Relationship between pregestational nutritional status and type of processing of foods consumed by high-risk pregnant women

Fernandes, Débora Cardoso; Carreno, Ioná; Silva, André Anjos da; Guerra, Tais Battisti; Adami, Fernanda Scherer

doi:10.1590/1806-93042019000200006

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ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 19 (2) • Apr-Jun 2019 • https://doi.org/10.1590/1806-93042019000200006 copy

Relationship between pregestational nutritional status and type of processing of foods consumed by high-risk pregnant women

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

to relate pregestational nutritional status, maternal age and number of pregnancies to the distribution of macronutrients and micronutrients according to the type of processing offoods consumed by high-risk pregnant women.

Methods:

a retrospective cross-sectional study was carried out with data from medical records of 200 pregnant women served by a public outpatient clinic in Rio Grande do Sul from 2014 to 2016.

Results:

the mean percentages of lipids, monounsaturated fatty acids, polyunsaturated fatty acids and sodium intake were higher among ultra-processed foods. There was a significant inverse correlation between maternal age and total calorie intake (p=0.003) and percentage of carbohydrates (p=0.005) and proteins (p=0.037) from ultra-processed foods. There was also a significant association between pregestational nutritional status and total calorie intake (p=0.018) and percentage of carbohydrates (p=0.048) from ultra-processed foods.

Conclusions:

the mean percentages of lipids, monounsaturated fatty acids, polyunsaturated fatty acids and sodium intake were higher among ultra-processed foods. It was observed that the older the maternal age of high-risk pregnant women, the lower the intake of total calories and percentages of carbohydrates and proteins from ultra-processed foods. It was also observed that pregestational nutritional status was significantly associated with the intake of total calories and percentage of carbohydrates from ultra-processed foods.

Key words
Pregnancy high-risk; Maternal health; Feeding behavior

Variables	n	Minimum	Maximum	X̄ ± SD
Total Kcal natural/minimally processed	200	35.01	2045.68	789.22 ± 378.27
Total Kcal processed	200	0.00	2643.81	246.03 ± 291.98
Total Kcal ultra-processed	200	0.00	3153.70	636.60 ± 557.40
% total CHO natural/minimally processed	200	3.45	100.00	50.47 ± 23.43
% total CHO processed	200	0.00	77.34	16.32 ± 15.55
% total CHO ultra-processed	200	0.00	96.55	33.21 ± 25.26
% total PTN natural/minimally processed	200	0.00	100.00	63.74 ± 27.52
% total PTN processed	200	0.00	74.81	11.82 ± 15.14
% total PTN ultra-processed	200	0.00	97.23	24.44 ± 24.47
% total LIP natural/minimally processed	200	0.00	100.00	38.21 ± 26.41
% total LIP processed	200	0.00	75.29	12.44 ± 15.34
% total LIP ultra-processed	200	0.00	99.63	49.35 ± 28.26
% total MUFA natural/minimallyprocessed	200	0.00	100.00	42.92 ± 31.91
% total MUFA processed	200	0.00	100.00	11.61 ± 18.10
% total MUFA ultra-processed	200	0.00	100.00	45.46 ± 32.26
% total PUFA natural/minimally processed	200	0.00	100.00	30.54 ± 31.86
% total PUFA processed	200	0.00	100.00	15.55 ± 21.75
% total PUFA ultra-processed	200	0.00	100.00	53.91 ± 35.87
% total SFA natural/minimally processed	200	0.00	100.00	45.10 ± 29.08
% total SFA processed	200	0.00	98.04	12.29 ± 17.33
% total SFA total ultra-processed	200	0.00	100.00	42.61 ± 28.90
% total sodium natural/minimally processed	200	0.00	100.00	22.48 ± 25.68
% total sodium processed	200	0.00	92.96	29.09 ± 27.33
% total sodium ultra-processed	200	0.00	99.89	48.43 ± 31.72

Variables	Number of Pregnancies		Age (years)		Pregestational BMI (kg/m²)
Variables	r	p	r	p	r	p
Total Kcal natural/minimally processed	-0.069	0.338	0.017	0.808	-0.110	0.124
Total Kcal processed	-0.119	0.096	-0.019	0.792	-0.057	0.424
Total Kcal ultra-processed	-0.057	0.430	-0.211	0.003	0.039	0.586
% total CHO natural/minimally processed	0.059	0.411	0.177	0.013	-0.047	0.510
% total CHO processed	-0.120	0.093	0.053	0.458	-0.011	0.876
% total CHO ultra-processed	0.018	0.798	- 0.198	0.005	0.051	0.480
% total PTN natural/minimally processed	0.021	0.770	0.084	0.242	-0.095	0.181
% total PTN processed	-0.081	0.257	0.089	0.214	0.111	0.120
% total PTN ultra-processed	0.027	0.711	-0.149	0.037	0.040	0.574
% total LIP natural/minimally processed	0.020	0.776	0.103	0.149	-0.111	0.118
% total LIP processed	-0.025	0.726	0.068	0.344	0.091	0.203
% total LIP ultra-processed	-0.005	0.939	-0.133	0.063	0.055	0.442
% total MUFA natural/minimally processed	-0.001	0.986	0.051	0.480	-0.120	0.093
% total MUFA processed	-0.037	0.605	0.081	0.259	0.126	0.076
% total MUFA ultra-processed	0.022	0.758	-0.095	0.183	0.048	0.499
% total PUFA natural/minimally processed	0.025	0.731	0.074	0.303	-0.121	0.089
% total PUFA processed	-0.049	0.496	0.076	0.287	0.087	0.223
% total PUFA ultra-processed	0.008	0.914	-0.111	0.119	0.055	0.444
% total SFA natural/minimally processed	-0.010	0.885	0.004	0.952	-0.129	0.069
% total SFA processed	-0.065	0.365	0.096	0.181	0.113	0.114
% total SFA total ultra-processed	0.049	0.491	-0.062	0.387	0.064	0.374
% total sodium natural/minimally processed	-0.015	0.832	0.048	0.503	-0.052	0.466
% total sodium processed	-0.118	0.099	0.061	0.393	-0.040	0.577
% total sodium ultra-processed	0.114	0.111	-0.092	0.199	0.076	0.284

Variables	BMI	n	X̄ ± SD	p
Total Kcal ultra-processed	Malnutrition	6	813.50AB ± 845.61	0.018
	Normal weight	36	715.75B ± 501.80
	Overweight	52	492.10A ± 481.62
	Class I Obesity	42	679.99AB ± 517.07
	Class II Obesity	29	457.13A ± 346.46
	Class III Obesity	33	874.19B ± 760.56
% total CHO natural/minimally processed	Malnutrition	6	46.87 ± 26.43	0.102
	Normal weight	36	47.64 ± 23.42
	Overweight	52	54.60 ± 23.94
	Class I Obesity	42	48.37 ± 22.40
	Class II Obesity	29	58.43 ± 23.89
	Class III Obesity	33	42.74 ± 20.92
% total CHO processed	Malnutrition	6	17.10 ± 10.52	0.997
	Normal weight	36	17.15 ± 18.04
	Overweight	52	16.55 ± 16.20
	Class I Obesity	42	15.09 ± 13.63
	Class II Obesity	29	16.99 ± 17.55
	Class III Obesity	33	15.05 ± 13.04
% total CHO ultra-processed	Malnutrition	6	36.03^AB ± 28.93	0.048
	Normal weight	36	35.21AB ± 24.46
	Overweight	52	28.85A ± 27.56
	Class I Obesity	42	36.53^AB ± 23.86
	Class II Obesity	29	24.58A ± 18.40
	Class III Obesity	33	42.21B ± 26.52
% total PTN natural/minimally processed	Malnutrition	6	65.16AB ± 31.56	0.021
	Normal weight	36	57.56AB ± 30.49
	Overweight	52	70.33A ± 24.98
	Class I Obesity	42	65.33A ± 25.76
	Class II Obesity	29	71.80A ± 23.37
	Class III Obesity	33	51.38B ± 28.00
% total PTN processed	Malnutrition	6	9.02 ± 5.02	0.914
	Normal weight	36	13.25 ± 17.01
	Overweight	52	10.42 ± 11.61
	Class I Obesity	42	9.12 ± 9.60
	Class II Obesity	29	9.79 ± 12.71
	Class III Obesity	33	16.60 ± 22.09
% total PTN ultra-processed	Malnutrition	6	25.83^AB ± 29.59	0.024
	Normal weight	36	29.19A ± 27.21
	Overweight	52	19.24B ± 24.56
	Class I Obesity	42	25.55A ± 22.58
	Class II Obesity	29	18.41B ± 18.03
	Class III Obesity	33	32.03A ± 26.35

Varibles	BMI	n	X ± SD	p
% total LIP natural/minimally processed	Malnutrition	6	44.40 ± 35.93	0.080
	Normal weight	36	35.87 ± 25.15
	Overweight	52	42.72 ± 26.16
	Class I Obesity	42	39.37± 27.06
	Class II Obesity	29	43.31 ± 24.45
	Class III Obesity	33	27.20±25.47
% total LIP processed	Malnutrition	6	12.04±14.18	0.729
	Normal weight	36	11.03±15.48
	Overweight	52	13.78±14.33
	Class I Obesity	42	10.61 ±12.51
	Class II Obesity	29	9.28±12.72
	Class III Obesity	33	16.01±20.57
% total LIPultra-processed	Malnutrition	6	43.56±35.33	0.405
	Normal weight	36	53.10±27.89
	Overweight	52	43.50±29.17
	Class I Obesity	42	50.02±28.77
	Class II Obesity	29	47.41±26.51
	Class III Obesity	33	56.78±27.32
% total MUFA natural/minimally processed	Malnutrition	6	60.91AB±41.42	0.040
	Normal weight	36	37.32ab±31.02
	Overweight	52	48.13ab±29.74
	Class I Obesity	42	43.85^AB±32.57
	Class II Obesity	29	51.03A±31.81
	Class III Obesity	33	30.26^B±30.55
% total MUFA processed	Malnutrition	6	12.49±15.87	0.742
	Normal weight	36	10.52±17.68
	Overweight	52	11.47±14.73
	Class I Obesity	42	9.19±13.93
	Class II Obesity	29	7.72±11.68
	Class III Obesity	33	18.02±28.45
% total MUFAultra-processed	Malnutrition	6	26.61±31.90	0.207
	Normal weight	36	52.16±30.83
	Overweight	52	40.41±32.23
	Class I Obesity	42	46.96±31.81
	Class II Obesity	29	41.25±31.05
	Class III Obesity	33	51.72±35.48
% total PUFA natural/minimally processed	Malnutrition	6	53.65±41.51	0.218
	Normal weight	36	26.47±32.14
	Overweight	52	33.62±31.34
	Class I Obesity	42	32.98±33.06
	Class II Obesity	29	33.89±34.16
	Class III Obesity	33	20.90±25.55
% total PUFA processed	Malnutrition	6	14.06±12.05	0.838
	Normal weight	36	14.59±18.62
	Overweight	52	17.92±24.48
	Class I Obesity	42	12.80±18.86
	Class II Obesity	29	11.17±18.06
	Class III Obesity	33	20.50±27.90
% total PUFA ultra-processed	Malnutrition	6	32.29 ± 41.83	0.414
	Normal weight	36	58.93 ± 33.45
	Overweight	52	48.45 ± 36.12
	Class I Obesity	42	54.22 ± 35.51
	Class II Obesity	29	54.94 ± 36.14
	Class III Obesity	33	58.59 ± 38.18
% total SFA natural/minimally processed	Malnutrition	6	54.87^AB ± 39.23	0.034
	Normal weight	36	42.60AB ± 28.99
	Overweight	52	48.24AB ± 27.83
	Class I Obesity	42	46.75^AB ± 28.55
	Class II Obesity	29	54.63A ± 26.15
	Class III Obesity	33	31.25B ± 28.56
% total SFA processed	Malnutrition	6	16.41 ± 17.97	0.777
	Normal weight	36	9.96 ± 13.42
	Overweight	52	12.47 ± 15.00
	Class I Obesity	42	9.70 ± 13.38
	Class II Obesity	29	9.48 ± 12.31
	Class III Obesity	33	18.13 ± 27.21
% total SFA ultra-processed	Malnutrition	6	28.72 ± 38.44	0.213
	Normal weight	36	47.44 ± 28.41
	Overweight	52	39.29 ± 30.09
	Class I Obesity	42	43.55 ± 26.40
	Class II Obesity	29	35.88 ± 25.18
	Class III Obesity	33	50.62 ± 31.47

Variables	BMI	n	X̄ ± SD	p
% total sodium natural/minimally processed	Malnutrition	6	18.53^AB ± 19.93	0.050
	Normal weight	36	17.99^AB ± 20.18
	Overweight	52	25.17^A ± 27.34
	Class I Obesity	42	25.95^A ± 26.53
	Class II Obesity	29	28.85^A ± 30.12
	Class III Obesity	33	14.52^B ± 23.14
% total sodium processed	Malnutrition	6	28.26 ± 22.54	0.787
	Normal weight	36	28.73 ± 26.31
	Overweight	52	33.88 ± 29.56
	Class I Obesity	42	24.02 ± 23.43
	Class II Obesity	29	26.83 ± 27.14
	Class III Obesity	33	27.57 ± 28.85
% total sodium ultra-processed	Malnutrition	6	53.22 ± 41.89	0.228
	Normal weight	36	53.28 ± 28.23
	Overweight	52	40.96 ± 33.89
	Class I Obesity	42	50.03 ± 30.05
	Class II Obesity	29	44.33 ± 31.73
	Class III Obesity	33	57.91 ± 30.39

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[1] Author's contribuition

Fernandes DC was responsible for the conception of the study, the selection of the articles to be included within the manuscript, for the organization, data interpretation and for the writing of the article. Carreno I e Silva AA contributed with the final revision of the manuscript. Guerra TB helped with the typing of the database. Adami FS contributed with the conception of the study, data interpretation, revision of the writing and was responsible by the exchange of correspondence. All authors approved the final version of the manuscript.