administered at baseline (gestational week 5 to 13). PARTICIPANTS/SETTING: Women with singleton pregnancy (N=299) aged 20 to 40 years, without infectious/chronic disease (except obesity) were enrolled in the study. One hundred ninety-nine women were included in the final analysis. The study took place at a prenatal service of a public health care center in Rio de Janeiro, Brazil, during the period from 2009 to 2012. MAIN OUTCOME MEASURES: Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and triglyceride levels, measured at all trimesters. STATISTICAL ANALYSES PERFORMED: Dietary patterns were derived by reduced rank regression. Fiber density, dietary energy density, and percent energy from saturated fat were response variables. Crude and adjusted longitudinal linear mixed-effects regression models were performed to account for confounders and mediators. Interaction terms between dietary pattern and gestational week were tested. RESULTS: Fast Food and Candies; Vegetables and Dairy; and Beans, Bread, and Fat patterns were derived. Our Fast Food and Candies pattern was positively associated with triglyceride level (ß=4.961, 95% CI 0.945 to 8.977; P=0.015). In the HDL-C rate of change prediction, significant interactions were observed between both the Fast Food and Candies and Vegetables and Dairy patterns and gestational week (ß=-.053, 95% CI -0.101 to -0.004; P=0.035 and ß=.055, 95% CI -0.002 to 0.112; P=0.060, respectively). The Beans, Bread, and Fat pattern was not associated with blood lipid levels. CONCLUSIONS: Prepregnancy dietary patterns were associated with gestational blood lipid levels; that is, higher scores for the Fast Food and Candies pattern were associated with higher triglyceride and slower HDL-C rates of change during pregnancy, whereas higher scores for the Vegetables and Dairy dietary patterns were associated with faster HDL-C rates of change over gestational weeks.
Assuntos
Dieta , Lipídeos/sangue , Cuidado Pré-Concepcional , Adulto , Brasil , Doces , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos de Coortes , Ingestão de Energia , Fast Foods , Feminino , Humanos , Fenômenos Fisiológicos da Nutrição Materna , Gravidez , Estudos Prospectivos , Inquéritos e Questionários , Triglicerídeos/sangue , VerdurasRESUMO
Little is known about how dietary patterns of mothers and their children track over time. The objectives of this study are to obtain dietary patterns in pregnancy using cluster analysis, to examine women's mean nutrient intakes in each cluster and to compare the dietary patterns of mothers to those of their children. Pregnant women (n = 12 195) from the Avon Longitudinal Study of Parents and Children reported their frequency of consumption of 47 foods and food groups. These data were used to obtain dietary patterns during pregnancy by cluster analysis. The absolute and energy-adjusted nutrient intakes were compared between clusters. Women's dietary patterns were compared with previously derived clusters of their children at 7 years of age. Multinomial logistic regression was performed to evaluate relationships comparing maternal and offspring clusters. Three maternal clusters were identified: 'fruit and vegetables', 'meat and potatoes' and 'white bread and coffee'. After energy adjustment women in the 'fruit and vegetables' cluster had the highest mean nutrient intakes. Mothers in the 'fruit and vegetables' cluster were more likely than mothers in 'meat and potatoes' (adjusted odds ratio [OR]: 2.00; 95% Confidence Interval [CI]: 1.69-2.36) or 'white bread and coffee' (OR: 2.18; 95% CI: 1.87-2.53) clusters to have children in a 'plant-based' cluster. However the majority of children were in clusters unrelated to their mother dietary pattern. Three distinct dietary patterns were obtained in pregnancy; the 'fruit and vegetables' pattern being the most nutrient dense. Mothers' dietary patterns were associated with but did not dominate offspring dietary patterns.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Dieta , Fenômenos Fisiológicos da Nutrição Materna , Relações Mãe-Filho , Adulto , Índice de Massa Corporal , Pão , Criança , Análise por Conglomerados , Feminino , Frutas , Humanos , Modelos Logísticos , Estudos Longitudinais , Carne , Micronutrientes/administração & dosagem , Mães , Avaliação Nutricional , Gravidez , Análise de Componente Principal , Fatores Socioeconômicos , Inquéritos e Questionários , Verduras , Adulto JovemRESUMO
OBJECTIVE: To evaluate the relationships prospectively between birth weight (standardized for gestational age) and problematic eating behaviors, as reported by the parents, at different ages in 3 birth cohorts: Generation XXI (Portugal), Avon Longitudinal Study of Parents and Children (United Kingdom), and Etude des Déterminants pre et postnatals précoces du développement et de la santé de l'ENfant study (France) - HabEat project. We also aimed to explore the effect of child's current body mass index (BMI) in these relationships. STUDY DESIGN: Problematic eating behaviors were assessed at 4-6, 12-15, 24, and 48-54 months, based on caregiver's perception. Children born small, appropriate, and large for gestational age were defined based on sex-specific Kramer growth references. Associations were tested by logistic regression (OR, 95% CI) adjusted for maternal age, education, BMI, smoking, breastfeeding duration, older siblings, birth type and, in a second step, for child's current BMI World Health Organization z-score. RESULTS: Parents of children born small for gestational age (compared with appropriate gestational age) reported more often feeding difficulties and poor eating patterns (eating small quantities or needing stimulation to eat) at 4-6 months (Generation XXI: OR 2.02, 95% CI 1.40-2.94; Avon Longitudinal Study of Parents and Children: OR 1.36, 95% CI 1.14-1.62; Etude des Déterminants pre et postnatals précoces du développement et de la santé de l'ENfant OR 3.24, 95% CI 1.50-6.96), but this effect was weaker at older ages. Overall, the effects decreased, after adjustment for child's BMI, but remained significant. CONCLUSIONS: Low birth weight for gestational age was related to later difficulty in eating behaviors, primarily in the first 4-6 months.
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Peso ao Nascer/fisiologia , Comportamento Alimentar/fisiologia , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Modelos Logísticos , Estudos Longitudinais , Masculino , Estudos ProspectivosRESUMO
Background: Breast-feeding in infancy has been associated with decreased coronary heart disease mortality, but the underlying mechanisms are unclear. We investigated the association of breast-feeding with blood pressure in a contemporary cohort...
Assuntos
Masculino , Feminino , Humanos , Aleitamento Materno , Doença das Coronárias , Pressão Arterial , Pressão SanguíneaRESUMO
Breast-feeding in infancy has been associated with decreased coronary heart disease mortality, but the underlying mechanisms are unclear...
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Masculino , Feminino , Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Aleitamento Materno , Pediatria , Pressão Sanguínea , Nutrição do LactenteRESUMO
BACKGROUND: Little is known about relationships between dietary patterns, n-3 polyunsaturated fatty acids (PUFA) intake and excessive anxiety during pregnancy. OBJECTIVE: To examine whether dietary patterns and n-3 PUFA intake from seafood are associated with high levels of anxiety during pregnancy. DESIGN: Pregnant women enrolled from 1991-1992 in ALSPAC (n 9,530). Dietary patterns were established from a food frequency questionnaire using principal component analysis. Total intake of n-3 PUFA (grams/week) from seafood was also examined. Symptoms of anxiety were measured at 32 weeks of gestation with the Crown-Crisp Experiential Index; scores ≥ 9 corresponding to the 85(th) percentile was defined as high anxiety symptoms. Multivariate logistic regression models were used to estimate the OR and 95% CI, adjusted by socioeconomic and lifestyle variables. RESULTS: Multivariate results showed that women in the highest tertile of the health-conscious (OR 0.77; 0.65-0.93) and the traditional (OR 0.84; 0.73-0.97) pattern scores were less likely to report high levels of anxiety symptoms. Women in the highest tertile of the vegetarian pattern score (OR 1.25; 1.08-1.44) were more likely to have high levels of anxiety, as well as those with no n-3 PUFA intake from seafood (OR 1.53; 1.25-1.87) when compared with those with intake of >1.5 grams/week. CONCLUSIONS: The present study provides evidence of a relationship between dietary patterns, fish intake or n-3 PUFA intake from seafood and symptoms of anxiety in pregnancy, and suggests that dietary interventions could be used to reduce high anxiety symptoms during pregnancy.