Early pregnancy body mass index modifies the association of pre‐pregnancy dietary patterns with serum polyunsaturated fatty acid concentrations throughout pregnancy in Brazilian women

Abstract

Dietary patterns (DPs) have been described as an important factor that may influence polyunsaturated fatty acid (PUFA) concentrations and body mass index (BMI) during pregnancy. We aim to evaluate the association between pre-pregnancy DPs and serum PUFA percentages throughout pregnancy considering early pregnancy BMI as a possible effect modifier. A prospective cohort of 154 pregnant women was followed (5th-13th, 20th-26th, and 30th-36th gestational weeks). Serum PUFA concentrations (total n-3 and total n-6, eicosapentaenoic + docosahexaenoic acids) were measured in each trimester and expressed as percentages. The n-6/n-3 ratio was calculated. Longitudinal linear mixed-effects models including interaction terms between DPs and early pregnancy BMI were employed. Serum PUFA percentages declined, whereas the n-6/n-3 ratio, monounsaturated, and saturated percentages increased throughout pregnancy for all BMI categories. Three pre-pregnancy DPs were identified by principal component analysis (common Brazilian, healthy, and processed). Overweight women with higher adherence to the common-Brazilian and to the healthy DPs presented reduced n-3 PUFA percentage and increased n-6 percentages and n-6/n-3 ratio compared to under or normal weight women. Obese women with higher adherence to the processed DP presented a more pronounced decrease of total n-3 percentage compared to under or normal weight women. Early pregnancy BMI modified the effect of pre-pregnancy DPs on PUFA profile throughout gestation. Higher adherence to the healthy pattern was associated with increased n-3 percentage, except for overweight women. Only for processed DP was the behaviour of PUFA the same for all BMI categories, showing a worse evolution profile, that is, increased n-6 and reduced n-3 fractions.

Dietary Determinants of Polyunsaturated Fatty Acid (PUFA) Status in a High Fish-Eating Cohort during Pregnancy

“…A limited number of such studies during pregnancy are reported. In a cohort of 154 women, Benaim et al [ 27 ] found that pre-pregnancy dietary patterns, as assessed by an FFQ six months prior to gestation, loading high for “healthy” foods were associated with increased n -3 fatty acid status during pregnancy. This “healthy” dietary pattern included foods such as vegetables, fruits, fruit juices, fish and dairy products.…”

“…This finding is consistent with the results of the current study as we concluded a dietary pattern loading high for fish and fruit was associated with increased DHA and total n -3 PUFA concentrations. It has been suggested that in a varied diet, foods not regarded to be a rich source of a certain nutrient may increase nutrient bioavailability, with nutrients interacting to increase or decrease bioavailability of one another, alluding to a food matrix effect [ 27 , 31 ]. They found that dietary patterns containing foods that do not have a significant PUFA content such as cabbages, root vegetables, coffee and tea were associated with increased plasma and red blood cell n -3 PUFA.…”

“…Dietary patterns reflect combinations of foods eaten together. Previous research has demonstrated that dietary patterns are associated with biomarkers for vitamin B12, folate [ 26 ], and PUFA [ 27 ]. The use of dietary pattern analysis allows dietary habits to be identified, giving an insight into the entire diet, rather than only single foods [ 2 , 28 , 29 , 30 ].…”

“…The use of dietary pattern analysis allows dietary habits to be identified, giving an insight into the entire diet, rather than only single foods [ 2 , 28 , 29 , 30 ]. Recent studies suggest that foods not considered to be a source of PUFA, such as vegetables, fruits and fruit juice, dairy products and tea, were associated with PUFA status, highlighting that the food matrix effect may influence PUFA status [ 27 , 31 ]. Although this could be a chance finding, this research suggests that PUFA status may be influenced by interactions between constituents of these food items.…”

Maternal obesity and developmental programming of neuropsychiatric disorders: An inflammatory hypothesis

“…MHFD models rely on diets usually enriched in SFAs with a high n-6/n-3 PUFA ratio, reflecting the Western diet. Indeed, obese pregnant women consistently have an elevated n-6/n-3 PUFA ratio ( Benaim et al, 2018 ; Vidakovic et al, 2015 ). Interestingly, a study in Hawaiian pregnant women, whose fish consumption is likely higher than in the typical Western diet, showed that obese women had higher n-3 PUFA levels than obese women from Ohio, albeit lower than their lean counterparts ( Alvarado et al, 2018 ).…”