Objective: To evaluate the ability of an FFQ, designed for use in Brazilian pregnant women, to estimate nutrient intakes during pregnancy. Design: A prospective study was conducted among 103 pregnant women attended by the Brazilian national health-care service. Food intake during pregnancy was evaluated by three 24 h dietary recalls (24hR), one per trimester of pregnancy, and also by two FFQ. The FFQ with eighty-five food items included questions about frequency of intake and portion sizes during two periods: the first 24 weeks of pregnancy and the pregnancy period as a whole. Deattenuated Pearson's correlation coefficients and joint classification into quartiles of nutrient intake were applied. Setting: Ribeirão Preto, São Paulo State, Brazil. Subjects: One hundred and three pregnant women, aged 18-35 years. Results: Acceptable correlation coefficients (r . 0?35) were found for Ca, K, Zn, Mg, fibre, vitamin C, niacin and folic acid for intake for the first 24 weeks; and for energy, lipids, protein, carbohydrate, Fe, K, Zn, fibre, vitamin B 6 , riboflavin and niacin for the gestational period as a whole. A high proportion of study participants ($70 %) were categorized into the same or adjacent quartiles for estimated energy, carbohydrate, Ca, K, fibre, Zn, cholesterol, vitamin A, riboflavin, niacin, vitamin C, vitamin E and folic acid. Gross misclassification ranged from 2?3 % (dietary fibre) to 12?5 % (vitamin A, thiamin and SFA). Conclusions: The FFQ is a useful tool for assessing categories of nutrient intake during pregnancy, since a high proportion of women were classified into the same or adjacent quartiles. Keywords FFQ Pregnant women Validation studiesInadequate maternal diet is a relevant risk factor for complications during pregnancy (1,2) , impaired fetal development (3) and may also be linked to higher risk of chronic diseases during childhood (4) and adult life (5) .The FFQ is a method widely used in epidemiological studies aimed at categorizing individuals into different levels of consumption and determining their relationships with health outcomes (6,7) . The FFQ's ability to assess dietary intake of pregnant women is due to the fact this method spans a longer time frame, thus allowing the detection of changes in dietary intake during each trimester of pregnancy (8)(9)(10)(11) .Validation studies of FFQ for use in pregnant women have shown that nutrient estimates using this method exhibit high levels of agreement with intake estimates using the 24 h dietary recall (24hR) (12)(13)(14) or daily records (DR) (15,16) , suggesting a good accuracy of the FFQ for assessing dietary intake in this population group. Since 24hR and FFQ might have correlated errors, related to memory and estimation of portion size, the use of multiple DR or weighed records as the reference method is recommended. Nevertheless, when literacy or motivation of participants is low, the 24hR might be applied as the reference measure of nutrient intake (6) .In an earlier study, an FFQ was developed for use in pregnant women ...

This study aimed to investigate the relationship between food intake (considering the nature, extent, and purpose of food processing) during pregnancy and overweight, obesity, and gestational diabetes mellitus conditions. This is a cross-sectional study conducted among 785 adult women in singleton pregnancies (between 24th and 39th weeks of gestation) in Brazil. Usual food intake was estimated by the Multiple Source Method, using two 24-hour dietary recalls. The food groups of interest in this study were the unprocessed or minimally processed foods and ultra-processed foods. The World Health Organization criteria for the diagnosis of gestational diabetes mellitus and the Atalah criteria for excess weight were used. Adjusted multinomial logistic regression models were used to assess the relationship between energy contribution (%E) from foods with overweight and obesity conditions and, adjusted logistic regression models for gestational diabetes mellitus. In total, 32.1% participants were overweight, 24.6% were obese, and 17.7% of women were diagnosed with gestational diabetes mellitus . After adjustments, an inverse association between the highest tertile of %E from the intake of unprocessed or minimally processed foods and obesity was found [0.49 (0.30-0.79)]. Moreover, a positive association between the highest tertile of %E from ultra-processed food intake [3.06 (1.27-3.37)] and obesity was observed. No association between food intake (considering the nature, extent, and purpose of food processing) during pregnancy and overweight or gestational diabetes mellitus was found. The findings suggest a role of food processing in obesity but not in gestational diabetes mellitus. Further research is warranted to provide robust evidence on the relationship between the role of processed foods in obesity and gestational diabetes mellitus.

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The data reported in the present study suggest that the FFQ might not be an appropriate dietary method for evaluating food group intake throughout pregnancy. The joint classification between methods by categories of intake of food groups was mostly into adjacent quartiles, which could lead to attenuated associations when investigating diet-disease relationships during pregnancy.