Abstract
This study aimed to investigate the relationship between food intake (considering the nature, extent, and purpose of food processing) during pregnancy and overweight, obesity, and gestational diabetes mellitus conditions. This is a cross-sectional study conducted among 785 adult women in singleton pregnancies (between 24th and 39th weeks of gestation) in Brazil. Usual food intake was estimated by the Multiple Source Method, using two 24-hour dietary recalls. The food groups of interest in this study were the unprocessed or minimally processed foods and ultra-processed foods. The World Health Organization criteria for the diagnosis of gestational diabetes mellitus and the Atalah criteria for excess weight were used. Adjusted multinomial logistic regression models were used to assess the relationship between energy contribution (%E) from foods with overweight and obesity conditions and, adjusted logistic regression models for gestational diabetes mellitus. In total, 32.1% participants were overweight, 24.6% were obese, and 17.7% of women were diagnosed with gestational diabetes mellitus . After adjustments, an inverse association between the highest tertile of %E from the intake of unprocessed or minimally processed foods and obesity was found [0.49 (0.30-0.79)]. Moreover, a positive association between the highest tertile of %E from ultra-processed food intake [3.06 (1.27-3.37)] and obesity was observed. No association between food intake (considering the nature, extent, and purpose of food processing) during pregnancy and overweight or gestational diabetes mellitus was found. The findings suggest a role of food processing in obesity but not in gestational diabetes mellitus. Further research is warranted to provide robust evidence on the relationship between the role of processed foods in obesity and gestational diabetes mellitus.
Highlights
Maternal obesity and hyperglycemia during pregnancy are recognized risk factors for maternal and fetal morbidities, affecting the child’s susceptibility to diseases in adulthood [1,2,3]
Given the relevance of the identification of modifiable risk factors related to the genesis of obesity and gestational diabetes mellitus during pregnancy, and that studies that on the food intake of pregnant women considering the NOVA food classification system are scarce [16,23], this study aimed to investigate the relationship between food intake during pregnancy and overweight, obesity, and gestational diabetes mellitus conditions in pregnant women in Brazil
32.1% were overweight, 24.6% were obese, and 17.7% of women were diagnosed with gestational diabetes mellitus
Summary
Maternal obesity and hyperglycemia during pregnancy are recognized risk factors for maternal and fetal morbidities, affecting the child’s susceptibility to diseases in adulthood [1,2,3]. The identification of modifiable risk factors related to the genesis of such diseases during pregnancy is fundamental. Growing evidence suggests that a higher intake of ultra-processed foods is associated with higher risks of developing obesity [5,6,7,8,9], hypertension 10, cancer 11, and others chronic diseases [12,13]. Given this evidence, the Guia Alimentar para a População Brasileira 14 proposes to make unprocessed and minimally processed foods the diet bases
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