Food consumption according to the degree of processing, dietary diversity and socio-demographic factors among pregnant women in Rio de Janeiro, Brazil: The Rio Birth Cohort Study of Environmental Exposure and Childhood Development (PIPA project)

Abstract

Background: Relevant evidence has addressed the negative impact of food processing on health. However, maternal ultra-processed food consumption is poorly investigated. Aim: To analyze food consumption according to the degree of food processing, dietary diversity, and associated socio-demographic factors during pregnancy. Methods: Cross-sectional data was taken from a birth cohort in Rio de Janeiro, Brazil, with 142 pregnant women. We assessed diet using a qualitative food frequency questionnaire and classified food items according to the NOVA classification system as non-ultra-processed-foods and ultra-processed-foods. Non-ultra-processed-food and ultra-processed-food scores were calculated, reflecting weekly intake of more than one subgroup. Dietary diversity of the non-ultra-processed-food diet fraction was described according to the Food and Agriculture Organization guidelines. The association between food consumption and socio-demographic factors were investigated using logistic regression models. Results: Over 60% of the pregnant women reported consumption of at least three non-ultra-processed-food groups. However, only 25% had adequate dietary diversity. The level of education (Complete high school: odds ratio, 5.36; 95% confidence interval, 1.73–16.65) was associated with regular intake of “meat and eggs.” Among the ultra-processed-food score, 27% of the participants described a weekly consumption of at least two ultra-processed-food subgroups. White women (odds ratio, 2.63; 95% confidence interval, 1.05–6.63) had a higher chance of reporting “packaged ready meals” consumption. Conclusions: This study shows a high weekly consumption of ultra-processed-food subgroups and low dietary diversity of the non-ultra-processed-food fraction of the diet of pregnant women in Brazil. Our results elucidate the influence of socio-demographic characteristics on diet quality during pregnancy.

Exposure to ultra-processed foods during pregnancy and ultrasound fetal growth parameters

“…Taking these differences into account, our results suggest that the effect of maternal UPF consumption is sustained after the first trimester of pregnancy. Especially in a lower resource setting and considering previous data relating UPF consumption to socio-economic status in pregnant women (31,32) , it is important to notice that the present associations were independent of household wealth index and maternal schooling.…”

Development and Validation of a Protocol for Pregnant Women Based on the Brazilian Dietary Guidelines

“…This approach includes robust evidence on the rapport between healthy eating and positive health outcomes and between consumption of ultraprocessed foods and excessive weight gain during pregnancy, as well as postpartum weight retention, and other negative maternal and child health outcomes, such as development of maternal obesity, and higher birth weight in infants. 13 30 31 In this sense, the protocol, in addition to guaranteeing recommendations on healthy eating for pregnant women who are not at nutritional risk, also favors those who present some risk of excessive weight gain, allowing its use in the range of demands of individual care for pregnant women.…”

“…Recent data on the diet of Brazilian pregnant women show a high consumption of ultraprocessed foods and a low-quality diet, evidenced by the low consumption of fruits and vegetables, especially in pregnant teens, mulatto and black women, and smokers. [9][10][11][12][13] The monitoring carried out by health professionals during prenatal care is a good opportunity to provide pregnant women with adequate advice on nutrition. However, dietary advice in prenatal care does not always occur, and when it does occur, it is carried out inappropriately or limited in content, not always consistent with current dietary guidelines, insufficient to meet the health needs of pregnant women, in addition to occurring from a vertical relationship between professional and user, perpetuating the care discontinuity, and nonadherence to dietary advice.…”

“…Recent data on the diet of Brazilian pregnant women show a high consumption of ultraprocessed foods and a low-quality diet, evidenced by the low consumption of fruits and vegetables, especially in pregnant teens, mulatto and black women, and smokers. 9 10 11 12 13 …”

Consumo alimentar de gestantes de alto risco através de um índice de qualidade da dieta adaptado

“…Fonte: Autores. Estudo realizado no Sudeste do Brasil, em que foi avaliado o grau de processamento dos alimentos consumidos em período gestacional (Naspolini et al, 2020), revelou frequência elevada na ingestão de fast-food, comidas embaladas e embutidos, enquanto apenas 8% relatou uso regular dos alimentos in-natura e minimamente processados. Estes resultados corroboram com nossos achados, que evidenciaram correlação negativa entre a pontuação máxima do IQDAG e consumo de alimentos ultraprocessados.…”