Prepregnancy Healthy Dietary Pattern Is Inversely Associated with Depressive Symptoms among Pregnant Brazilian Women

Abstract

Dietary patterns before pregnancy may be associated with depressive symptomatology during pregnancy. The aim of this study was to identify dietary patterns before pregnancy and to examine the association between these dietary patterns and depressive symptoms during pregnancy. A prospective cohort of 248 healthy pregnant women were followed at 5-13, 20-26, and 30-36 gestational weeks. Dietary intake was obtained by using a food-frequency questionnaire administered between 5 and 13 gestational weeks, which referred to the 6 mo preceding gestation, and factor analysis (principal components) was applied to identify dietary patterns. The Edinburgh Postnatal Depressive Scale (EPDS) was used to evaluate depressive symptoms during 3 follow-up pregnancy points. A multiple linear mixed-effects model was applied to verify the association between dietary patterns and depressive symptoms adjusted for obstetric factors, socioeconomic status, and energy intake. Three prepregnancy dietary patterns were identified: common-Brazilian, healthy, and processed. Together, these patterns explained 36.1% of the total percentage of variance; the eigenvalues were 2.88, 2.12, and 1.86, respectively. Mean depressive symptom scores were 9.0 (95% CI: 8.4, 9.6), 7.2 (95% CI: 6.5, 7.8), and 7.0 (95% CI: 6.4, 7.7) for trimesters 1, 2, and 3, respectively. The rate of decrease in depressive symptoms was -0.088/wk (95% CI: -0.115, -0.061; P < 0.001). In the multiple longitudinal linear regression model, the healthy dietary pattern before pregnancy was inversely associated with depressive symptoms (β:-0.723; 95% CI: -1.277, -0.169; P = 0.011). High adherence to the healthy pattern before pregnancy was associated with lower EPDS scores during pregnancy in women from Rio de Janeiro, Brazil.

Association of Prepregnancy Dietary Patterns and Anxiety Symptoms from Midpregnancy to Early Postpartum in a Prospective Cohort of Brazilian Women

“…d The pre-pregnancy dietary patterns employed in the current study were previously derived in an investigation of the association of dietary patterns and depressive symptoms during pregnancy. 28 Those authors observed that the healthy dietary pattern was inversely associated with depressive symptoms, and the current study has shown that the healthy dietary pattern may reduce the risk of anxiety. Anxiety and depression are common mental illnesses during pregnancy and the postpartum period that deserve attention because they can affect maternal and child health.…”

“…28 The common-Brazilian pattern consisted of rice, beans, meats and eggs, and vegetable spices. The healthy pattern was composed of roots and tubers, green vegetables and legumes, fruits and fruit juice, dairy products, fish, tea, pasta, cakes and cookies-crackers, and candies, and was inversely related with coffee intake.…”

“…The foods were grouped as: rice; beans; breads; cakes and cookies-crackers; pasta, roots, and tubers; gnocchi/ lasagna/ravioli; baked/mashed potato; cassava/yam, cassava flour, and polenta; meats and eggs: pork, beef, chicken, barbecue, giblets (eg, gizzard, heart, liver, stomach/tripe, and kidneys), and eggs; vegetable spices: onion, garlic, and red/ green/yellow pepper; dairy products: cheese, milk, cottage cheese, and yogurt; green vegetables and legumes: lentils/ peas/chickpeas, lettuce, cabbage, kale, cauliflower/broccoli, tomato, cucumber, chayote, squash, zucchini, carrots, beets, okra, and pea pods; fruit and fruit juice: orange/tangerine, banana, papaya, apple, watermelon/melon, pineapple, grape, mango, and fruit juices/pulp; fish; sausages and deli meats: sausage/frankfurter, cold cuts (bologna, ham, fatty ham, and salami), and bacon; fat: butter and margarine; fast food and snacks: pizza, hamburgers, french fries/chips/straw potatoes, mayonnaise, snacks, popcorn, fried/baked salted pastries, canned vegetables, and peanuts; coffee; tea; sodas; candies: ice cream, candies/caramels, chocolate powder, chocolate bars/bonbon, fruit jam/jelly, and sweet dairy; and sugar. 28 Dietary patterns were extracted using principal component analysis. Initially, the Kaiser-Meyer-Olkin test was used to measure sampling adequacy (Kaiser-Meyer-Olkin >0.6) and…”

“…We hypothesized that adherence to dietary patterns with healthy foods would be associated with lower anxiety symptoms during the study period. In a recent study from our research group, 28 we observed that the higher adherence to a healthy pattern before pregnancy was associated with lower depressive symptoms during pregnancy, but little is known about the influence of diet on other mental illnesses during gestation, including anxiety. Findings from our study may contribute to closing this gap and provide insights to guide the enrichment of maternal nutrition to improve mental health during the perinatal period.…”

Dietary patterns and significance of nutrition for women with low-risk pregnancy

“…A dietary pattern denominated healthy was identified in other studies involving pregnant women and with similar food group distribution [2,18]. In some studies, similar patterns were found with different names, such as "vegetable" [1] "health conscious" [24] and "prudent" [25,26].…”