PDF herunterladen
CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(07): 380-389
DOI: 10.1055/s-0040-1712996
Original Article
Obstetrics
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Maternal and Sociodemographic Factors Influence the Consumption of Ultraprocessed and Minimally-Processed Foods in Pregnant Women

Fatores maternos e sociodemográficos influenciam o consumo de alimentos ultraprocessados e minimamente processados em gestantes
Monique Tavares Pereira 
1   Graduate Program in Nutrition and Health, Department of Integrated Health Education, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
,
Monica Cattafesta 
2   Graduate Program in Collective Health, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
,
Edson Theodoro dos Santos Neto 
2   Graduate Program in Collective Health, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
,
Luciane Bresciani Salaroli 
1   Graduate Program in Nutrition and Health, Department of Integrated Health Education, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
2   Graduate Program in Collective Health, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

22. Dezember 2019

23. April 2020

Publikationsdatum:
19. Juni 2020 (online)

   Lizenzen und Reprints

Abstract

Objective To analyze the consumption of minimally-processed and ultraprocessed foods in relation with sociodemographic variables, maternal habits, educational activity received during prenatal care and clinical history.

Methods A cross-sectional, analytical and descriptive study with 1,035 pregnant women who lives in the municipalities of the metropolitan region of Grande Vitória, Espírito Santo, Brazil (RMGV-ES), and who were hospitalized in establishments of the Unified Health System (SUS) due to childbirth (April–September 2010). The food frequency questionnaire, pregnant woman's card and information from the medical records of the health facility unit were analyzed. The Chi-square test and the binary logistic regression model were used to investigate the association between the independent variables and the consumption of ultraprocessed foods.

Results It was identified that pregnant women ≤19 years of age were 2.9 times more likely to consume ultraprocessed foods (confidence interval [CI] 95% 1.683–5.168, p < 0.001), while those ≥35 years old were less likely to consume them (odds ratio [OR] 0.265, 95% CI 0.105–0.666, p = 0.005). Maternal smoking increased the odds of consumption of ultraprocessed foods by 2.2 times (95% CI 1.202–4.199, p = 0.011) and pregnant women who did not obtain information on healthy food during prenatal care presented 54.1% less chances of consuming minimally-processed foods (OR 0.459, 95% CI 0.307–0.687, p < 0.001).

Conclusion Smoking during the gestational period and being a teenager are factors that influence the consumption of ultraprocessed foods of pregnant women. Race/color, head of household, age group, receiving of information about feeding in the prenatal period and not having smoked in gestation determined the consumption of minimally-processed foods.

Resumo

Objetivo Analisar o consumo de alimentos minimamente processados e ultraprocessados e a sua associação com variáveis sociodemográficas, hábitos maternos, atividade educacional recebida durante o pré-natal e histórico clínico.

Métodos Estudo transversal, analítico e descritivo com 1.035 gestantes que moram nos municípios da Região Metropolitana da Grande Vitória, Espírito Santo, Brasil (RMGV-ES), e que foram internadas em estabelecimentos do Sistema Único de Saúde (SUS) devido ao parto (abril–setembro de 2010). Foram analisados o questionário de frequência alimentar, o cartão da gestante e as informações dos prontuários da unidade de saúde. O teste do Qui-quadrado e o modelo de regressão logística binária foram utilizados para investigar a associação entre as variáveis independentes e o hábito alimentar.

Resultados Identificou-se que as gestantes com idade ≤19 anos tinham 2,9 vezes mais chances de consumirem alimentos ultraprocessados (intervalo de confiança [IC] 95% 1,683–5,168; p < 0,001), enquanto aquelas com ≥ 35 anos tinham menos chances de consumí-los (razão de chances [RC] 0,265; IC 95% 0,105–0,666; p = 0,005). O tabagismo materno aumentou as chances de consumo de alimentos ultraprocessados em 2,2 vezes (IC95% 1,202–4,199; p = 0,011) e as gestantes que não receberam orientações sobre alimentação saudável durante o pré-natal apresentaram 54,1% menos chances de consumirem alimentos minimamente processados (RC 0,459; IC95% 0,307–0,687; p < 0,001).

Conclusão Fumar durante o período gestacional e ser adolescente são fatores que influenciam o consumo de alimentos ultraprocessados em gestantes. Raça/cor, chefe da família, faixa etária, recebimento de informações sobre alimentação no pré-natal e não fumar na gestação determinaram o consumo de minimamente processados.

Keywords

feeding behavior - dietary habits - ultraprocessed foods - pregnant - maternal nutrition

Palavras-chave

comportamento alimentar - hábitos alimentares - alimentos ultraprocessados - gestante - nutrição materna

Contributors

Pereira M. T. contributed to conceptualization, data curation, formal analysis, investigation, methodology, resources, visualization, writing-original draft and writing-review & editing. Cattafesta M. contributed to conceptualization, data curation, formal analysis, investigation, methodology, resources, supervision, validation, visualization, writing-original draft and writing-review & editing. Santos Neto E. T. contributed to conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, resources, supervision, validation, visualization, writing-original draft and writing-review & editing. Salaroli L. B. contributed to conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, supervision, validation, visualization, writing-original draft and writing-review & editing.


 

  • References

  • 1 Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica [Internet]. [Food guide for the Brazilian population]. 2nd ed. Brasília (DF): Ministério da Saúde; 2014. [cited 2018 Mar 20]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/guia_alimentar_populacao_brasileira_2ed.pdf
    Google Scholar
  • 2 Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 2012; 70 (01) 3-21 . Doi: 10.1111/j.1753-4887.2011.00456.x
    CrossrefPubMedGoogle Scholar
  • 3 Monteiro CA, Cannon G, Levy RB, Moubarac JC, Jaime P, Martins AP. , et al. NOVA. The star shines bright. World Nutr. 2016; 7 (1–3): 28-38
    PubMedGoogle Scholar
  • 4 Monteiro CA, Levy RB, Claro RM, Castro IRR, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica 2010; 26 (11) 2039-2049 . Doi: 10.1590/S0102-311X2010001100005
    CrossrefPubMedGoogle Scholar
  • 5 Martins AP, Levy RB, Claro RM, Moubarac JC, Monteiro CA. Increased contribution of ultra-processed food products in the Brazilian diet (1987-2009). Rev Saude Publica 2013; 47 (04) 656-665 . Doi: 10.1590/S0034-8910.2013047004968
    CrossrefPubMedGoogle Scholar
  • 6 Devine CM, Bove CF, Olson CM. Continuity and change in women's weight orientations and lifestyle practices through pregnancy and the postpartum period: the influence of life course trajectories and transitional events. Soc Sci Med 2000; 50 (04) 567-582 . Doi: 10.1016/s0277-9536(99)00314-7
    CrossrefPubMedGoogle Scholar
  • 7 Padmanabhan U, Summerbell CD, Heslehurst N. A qualitative study exploring pregnant women's weight-related attitudes and beliefs in UK: the BLOOM study. BMC Pregnancy Childbirth 2015; 15: 99 . Doi: 10.1186/s12884-015-0522-3
    CrossrefPubMedGoogle Scholar
  • 8 Santos Neto ET, Oliveira AE, Zandonade E, Gama SGN, Leal MdoC. [Prenatal patient cards and quality of prenatal care in public health services in Greater Metropolitan Vitória, Espírito Santo State, Brazil]. Cad Saude Publica 2012; 28 (09) 1650-1662 . Doi: 10.1590/S0102-311X2012000900005
    CrossrefPubMedGoogle Scholar
  • 9 Associação Brasileira de Empresas de Pesquisa. [Economic Classification Criteria Brazil] [Internet]. 2003 [cited 2018 Jan 11]. Available from: http://www.abep.org/criterio-brasil
    PubMed
  • 10 Ministério da Saúde. Secretaria de Vigilância em Saúde. Secretaria de Gestão Estratégica e Participativa [Internet]. [Vigitel Brazil 2009: surveillance of risk and protective factors for chronic diseases by telephone survey]. Brasília (DF): Ministério da Saúde; 2010. [cited 2020 Mar 10]. Available from: http://189.28.128.100/dab/docs/publicacoes/geral/publicacao_vigitel_2009.pdf
    Google Scholar
  • 11 Cade J, Thompson R, Burley V, Warm D. Development, validation and utilisation of food-frequency questionnaires - a review. Public Health Nutr 2002; 5 (04) 567-587 . Doi: 10.1079/PHN2001318
    CrossrefPubMedGoogle Scholar
  • 12 Alves-Santos NH, Eshriqui I, Franco-Sena AB, Cocate PG, Freitas-Vilela AA, Benaim C. , et al. Dietary intake variations from pre-conception to gestational period according to the degree of industrial processing: A Brazilian cohort. Appetite 2016; 105: 164-171 . Doi: 10.1016/j.appet.2016.05.027
    CrossrefPubMedGoogle Scholar
  • 13 McGowan CA, McAuliffe FM. Maternal dietary patterns and associated nutrient intakes during each trimester of pregnancy. Public Health Nutr 2013; 16 (01) 97-107 . Doi: 10.1017/S1368980012000997
    CrossrefPubMedGoogle Scholar
  • 14 Instituto Brasileiro de Geografia e Estatística [Internet]. [Family budget survey 2008–2009: analysis of personal food consumption in Brazil]. Rio de Janeiro: IBGE; 2011. [cited 2018 Jun 13]. Available from: https://biblioteca.ibge.gov.br/visualizacao/livros/liv50063.pdf
    Google Scholar
  • 15 Barros DC, Pereira RA, Gama SGN, Leal MdoC. [Food consumption by pregnant adolescents in Rio de Janeiro, Brazil]. Cad Saude Publica 2004; 20 (Suppl. 01) S121-S129 . Doi: 10.1590/S0102-311X2004000700013
    CrossrefPubMedGoogle Scholar
  • 16 Chen YC, Huang YC, Lo YC, Wu HJ, Wahlqvist ML, Lee MS. Secular trend towards ultra-processed food consumption and expenditure compromises dietary quality among Taiwanese adolescents. Food Nutr Res 2018; 62: 1565 . Doi: 10.29219/fnr.v62.1565
    PubMedGoogle Scholar
  • 17 Roelands J, Jamison MG, Lyerly AD, James AH. Consequences of smoking during pregnancy on maternal health. J Womens Health (Larchmt) 2009; 18 (06) 867-872 . Doi: 10.1089/jwh.2008.1024
    CrossrefPubMedGoogle Scholar
  • 18 Freire K, Padilha PdeC, Saunders C. [Factors associated to alcohol and smoking use in pregnancy]. Rev Bras Ginecol Obstet 2009; 31 (07) 335-341 . Doi: 10.1590/S0100-72032009000700003
    PubMedGoogle Scholar
  • 19 Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S. , et al. Prevalence of gestational diabetes mellitus and its risk factors in Chinese pregnant women: a prospective population-based study in Tianjin, China. PLoS One 2015; 10 (03) e0121029 . Doi: 10.1371/journal.pone.0121029
    CrossrefPubMedGoogle Scholar
  • 20 Lanting CI, Buitendijk SE, Crone MR, Segaar D, Bennebroek Gravenhorst J, van Wouwe JP. Clustering of socioeconomic, behavioural, and neonatal risk factors for infant health in pregnant smokers. PLoS One 2009; 4 (12) e8363 . Doi: 10.1371/journal.pone.0008363
    CrossrefPubMedGoogle Scholar
  • 21 Kyrklund-Blomberg NB, Granath F, Cnattingius S. Maternal smoking and causes of very preterm birth. Acta Obstet Gynecol Scand 2005; 84 (06) 572-577 . Doi: 10.1111/j.0001-6349.2005.00848.x
    CrossrefPubMedGoogle Scholar
  • 22 Beyerlein A, Rückinger S, Toschke AM, Schaffrath Rosario A, von Kries R. Is low birth weight in the causal pathway of the association between maternal smoking in pregnancy and higher BMI in the offspring?. Eur J Epidemiol 2011; 26 (05) 413-420 . Doi: 10.1007/s10654-011-9560-y
    CrossrefPubMedGoogle Scholar
  • 23 Hackshaw A, Rodeck C, Boniface S. Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update 2011; 17 (05) 589-604 . Doi: 10.1093/humupd/dmr022
    CrossrefPubMedGoogle Scholar
  • 24 Haug K, Irgens LM, Skjaerven R, Markestad T, Baste V, Schreuder P. Maternal smoking and birthweight: effect modification of period, maternal age and paternal smoking. Acta Obstet Gynecol Scand 2000; 79 (06) 485-489 . Doi: 10.1034/j.1600-0412.2000.079006485.x
    CrossrefPubMedGoogle Scholar
  • 25 Suzuki K, Sato M, Zheng W, Shinohara R, Yokomichi H, Yamagata Z. Effect of maternal smoking cessation before and during early pregnancy on fetal and childhood growth. J Epidemiol 2014; 24 (01) 60-66 . Doi: 10.2188/jea.JE20130083
    CrossrefPubMedGoogle Scholar
  • 26 Rogers JM. Tobacco and pregnancy. Reprod Toxicol 2009; 28 (02) 152-160 . Doi: 10.1016/j.reprotox.2009.03.012
    CrossrefPubMedGoogle Scholar
  • 27 Vardavas CI, Chatzi L, Patelarou E, Plana E, Sarri K, Kafatos A. , et al. Smoking and smoking cessation during early pregnancy and its effect on adverse pregnancy outcomes and fetal growth. Eur J Pediatr 2010; 169 (06) 741-748 . Doi: 10.1007/s00431-009-1107-9
    CrossrefPubMedGoogle Scholar
  • 28 Gennaro S, Biesecker B, Fantasia HC, Nguyen M, Garry D. Nutrition profiles of African [corrected] American women in the third trimester. MCN Am J Matern Child Nurs 2011; 36 (02) 120-126 . Doi: 10.1097/NMC.0b013e3182057a13
    CrossrefPubMedGoogle Scholar
  • 29 Pinto RMF, Micheletti FABO, Bernardes LM, Fernandes JMPA, Monteiro GV, Silva MLN. , et al. [Female condition of female heads of households in situations of social vulnerability]. Serv Soc Soc 2011; (105) 167-179 . Doi: 10.1590/S0101-66282011000100010
    PubMedGoogle Scholar
  • 30 Ministério da Saúde [Internet]. [Pregnant woman's notebook]. 3rd ed. Brasília (DF): Ministério da Saúde; 2016. [cited 2018 Sep 27]. Available from: https://www.mds.gov.br/webarquivos/arquivo/crianca_feliz/Treinamento_Multiplicadores_Coordenadores/Caderneta-Gest-Internet(1).pdf
    Google Scholar
  • 31 Tomasi E, Fernandes PA, Fischer T, Siqueira FC, Silveira DS, Thumé E. , et al. [Quality of prenatal services in primary healthcare in Brazil: indicators and social inequalities]. Cad Saude Publica 2017; 33 (03) e00195815 . Doi: 10.1590/0102-311X00195815
    PubMedGoogle Scholar
  • 32 Rios CTF, Vieira NFC. [Educational action in prenatal care: a reflection on nursing consultation as an opportunity for health education]. Cien Saude Colet 2007; 12 (02) 477-486 . Doi: 10.1590/S1413-81232007000200024
    CrossrefPubMedGoogle Scholar
  • 33 Verbeke W, De Bourdeaudhuij I. Dietary behaviour of pregnant versus non-pregnant women. Appetite 2007; 48 (01) 78-86 . Doi: 10.1016/j.appet.2006.07.078
    CrossrefPubMedGoogle Scholar
  • 34 Moubarac JC, Martins AP, Claro RM, Levy RB, Cannon G, Monteiro CA. ; Evidence from Canada. Consumption of ultra-processed foods and likely impact on human health. Public Health Nutr 2013; 16 (12) 2240-2248 . Doi: 10.1017/ S1368980012005009
    CrossrefPubMedGoogle Scholar
  • 35 Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med 2014; 174 (04) 516-524 . Doi: 10.1001/jamainternmed.2013.13563
    CrossrefPubMedGoogle Scholar
  • 36 Louzada MLC, Martins APB, Canella DS, Baraldi LG, Levy RB, Claro RM. , et al. Impact of ultra-processed foods on micronutrient content in the Brazilian diet. Rev Saude Publica 2015; 49: 45 . Doi: 10.1590/S0034-8910.2015049006211
    PubMedGoogle Scholar