Quality of the diet of pregnant women in the scope of Primary Health Care
Palabras clave:
Diet, healthy, Diet, food, and nutrition, Prenatal nutritionResumen
Objective
To evaluate the quality of the diet of the pregnant women monitored by the Family Health Strategy teams and associated factors.
Methods
This is a population-based cross-sectional study, carried out with 1244 pregnant women between 2018 and 2019. The Diet Quality Index Adapted for Pregnant Women was used to measure the quality of the diet and associate it with risk factors (sociodemographic, obstetric, clinical, behavioral, nutritional status) during the pregnancy. A hierarchical model composed of three blocks was used. A multinomial logistic regression was applied.
Results
The general average of this Diet Quality Index was 72.75 points, the average of the 1st tercile was 56.06 points, the average of the 2nd tercile was 73.71 points and the average of the 3rd was 88.51 points. The worst diet quality was related to pregnant women with lower education (OR=2.36; 95% CI=1.39-4.01), sedentary women (OR=1.37; 95% CI=1.17-2, 61), those who had a negative self-perception of food (OR=2.00; 95% CI=1.45-2.76) and who had 3 to 5 meals a day (OR=1.83; 95% CI=1.26-2.77), and less than 3 (OR=2.64; 95% CI=1.13-6.18).
Conclusion
The present study identified that pregnant women with less education, sedentary, and with inadequate nutritional characteristics presented worse diet qualities.
Citas
Leal MDC, Esteves-Pereira AP, Viellas EF, Domingues RMSM, Gama SGND. Prenatal care in the Brazilian public health services. Rev Saude Publica. 2020;20(54):08. https://doi.org/10.11606/s1518-8787.2020054001458
Bortolini GA, Oliveira TFV, Silva SA, Santin RDC, Medeiros OL, Spaniol AM, et al. Ações de alimentação e nutrição na atenção primária à saúde no Brasil. Rev Panam Salud. 2020;23(44):e39. https://doi.org/10.26633/RPSP.2020.39
Pimentel C. A nutrição ideal da pré concepção à amamentação. In: Pimentel C, editor. Além da nutrição: o impacto da nutrição materna na saúde das futuras gerações. São Paulo: Luiz Martins; 2019 [cited 2021 June 10]. Available from: http://abran.org.br/new/wp-content/uploads/2019/08/ALEM_DA_NUTRICAO.pdf
Gomes CB, Vasconcelos LG, Cintra RMGC, Dias LCGD, Carvalhaes MABL. Hábitos alimentares das gestantes brasileiras: revisão integrativa da literatura. Cienc Saude Coletiva. 2019;24(6):2293-2306. https://doi.org/10.1590/1413- 81232018246.14702017
Institute of Medicine. Dietary Reference Intakes (DRIs): recommended dietary allowances and adequate intakes, elements. Washington: National Academies Press; 2019 [cited 2021 June 13]. Available from: https://www.ncbi.nlm. nih.gov/books/NBK545442/table/appJ_tab3/?report=objectonly
Institute of Medicine. Dietary Reference Intakes (DRIs): recommended dietary allowances and adequate intakes, total water and macronutrients. Washington: National Academies Press; 2011 [cited 2021 June 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56068/table/summarytables.t4/?report=objectonly
Melere C, Hoffmann JF, Nunes MAA, Drehmer M, Buss C, Ozcariz SGI, et al. Índice de alimentação saudável para gestantes: adaptação para uso em gestantes brasileiras. Rev Saude Publica. 2013;47(1):20-8. https://doi.org/10.1590/ S0034-89102013000100004
Demilew YM, Alene GD, Belachew T. Dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia. BMC Pregnancy Childbirth. 2020;20(1):e18. https://doi.org/10.1186/s12884- 019-2702-z
Crozier SR, Inskip HM, Godfrey KM, Cooper C, Robinson SM, SWS Study Group. Nausea and vomiting in early pregnancy: effects on food intake and diet quality. Matern Child Nutr. 2017;13(4):e12389. https://doi.org/10.1111/ mcn.12389
Forbes LE, Graham JE, Berglund C, Bell RC. Dietary Change during Pregnancy and Women’s Reasons for Change. Nutrients. 2018;10(8):e1032. https://doi.org/10.3390/nu10081032
Jardí C, Aparicio E, Bedmar C, Aranda N, Abajo S, March G, et al. Food Consumption during Pregnancy and Post- Partum. ECLIPSES Study. Nutrients. 2019;11(10):e2447. https://doi.org/10.3390/nu11102447
Kourlaba G, Panagiotakos DB. Dietary quality indices and human health: a review. Maturitas 2009;62(1):1-8. https:// doi.org/10.1016/j.maturitas.2008.11.021
Crivellenti LC, Zuccolo DCC, Sartorelli DS. Desenvolvimento de um índice de qualidade da dieta adaptado para gestantes. Rev Saude Publica. 2018;52-9. https://doi.org/10.11606/S1518-8787.2018052000184
Crivellenti LC, Zuccolo DCC, Sartorelli DS. Associação entre o Índice de Qualidade da Dieta Adaptado para Gestantes (IQDAG) e o excesso de peso materno. Rev Bras Saude Mater Infant. 2019;19(2):285-94. https://doi. org/10.1590/1806-93042019000200002
Fisberg, RM, Marchioni DML, Colucci ACA. Avaliação do consumo alimentar e da ingestão de nutrientes na prática clínica. Arq Bras Endocrinol Metab. 2009;53(5):617-24. https://doi.org/10.1590/S0004-27302009000500014
Duarte, ACOR, Pinho L, Silveira MF, Botelho EM. Validação de um questionário de frequência de consumo alimentar para gestantes atendidas em unidades básicas de saúde. J Hum Growth Dev. 2020;30(1),75-83. http://dx.doi. org/10.7322/jhgd.v30.9972
Philippi, Sonia Tucunduva. Tabela de Composição de Alimentos: suporte para decisão nutricional. 7th ed. São Paulo: Coronário; 2021.
Unicamp. Tabela brasileira de composição de alimentos (TACO). 4th ed. Campinas: NEPA- UNICAMP; 2011.
Ministério da Saúde (Brasil). Atenção ao pré-natal de baixo risco. Brasília: Ministério; 2012 [cited 2022 May 24]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/cadernos_atencao_basica_32_ prenatal.pdf
Previdelli NA, Andrade SC, Pires MM, Ferreira SRG, Fisberg RM, Marchioni DM. Índice de Qualidade da Dieta Revisado para população brasileira. Rev Saude Publica. 2011;45(4):794-8. https://doi.org/10.1590/S0034- 89102011005000035
Ministério da Saúde (Brasil). Guia alimentar para população brasileira. 2nd ed. Brasília: Ministério; 2014 [cited 2022 May 24]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/guia_alimentar_ populacao_brasileira_2ed.pdf
Emmett PM, Jones LR, Golding J. Pregnancy diet and associated outcomes in the Avon longitudinal study of parents and children. Nutr Rev. 2015;73(3):154-74. https://doi.org/10.1093/nutrit/nuv053
Guenther PM, Reedy J, Krebs-Smith SM, Reeve BB, Basiotis PP. Development and evaluation of the Healthy Eating Index – 2005: technical report. Washington: Center for Nutrition Policy and Promotion, Department of Agriculture; 2007 [cited 2022 May 24]. Available from: https://vtechworks.lib.vt.edu/bitstream/handle/10919/18682/HEI- 2005TechnicalReport.pdf?sequence=3
Giroto E., Loch MR, Mesas AE, Gonzále AD, Guidoni CM, Andrade SM. Comportamentos alimentares de risco à saúde e fatores associados entre motoristas de caminhão. Cienc Saude Coletiva. 2020;25(3):1011-23. https://doi. org/10.1590/1413-81232020253.11402018
Ługowska K, Kolanowski W. The Nutritional Behaviour of Pregnant Women in Poland. Int J Environ Res Public Health. 2019;16(22):4357. https://doi.org/10.3390/ijerph16224357
Yee LM, Silver RM, Haas DM, Parry S, Mercer BM, Iams J, et al. Quality of periconceptional dietary intake and maternal and neonatal outcomes. Am J Obstet Gynecol. 2020;223(1):e1-121.e8. https://doi.org/10.1016/j.ajog.2020.01.042
Leech RM, Livingstone KM, Worsley A, Timperio A, McNaughton SA. Meal frequency but not snack frequency is associated with micronutrient intakes and overall diet quality in australian men and women. J Nutr. 2016;146(10):2027-34. https://doi.org/10.3945/jn.116.234070
Moreira LN, Barros DCd, Baião MR. “Quando tem como comer, a gente come”: fontes de informações sobre alimentação na gestação e as escolhas alimentares. Rev de Saude Coletiva. 2018;28(3):e280321. https://doi. org/10.1590/S0103-73312018280321
Falcão IR, Ribeiro-Silva RC, Almeida MF, Fiaccone RL, Rocha AS, Ortelan N, et al. Factors associated with low birth weight at term: a population-based linkage study of the 100 million Brazilian cohort. BMC Pregnancy Childbirth. 2020;20(1):536. https://doi.org/10.1186/s12884-020-03226-x
Rahman MMD, Abe SK, Kanda K, Narita S, Bilano V, Ota E, et al. Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis. Am J Clin Nutr. 2016;103(2):495-504. https://doi.org/10.3945/ajcn.115.107896
Meander L, Lindqvist M, Mogren I, Sandlund J, West CE, Domellöf M. Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes: an epidemiological study. BMC Pregnancy Childbirth. 2021;21(1):166. https://doi.org/10.1186/s12884-021-03627-6
Fazzi C, Saunders DH, Linton K, Norman JE, Reynolds RM. Sedentary behaviours during pregnancy: a systematic review. Int J Behav Nutr Phys Act. 2017;14(1):32. https://doi.org/10.1186/s12966-017-0485-z
Thomas Berube L, Messito MJ, Woolf K, Deierlein A, Gross R. Correlates of prenatal diet quality in low-income Hispanic women. J Acad Nutr Diet. 2019;119(8):1284-95. https://doi.org/10.1016/j.jand.2019.02.004
Vries H, van ‘t Riet J, Spigt M, Metsemakers J, van den Akker M, Vermunt JK, Kremers S. Clusters of lifestyle behaviors: results from the Dutch SMILE study. Prev Med. 2008;46(3):203-8. https://doi.org/10.1016/j.ypmed.2007.08.005
Silva DA, Rinaldi AEM, Azeredo CM. Clusters of risk behaviors for noncommunicable diseases in the Brazilian adult population. Int J Public Health. 2019;64(6):821-30. https://doi.org/10.1007/s00038-019-01242-z
Moreno-Fernandez J, Ochoa JJ, Lopez-Frias M, Diaz-Castro J. Impact of early nutrition, physical activity and sleep on the fetal programming of disease in the pregnancy: a narrative review. Nutrients. 2020;12(12):3900. https://doi. org/10.3390/nu12123900
Muñóz Muñóz A, Gómez-Cantarino S, Dios Aguado MLM, Velasco Abellán M, González López B, Molina Gallego B, et al. Nutritional habits and levels of physical activity during pregnancy, birth and the postpartum period of women in Toledo (Spain): study protocol for a two-year prospective cohort study (the PrePaN study). BMJ Open. 2019;30(7):e029487. https://doi.org/10.1136/bmjopen-2019-029487
Souza RK, Backes V. Autopercepção do consumo alimentar e adesão aos Dez Passos para Alimentação Saudável entre universitários de Porto Alegre, Brasil. Cienc Saude Coletiva. 2020;25(11):4463-72. https://doi.org/10.1590/1413- 812320202511.35582018
Lindemann IL, Barros KS, Sassi RAM. Autopercepção da alimentação entre usuários da atenção básica de saúde e fatores associados. Rev Baiana de Saude Publica. 2017;41(2):424-39. https://doi.org/10.22278/2318-2660.2017. v41.n2.a2393
Danielewicz H, Myszczyszyn G, Dębińska A, Myszkal A, Boznański A, Hirnle L. Diet in pregnancy-more than food. Eur J Pediatr. 2017;176(12):1573-79. https://doi.org/10.1007/s00431-017-3026-5
Kominiarek MA, Rajan P. Nutrition Recommendations in Pregnancy and Lactation. Med Clin North Am. 2016;100(6):1199-1215. https://doi.org/10.1016/j.mcna.2016.06.004
Pacheco CR, Guerrero ATG, Oliveira SMVL, Hayashi SY, Ferreira RS. Estado nutricional e condições socioeconômicas de gestantes atendidas em uma unidade de saúde da família. Rev Saude Publica. 2020 [cited 2021 Aug 17];3(1):41-54. Available from: file:///C:/Users/Usuario/Downloads/90-Texto%20do%20artigo-823-1-10-20201230.pdf
Desta M, Akibu M, Tadese M, Tesfaye M. Dietary Diversity and Associated Factors among Pregnant Women Attending Antenatal Clinic in Shashemane, Oromia, Central Ethiopia: a Cross-SectionalStudy. J Nutr Metab. 2019 [cited 2021 Aug 12]; e3916864. https://dx.doi.org/10.1155/2019/3916864
Englund-Ögge L, Brantsæter AL, Juodakis J, Haungen M, Meltzer HM, Jacobsson B, et al. Associations between maternal dietary patterns and infant birth weight, small and large for gestational age in the Norwegian Mother and Child Cohort Study. Eur J Clin Nutr. 2019;73(9):1270-182. https://doi.org/10.1038/s41430-018-0356-y
Murakami K, Livingstone BEM. Associations between meal and snack frequency and Diet Quality in US Adults: National Health and Nutrition Examination Survey 2003-2012. J Acad Nutr Diet. 2016;116(7):1101-13. https:// dx.doi.org/10.1016/j.jand.2015.12.012
Pereira, LM, Vieira, ALS, Horta PM, Santos LC. Fracionamento da dieta e o perfil nutricional e de saúde de mulheres. Rev Nutr. 2014;(1):15-23. https://doi.org/10.1590/1415-52732014000100002
Ministério da Saúde (Brasil). Contribuições dos Núcleos de Apoio à Saúde da Família para a Atenção Nutricional. Brasília: Ministério; 2017 [cited 2022 Mar 31]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/ contribuicoes_saude_familia_atencao_nutricional.pdf
Ministério da Saúde (Brasil). Núcleo Ampliado de Saúde da Família e Atenção Básica (NASF-AB) e Programa Previne Brasil. Brasília: Ministério; 2020 [cited 2022 May 16]. Available from: https://www.conasems.org.br/wp-content/ uploads/2020/01/NT-NASF-AB-e-Previne-Brasil-1.pdf
Louzada MLDC, Tramontt CR, Jesus JGL, Rauber G, Hochberg JRB, Santos TSS, et al. Developing a protocol based on the Brazilian Dietary Guidelines for individual dietary advice in the primary healthcare: theoretical and methodological bases. Fam Med Community Health. 2022;10:e001276. https://doi.org/10.1136/fmch-2021-001276
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Derechos de autor 2023 Giselle Mara Mendes Silva LEÃO, Lívia Castro CRIVELLENTI, Maria Fernanda Santos Figueiredo BRITO, Marise Fagundes SILVEIRA, Lucinéia de PINHO
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