Dietary patterns and their associations with gestational weight gain in the United Arab Emirates: results from the MISC cohort

Abstract

Background: Suboptimum weight gain during pregnancy may carry long term health consequences for the infant or mother. Nutritional imbalances are well recognized as a determinant of gestational weight gain. Few studies examined the effect of dietary patterns on gestational weight gain, especially in countries undergoing nutrition transition, such as the United Arab Emirates. Objectives: To characterize dietary patterns among pregnant women living in the UAE and examine their associations with gestational weight gain and gestational weight rate. Methodology: Data were drawn from the Mother-Infant Study Cohort, a two-year prospective cohort study of pregnant women living in the United Arab Emirates, recruited during their third trimester (n = 242). Weight gain during pregnancy was calculated using data from medical records. The Institute of Medicine's recommendations were used to categorize gestational weight gain and gestational weight gain rate into insufficient, adequate, and excessive. During face-to-face interviews, dietary intake was assessed using an 89-item culture-specific semiquantitative food frequency questionnaire that referred to usual intake during pregnancy. Dietary patterns were derived by principal component analysis. Multiple logistic regression analyses were used to evaluate the associations of derived dietary patterns with gestational weight gain/gestational weight gain rate. Results: Two dietary patterns were derived, a "Diverse" and a "Western" pattern. The "Diverse" pattern was characterized by higher intake of fruits, vegetables, mixed dishes while the "Western" pattern consisted of sweets and fast food. The "Western" pattern was associated with excessive gestational weight gain (OR:4.04,95% CI:1.07-15.24) and gestational weight gain rate (OR: 4.38, 95% CI:1.28-15.03) while the "Diverse" pattern decreased the risk of inadequate gestational weight gain (OR:0.24, 95% CI:0.06-0.97) and gestational weight gain rate (OR:0.28, 95% CI: 0.09-0.90). Conclusion:The findings of this study showed that adherence to a "Diverse" pattern reduced the risk of insufficient gestational weight gain/gestational weight gain rate, while higher consumption of the "Western" pattern increased the risk of excessive gestational weight gain/gestational weight gain rate. In view of the established consequences of gestational weight gain on the health of the mother and child, there is a critical need for health policies and interventions to promote a healthy lifestyle eating through a life course approach.

Dietary diversity and diet quality with gestational weight gain and adverse birth outcomes, results from a prospective pregnancy cohort study in urban Tanzania

“…While no studies in SSA have examined MDD-W or PDQS with GWG, a longitudinal study in urban South Africa (n = 538) examined western, traditional, and mixed maternal dietary patterns; the authors reported that increased intakes of a traditional diet pattern with high in whole grains, legumes, vegetables, and traditional meats and low intakes of refined grains, sugar, and fats, were associated with lower risk of excessive GWG (odds ratio [OR] = 0.81, p = 0.006) (Wrottesley et al, 2017), supporting the role of high-quality maternal diets in supporting optimal GWG in African population. Studies conducted in developed settings also reported similar conclusions (Guilloty et al, 2015;Itani et al, this present study, given its enrollment criteria that entailed excluding women with anemia at baseline and the study setting in urban Eastern SSA, women in this study were in general well-nourished with secure food access and less concern of under-nutrition or suboptimal dietary diversity. Since PDQS considered both quantity and quality of the diet, it might be more useful in characterizing maternal dietary patterns in this well-nourished Tanzanian population.…”

Effective psychological therapies to improve lifestyle behaviors in (pre)pregnant women: A systematic review

“…In the current review, only one study measured components of dietary intake, while others used GWG as a proxy for dietary intake. Although GWG reflects dietary intake ( Itani et al, 2020 ) and higher GWG is associated with adverse pregnancy outcomes ( Sun et al, 2020 ), wide usage in daily practice and scientific research has been a subject of debate ( Abrams et al, 2000 ). GWG is not a simple sum of the increased maternal body mass, weight of the fetus, placenta and amniotic fluid, but it is a complex biological phenomenon influenced by several changes in maternal physiology and metabolism, such as total body water accretion and fat accretion ( National Research, 2010 ).…”

“…In general, BMI, and gestational weight gain (GWG) in particular, do not directly reflect dietary intake. However, they are considered as a composite outcome of lifestyle behaviors ( Itani et al, 2020 , Sun et al, 2020 ). Therefore, BMI and GWG are included as lifestyle behaviors in our systematic review.…”

Polyunsaturated fatty acid consumption and weight gain during pregnancy: NISAMI Cohort study

“…It can be observed that women with a tendency for these dietary patterns were more susceptible to an increase in excess weight throughout pregnancy compared to those with lower adhesion to these patterns. The pattern of weight gain in pregnant women has changed over time, with recent decades seeing an excessive increase in weight gain, varying in the literature between 29.1% (Kac & Vel asquez-Meléndez, 2005), 42.5% (Magalhães et al, 2015), and 57.4% (Itani et al, 2020).…”

“…This unhealthy dietary pattern affects the anthropometric status of the population. Specifically for pregnant women, studies indicate that their diet is characterized by inadequate consumption of fruit and vegetable groups (Da Mota Santana et al, 2015), an inefficient intake of dairy and legumes, excessive consumption of soft drinks and fat in foods of animal origin (Da Mota Santana et al, 2015), an excessive intake of meats and sugars/sweets (Da Mota Santana et al, 2015), and greater consumption of processed and ultraprocessed foods (Benaim et al, 2018;Gomes et al, 2021;Itani et al, 2020;Rohatgi et al, 2017).…”