Relationship between diet quality and biochemical profile in Brazilian overweight pregnant women.

OBJECTIVE: The aim of this study was to evaluate the relationship between the Adapted Diet Quality Index for Pregnant Women (IQDAG) and the biochemical profile of overweight pregnant adult women. METHODS: This was a cross-sectional study, using baseline data from a randomized controlled clinical trial conducted with 239 pregnant women in Brazil. The usual diet was obtained through two dietary recalls and the Multiple Source Method. Diet quality was assessed using the IQDAG, which has nine components: eight for adequacy and one for moderation. Fasting blood glucose, insulin, total cholesterol, low-density lipoprotein, high-density lipoprotein, triacylglycerols, and C-reactive protein were measured to evaluate the biochemical profile. Adjusted linear regression models were used to evaluate the association between the score of the IQDAG (and its components) and the biochemical profile. The significance level considered was P ≤ 0.05. RESULTS: The mean index score was 75.4 points. An inverse association was observed between the consumption of legumes and total cholesterol level (ß = -4.76; 95% confidence interval [CI], -9.16 to -0.35; P = 0.03) and low-density lipoprotein (ß = -4.13; 95% CI, -7.56 to -0.69; P = 0.02), and a direct association between calcium intake and total cholesterol (ß = 0.02; 95% CI, 0.002-0.41; P = 0.03). No other associations were observed between the investigated variables. CONCLUSIONS: The data from the present study suggest that higher consumption of legumes is associated with lower levels of total cholesterol and low-density lipoprotein. A higher intake of calcium was directly associated with total cholesterol . Further research is required to fully understand how diet quality affects pregnant women's biochemical profiles and what that means for the health of the mother and the fetus.

Effectiveness of a minimally processed food-based nutritional counselling intervention on weight gain in overweight pregnant women: a randomized controlled trial.

PURPOSE: This study aimed at evaluating the effectiveness of a nutritional counselling intervention based on encouraging the consumption of unprocessed and minimally processed foods, rather than ultra-processed products, and the practice of physical activities to prevent excessive gestational weight gain in overweight pregnant women. METHODS: This was a two-armed, parallel, randomized controlled trial conducted in primary health units of a Brazilian municipality from 2018 to 2021. Overweight, adult pregnant women (n = 350) were randomly assigned to control (CG) or intervention groups (IG). The intervention consisted of three individualized nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods rather than ultra-processed products, following the NOVA food classification system, and the practice of physical activities. The primary outcome was the proportion of women whose weekly gestational weight gain (GWG) exceeded the Institute of Medicine guidelines. Adjusted logistic regression models were employed. RESULTS: Complete data on weight gain were available for 121 women of the IG and 139 of the CG. In modified intention-to-treat analysis, there was a lower chance of the IG women having excessive GWG [OR 0.56 (95% CI 0.32, 0.98), p = .04], when compared to the CG. No between-group differences were observed for the other maternal outcomes investigated. CONCLUSION: The present study was unprecedented in demonstrating that nutritional counselling based on the NOVA food classification system, together with encouraging the practice of physical activity, is effective in preventing excessive weight gain in overweight pregnant women. TRIAL REGISTRATION: Registered on July 30th 2018 at Brazilian Registry of Clinical Trials (RBR-2w9bhc).

A better quality of maternal dietary fat reduces the chance of large-for-gestational-age infants: A prospective cohort study.

OBJECTIVES: We sought to investigate the relationship between the usual intake of fatty acids and indices of dietary fat quality in pregnant women and the birth-weight categories of their newborns. METHODS: This prospective cohort study was conducted with 734 mother-infant pairs in Brazil. Dietary intake was estimated through 24-h dietary recalls. Secondary data on birth weight, sex of the newborn, and pregnancy duration were obtained. The relationship of fatty acids and indices with birth-weight categories were investigated using logistic regression models adjusted for confounding factors. We considered P values < 0.05 significant. RESULTS: The median (interquartile range) maternal age was 27 (23-31) y; 46.2% of the pregnant women had pregestational body mass index ≥ 25 kg/m2, 18.1% had gestational diabetes mellitus, and 11.2% had hypertension. Regarding the newborns, 68 (9.3%) were classified as small for gestational age, 545 (74.2%) as appropriate size for gestational age, and 121 (16.5%) as large for gestational age. In adjusted logistic regression models, a lower chance of being large for gestational age was observed among the children of women classified in the third tertile (versus the first tertile) for intake of polyunsaturated fatty acids (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.31-0.89; P = 0.02), ω-3 fatty acids (OR, 0.48; 95% CI, 0.28-0.80; P = 0.005), and ω-6 fatty acids (OR, 0.56; 95% CI, 0.33-0.96; P = 0.04) and for ratios of polyunsaturated to saturated fatty acids (OR, 0.54; 95% CI, 0.32-0.92; P = 0.03) and hypocholesterolemic to hypercholesterolemic fatty acids (OR, 0.51; 95% CI, 0.30-0.87; P = 0.01). CONCLUSIONS: The data suggest that better-quality fat in the maternal diet can reduce the chance of a large-for-gestational-age newborn.