Associação entre o consumo alimentar materno na gravidez de acordo com o grau de processamento e peso ao nascer segundo a idade gestacional e sexo
Palavras-chave:
Consumo alimentar, Dieta saudável, Recém-nascido, Alimentos ultraprocessadosResumo
Objetivo
Avaliar a associação da dieta materna de acordo com o grau de processamento dos alimentos e o peso ao nascer segundo a idade gestacional e sexo.
Métodos
Estudo transversal com 300 mulheres captadas entre os meses de fevereiro de 2009 e 2011. Utilizou-se a classificação do peso ao nascer segundo sexo e idade gestacional para caracterizar os desfechos: pequeno, adequado ou grande. O questionário de frequência alimentar estimou o consumo durante o 2º e 3º trimestres da gestação. Os alimentos foram classificados segundo o grau de processamento: 1) alimentos in natura ou minimamente processados e ingredientes culinários (óleos, gordura, sal e açúcar), 2) alimentos processados e 3) alimentos ultraprocessados. Os tercis de energia das categorias descritas acima foram distribuídos segundo o desfecho e as características maternas e do recém-nascido. Adotou-se a regressão logística multinomial para analisar a associação do consumo de alimentos segundo o grau de processamento sobre os desfechos do peso ao nascer segundo a idade gestacional e o sexo (pequeno, adequado ou grande).
Resultados
A análise do questionário de frequência do consumo alimentar das 300 mulheres indicou que a contribuição de alimentos in natura ou minimamente processados e ingredientes culinários foi de 54,0%, enquanto que os percentuais dos grupos de alimentos processados e ultraprocessados foram 2,0% e 44,0%, respectivamente. O maior tercil de alimentos in natura ou minimamente processados e ingredientes culinários obteve efeito protetor para a prevalência de recém-nascidos grandes para a idade gestacional e o sexo em relação ao menor tercil (OR: 0,13; IC 95%: 0,02;0,89; p=0,04).
Conclusão
O maior consumo de alimentos in natura ou minimamente processados e ingredientes culinários durante a gestação pode ser um fator de proteção contra a ocorrência de recém-nascidos grandes para a idade gestacional e o sexo quando comparado com mães classificadas no menor tercil de consumo.
Referências
World Health Organization. Promoting optimal fetal development: Report of a Technical Consultation. Switzerland: Organization; 2006.
Sparano S, Ahrens W, Henauw S, Marild S, Molnar D, Moreno LA, et al. Being macrosomic at birth is an independent predictor of overweight in children: results from the IDEFICS study. Matern Child Health J. 2013;17(8):1373-81.
Wang SF, Shu L, Sheng J, Mu M, Wang S, Tao XY, et al. Birth weight and risk of coronary heart disease in adults: a meta-analysis of prospective cohort studies. J Dev Orig Health Dis. 2014;5(6):408-19.
Downs DS. Obesity in special populations: pregnancy. Prim Care. 2016;43(1):109-20.
Villar J, Cheikh IL, Victora CG, Ohuma EO, Bertino E, Altman DG, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384(9946):857-68.
Harder T, Rodekamp E, Schellong K, Dudenhausen JW, Plagemann A. Birth weight and subsequent risk of type 2 diabetes: a meta-analysis. Am J Epidemiol. 2007;165(8):849-57.
Knudsen VK, Orozova-Bekkevold IM, Mikkelsen TB, Wolff S, Olsen SF. Major dietary patterns in pregnancy and fetal growth. Eur J Clin Nutr. 2008;62(4):463-70.
Malhotra N, Upadhyay RP, Bhilwar M, Choy N, Green T. The role of maternal diet and iron-folic acid supplements in influencing birth weight: evidence from India’s National Family Health Survey. J Trop Pediatr. 2014;60(6):454-60.
Okubo H, Miyake Y, Sasaki S, Tanaka K, Murakami K, Hirota Y, et al. Maternal dietary patterns in pregnancy and fetal growth in Japan: the Osaka Maternal and Child Health Study. Br J Nutr. 2012;107(10):1526-33.
Coelho NL, Cunha DB, Esteves AP, Lacerda EM, Theme-Filha MM, et al. Dietary patterns in pregnancy and birth weight. Rev Saude Publica. 2015;49:62.
Grandy M, Snowden JM, Boone-Heinonen J, Purnell JQ, Thornburg KL, Marshall NE. Poorer maternal diet quality and increased birth weight. J Matern Fetal Neonatal Med. 2018;31(12):1613-19.
Marchioni DM, Claro RM, Levy RB, Monteiro CA. Patterns of food acquisition in Brazilian households and associated factors: a population-based survey. Public Health Nutr. 2011;14(9):1586-92.
Monteiro CA, Levy RB, Claro RM, Castro IR, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica. 2010;26(11):2039-49.
Ministério da Sáude (Brasil). Guia alimentar para a população brasileira. 2nd ed. Brasília: Ministério; 2014.
Monteiro CA, Cannon G, Levy RB, Moubarac J, Louzada MLC, Rauber F, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutrition. 2019;22(5):936-41.
Monteiro CA, Cannon G, Moubarac J, Levy RB, Louzada MLC, Jaime PC. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutrition. 2018;21(1):5-17.
Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Alles B, Mejean C, et al. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Sante prospective cohort. BMJ. 2018;360:k322.
Rohatgi KW, Tinius RA, Cade WT, Steele EM, Cahill AG, Parra DC. Relationships between consumption of ultra-processed foods, gestational weight gain and neonatal outcomes in a sample of US pregnant women. Peer J. 2017;5:e4091.
Louzada ML, Baraldi LG, Steele EM, Martins AP, Canella DS, Moubarac J, et al. Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med. 2015;81:9-15.
Louzada ML, Martins AP, Canella DS, Baraldi LG, Levy RB, Claro RM, et al. Impact of ultra-processed foods on micronutrient content in the Brazilian diet. Rev Saude Publica. 2015;49:45.
Louzada MLC, Martins AP, Canella DS, Baraldi LG, Levy RB, Claro RM, et al. Ultra-processed foods and the nutritional dietary profile in Brazil. Rev Saude Publica. 2015;49:e38.
Melo B, Rezende L, Machado P, Gouveia N, Levy R. Associations of ultra-processed food and drink products with asthma and wheezing among Brazilian adolescents. Pediatr Allergy Immunol. 2018;29(5): 504-11.
Sartorelli DS, Crivellenti LC, Zuccolotto DCC, Franco LJ. Relationship between minimally and ultra-processed food intake during pregnancy with obesity and gestational diabetes mellitus. Cad Saude Publica. 2019;35(4):e00049318.
Melo ISV, Costa CACB, Santos JVL, Santos AF, Florencio TMMT, Bueno NB. Consumption of minimally processed food is inversely associated with excess weight in adolescents living in an underdeveloped city. Plos One. 2017;12(11):e0188401.
Nasreddine L, Tamim H, Itani L, Nasrallah MP, Isma’eel H, Nakhoul NF, et al. A minimally processed dietary pattern is associated with lower odds of metabolic syndrome among Lebanese adults. Public Health Nutr. 2018;21(1):160-71.
World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: Organization; 2000.
Institute of Medicine, National Research Council. Weight gain during pregnancy: reexamining the guidelines. Washington: National Academies Press; 2009. 868 p.
Sichieri R, Everhart JE. Validity of a Brazilian food frequency questionnaire against dietary recalls and estimated energy intake. Nutrition Research. 1998;18(10):1649-59.
Giacomello A, Schmidt MI, Nunes MAA, Duncan BB, Soares RM, Manzolli P, et al. Validação relativa de Questionário de Freqüência Alimentar em gestantes usuárias de serviços do Sistema Único de Saúde em dois municípios no Rio Grande do Sul, Brasil. Rev Bras Saude Mater Infant. 2008;8:445-54.
Pinheiro A, Lacerda E, Benzecry E, Gomes, M, Costa V. Tabela para avaliação de consumo alimentar em medidas caseiras. São Paulo: Atheneu; 2004.
Núcleo de Estudos e pesquisas em Alimentação. Tabela Brasileira de Composição de Alimentos. 4th ed. Campinas: NEPA; 2011.
Agricultural Research Service. USDA national nutrient database for standard reference, release. Version 10.31.12 [software]. 2011. [cited 2018 Oct. 23] Available from: http://www.ars.usda.gov/ba/bhnrc/ndl.
Alves-Santos NH, Eshriqui I, Franco-Sena AB, Cocate PG, Freitas-Vilela AA, Benaim C, et al. Dietary intake variations from pre-conception to gestational period according to the degree of industrial processing: a Brazilian cohort. Appetite. 2016;105:164-71.
Monteiro CA, Cannon G, Moubarac JC, Martins AP, Martins CA, Garzillo J, et al. Dietary guidelines to nourish humanity and the planet in the twenty-first century: a blueprint from Brazil. Public Health Nutr. 2015;18(13):2311-22.
Hoffmann JF, Nunes MA, Schmidt MI, Olinto MT, Melere C, Ozcariz SG, et al. Dietary patterns during pregnancy and the association with sociodemographic characteristics among women attending general practices in southern Brazil: the ECCAGe Study. Cad Saude Publica. 2013;29(5):970-80.
Nogueira MB, Mazzucchetti L, Mosquera PS, Cardoso MA, Malta MB. Consumption of ultra-processed foods during the first year of life and associated factors in Cruzeiro do Sul, Brazil. Cien Saude Colet. 2022;27(2):725-36.
Castro MBT, Souza RAG, Vilela AAF, Kac G. Association between sociodemographics factors and dietary patterns during pregnancy. Rev Nutr. 2014;27:173-81.
Fliss-Isakov N, Zelber-Sagi S, Ivancovsky-Wajcman D, Shibolet O, Kariv R. Ultra-processed food intake and smoking interact in relation with colorectal adenomas. Nutrients. 2020;12(11):3507.
Abubakari A, Jahn A. Maternal dietary patterns and practices and birth weight in northern ghana. Plos One, 2016;11(9):e0162285.
Starling AP, Sauder KA, Kaar JL, Shapiro AL, Siega-Riz AM, Dabelea D. Maternal dietary patterns during pregnancy are associated with newborn body composition. J Nutr. 2017;147(7):1334-39.
Barros DC, Pereira RA, Gama SG, Leal MC. Food consumption by pregnant adolescents in Rio de Janeiro, Brazil. Cad Saude Publica. 2004;20 Suppl 1:S121-9.
Sato AP, Fujimori E, Szarfarc SC, Borges AL, Tsunechiro MA. Food consumption and iron intake of pregnant and reproductive aged women. Rev Lat Am Enfermagem. 2010;18(2):247-54.
Santos Q, Sichieri R, Marchioni DM, Verly EJ. Brazilian pregnant and lactating women do not change their food intake to meet nutritional goals. BMC. 2014;14:186.
Stephenson J, Patel D, Barrett G, Howden B, Copas A, Ojukwu O, et al. How do women prepare for pregnancy? preconception experiences of women attending antenatal services and views of health professionals. Plos One. 2014;9(7):e103085.
Fardet A, Rock E, Bassama J, Bohuon P, Prabhasankar P, Monteiro C, et al. Current food classifications in epidemiological studies do not enable solid nutritional recommendations for preventing diet-related chronic diseases: the impact of food processing. Adv Nutr. 2015;6(6):629-38.
Monteiro CA, Cannon G, Lawrence M, Costa MLC, Pereira-Machado P. FAO: ultra-processed foods, diet quality, and health using the NOVA classification system. Rome: FAO; 2019.
Fardet A. Minimally processed foods are more satiating and less hyperglycemic than ultra-processed foods: a preliminary study with 98 ready-to-eat foods. Food Funct. 2016;7(5):2338-46.
Silva CA, Santos IDS, Shivappa N, Hebert JR, Crivellenti LC, Sartorelli D. The role of food processing in the inflammatory potential of diet during pregnancy. Rev Saude Publica. 2019;53113.
James WA, Baird P, Davis RH, Ferreri S, Knudtson M, Koraym A, et al. Health benefits of dietary fiber. Nutr Rev. 2009;67(4):188-205.
Dahl WJ, Stewart ML. Position of the Academy of Nutrition and Dietetics: health implications of dietary fiber. J Acad Nutr Diet. 2015;115(11):1861-70.
Gomes CB, Malta MB, Benicio MHD, Carvalhaes M. Consumption of ultra-processed foods in the third gestational trimester and increased weight gain: a Brazilian cohort study. Public Health Nutr. 2021;24(11):3304-12.
Gardner B, Croker H, Barr S, Briley A, Poston L, Wardle, J. Psychological predictors of dietary intentions in pregnancy. J Hum Nutr Diet. 2012;25(4):345-53.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Gracielle Gesteira ROCHA, Andreia ANDRADE-SILVA, Nadya Helena ALVES-SANTOS, Maria Beatriz Trindade de CASTRO
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
