Development of a Diet Quality Index Adapted for Pregnant Women

Abstract

OBJECTIVE:To develop a Diet Quality Index Adapted for Pregnant Women (IQDAG) and to evaluate its relation with the characteristics of women treated at the Brazilian Unified Health System.METHODS:The data on food intake come from a cross-sectional study carried out with 785 adult pregnant women in the city of Ribeirão Preto, state of São Paulo, Brazil, between 2011 and 2012. The index was based on the recommendations of the Brazilian Ministry of Health, previous national dietary indexes, and the new Dietary Guidelines for the Brazilian Population. We used the ANOVA, Kruskal-Wallis, and chi-square tests to describe the quality of the diet according to the characteristics of the mother.RESULTS:The IQDAG has nine components, and it is represented by three food groups (in servings/1,000 kcal), five nutrients, and a moderator component. A high proportion of pregnant women reached the maximum score for the components of legumes and vegetables. However, few women reached the maximum score for consumption of fresh fruits, fiber, omega-3, calcium, folate, iron, and ultra-processed foods. We verified a better quality of diet among older and eutrophic pregnant women who reported practicing more physical activity and taking dietary supplements. We also observed the highest index score among women with higher intake of carbohydrates, proteins, vitamins C, E, and A, and minerals calcium, folate, and iron, as well as among those with lower intake of total fats and saturated fats.CONCLUSIONS:This dietary index is unprecedented in incorporating the recommendation of the new Dietary Guidelines for the Brazilian Population regarding the moderation of the consumption of ultra-processed foods. It was useful in evaluating the quality of the diet of pregnant women and we verified a higher score among older and eutrophic women who reported a healthy lifestyle. Strategies are needed to promote a higher consumption of fresh fruits, foods high in fiber, omega-3, calcium, folate, iron, and minimally processed foods in pregnant women.

Pre-Pregnancy BMI Influences the Association of Dietary Quality and Gestational Weight Gain: The SECOST Study

“…The mean total HEI score (52.76–56.10) for pregnant women in this study was substantially lower than those reported in Western countries (62.9–70.2) [16,17,44,45] but almost parallel to those in other Asian countries, such as Singapore (52.4) [13] and Indonesia (58.9) [15]. Cross-study variations in HEI scores could be explained by the differences in study design, measurement of dietary intake (e.g., diet recall, diet history, food frequency questionnaire), socio-demographic background (e.g., age, ethnicity, and nutritional knowledge) and food environment (e.g., accessibility to fast food, convenience store and food court setting).…”

Consumo alimentar de gestantes de alto risco através de um índice de qualidade da dieta adaptado

“…Está bem estabelecida a associação entre fatores nutricionais e o desenvolvimento de patologias ou complicações na gestação (Gomes et al, 2019). Tendo em vista a importância de uma ingestão alimentar adequada, a avaliação do consumo alimentar de gestantes é necessária para identificar distúrbios nutricionais e metabólicos (Zuccolotto et al, 2019 (Crivellenti et al, 2018).…”

“…Como componente moderador da dieta, Crivellenti et al (2018), incorporou no IQDAG a porcentagem calórica proveniente de alimentos ultraprocessados como bebidas açucaradas, biscoitos, pães industrializados, macarrão instantâneo, sorvetes, chocolates, enlatados, embutidos e produtos congelados prontos para aquecimento, conforme recomendações do guia alimentar para a população brasileira.…”

“…Fonte: Crivellenti et al (2018) No Quadro 1 consta os alimentos e nutrientes avaliados pelo IQDAG. Foram analisados três grupos alimentares (Hortaliças, leguminosas e frutas frescas) e cinco nutrientes (fibras, ômega 3, cálcio, folato e ferro), os quais foram atribuídos pontuação de 0 a 10 conforme adequação do consumo.…”

Qualidade da dieta durante a gestação e sua relação com o peso ao nascer

“…Dietary indices are tools that assess overall diet quality and are based on theoretical assumptions about the effect of food and nutrients on the health of individuals (10). The Diet Quality Index Adapted for Pregnant Women (Índice de Qualidade da Dieta Adaptado para Gestantes -IQDAG) was developed for Brazilian pregnant women and is unprecedented in using the percentage of energy from ultra-processed foods as its moderator component (11).…”