Dietary Pattern Influences Gestational Weight Gain: Results from the ProcriAr Cohort Study—São Paulo, Brazil

Abstract

The maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) influence maternal and infant outcomes. This study identified patterns of habitual dietary intake in 385 pregnant women in São Paulo and explored their associations with excessive weight gain (EGWG). Weight at the first visit (<14 weeks) was used as a proxy for pre-pregnancy weight. Food consumption was assessed using the 24HR method, administered twice at each gestational trimester, and dietary patterns were identified by principal component analysis. Three dietary patterns were identified: “Vegetables and Fruits,” “Western,” and “Brazilian Traditional.” Descriptive data analysis was performed using absolute and relative frequencies for each independent variable and multilevel mixed-effects logistic regression was used to analyze excessive gestational gain weight (EGWG) and dietary patterns (DP). The Brazilian Traditional dietary pattern showed a protective effect on EGWG (p = 0.04) and age > 35 years (p = 0.03), while subjects overweight at baseline had a higher probability of EGWG (p = 0.02), suggesting that the identification of dietary and weight inadequacies should be observed from the beginning of pregnancy, accompanied by nutritional intervention and weight monitoring throughout the gestational period to reduce risks to the mother and child’s health.

Dietary intake patterns during pregnancy and excessive gestational weight gain: a systematic review and meta-analysis

“…Duplicate studies (n = 20 312), irrelevant studies detected by browsing titles and abstracts (n = 58 065), interventional studies investigating diets and physical activity control (n = 8), studies on food items instead of dietary patterns (n = 3), studies with participants having gestational diabetes mellitus or HIV(n = 3), a study on dietary patterns prior to pregnancy (n = 1), studies without full text (n = 3), studies with the total gestational weight gain (GWG) instead of the EGWG outcome (n = 10), and a study on diet quality and GWG (n = 1) were all excluded after a full-text review. Finally, a total of 14 articles [16][17][18][19][20][21][22][24][25][26][27][28][29][30] with four cross-sectional 16,18,22,28 studies and eight cohort 17,[19][20][21][24][25][26][27]29,30 studies met the eligibility criteria, and were included in the present meta-analysis. Table 1 presents the characteristics of the included studies.…”

“…According to previous studies, we classified the dietary patterns in the included articles into three categories: healthy dietary patterns, [16][17][18][19]21,22,[24][25][26][27] unhealthy dietary patterns, [18][19][20][21][22]26,28,29 and mixed dietary patterns. [18][19][20][21][22][27][28][29][30] Healthy dietary patterns are characterized by high intake of fruits, vegetables, soy products, whole grains, fish, seafood, low-fat yogurt, olive oil, low-fat dairy, nuts, and legumes. 31 Unhealthy dietary patterns are mainly characterized by higher intake of refined grains, processed meat, desserts, red meat, sweets, sugar-sweetened beverages, fast food, dry fruits, readymade meals, cheese, butter, solid fat, meat products, offal, and liquor.…”

“…Eight dietary patterns described in eight studies [18][19][20][21][22]28,29 were classified as unhealthy dietary patterns and, consisted of higher refined grains, red meat, dry fruits, processed meat, sweets, desserts, sugar-sweetened beverages, fast food, ready-made meals, cheese, butter, solid fat, meat products, offal and liquor. Ten remaining dietary patterns described in nine studies [18][19][20][21][22][28][29][30] were classified as mixed dietary patterns because they cannot be classified as healthy or unhealthy.…”

“…The quality of each study (including sample size, dietary intake, EGWG description, sampling methods, adjusted confounding factors, and statistical analysis) is summarized in Tables S2 and S3. ‡ All cohort studies 17,[19][20][21][24][25][26][27]29,30 received a score of 8 or higher on the NOS and were considered to be of high methodological quality. All cross-sectional studies 16,18,22,28 scored 8 or higher on the scale of AHQR.…”

Recent Insights and Recommendations for Preventing Excessive Gestational Weight Gain

“…In turn, “Brazilian style” was associated with a greater consumption of rice or beans. The most beneficial effect on EGWG was demonstrated by the “Brazilian style” and age > 35 years [ 56 ].…”