de Souza Russell J, Zulyniak Michael A, Desai Dipika, Shaikh Mateen R, Campbell Natalie C, Lefebvre Diana L, Gupta Milan, Wilson Julie, Wahi Gita, Atkinson Stephanie A, Teo Koon K, Subbarao Padmaja, Becker Allan B, Mandhane Piushkumar J, Turvey Stuart E, Sears Malcolm R, Anand Sonia S
Departments of Clinical Epidemiology and Biostatistics,
Department of Nutritional Sciences and.
J Nutr. 2016 Nov;146(11):2343-2350. doi: 10.3945/jn.116.236729. Epub 2016 Oct 5.
Canada is an ethnically diverse nation, which introduces challenges for health care providers tasked with providing evidence-based dietary advice.
We aimed to harmonize food-frequency questionnaires (FFQs) across 4 birth cohorts of ethnically diverse pregnant women to derive robust dietary patterns to investigate maternal and newborn outcomes.
The NutriGen Alliance comprises 4 prospective birth cohorts and includes 4880 Canadian mother-infant pairs of predominantly white European [CHILD (Canadian Healthy Infant Longitudinal Development) and FAMILY (Family Atherosclerosis Monitoring In earLY life)], South Asian [START (SouTh Asian birth cohoRT)-Canada], or Aboriginal [ABC (Aboriginal Birth Cohort)] origins. CHILD used a multiethnic FFQ based on a previously validated instrument designed by the Fred Hutchinson Cancer Research Center, whereas FAMILY, START, and ABC used questionnaires specifically designed for use in white European, South Asian, and Aboriginal people, respectively. The serving sizes and consumption frequencies of individual food items within the 4 FFQs were harmonized and aggregated into 36 common food groups. Principal components analysis was used to identify dietary patterns that were internally validated against self-reported vegetarian status and externally validated against a modified Alternative Healthy Eating Index (mAHEI).
Three maternal dietary patterns were identified-"plant-based," "Western," and "health-conscious"-which collectively explained 29% of the total variability in eating habits observed in the NutriGen Alliance. These patterns were strongly associated with self-reported vegetarian status (OR: 3.85; 95% CI: 3.47, 4.29; r = 0.30, P < 0.001; for a plant-based diet), and average adherence to the plant-based diet was higher in participants in the fourth quartile of the mAHEI than in the first quartile (mean difference: 46.1%; r = 0.81, P < 0.001).
Dietary data collected by using FFQs from ethnically diverse pregnant women can be harmonized to identify common dietary patterns to investigate associations between maternal dietary intake and health outcomes.
加拿大是一个种族多元化的国家，这给负责提供循证饮食建议的医疗保健提供者带来了挑战。
我们旨在协调来自4个不同种族孕妇出生队列的食物频率问卷（FFQ），以得出可靠的饮食模式，用于调查孕产妇和新生儿结局。
NutriGen联盟包括4个前瞻性出生队列，涵盖4880对加拿大母婴，主要来自欧洲白人[儿童（加拿大健康婴儿纵向发育研究）和家庭（早期家庭动脉粥样硬化监测）]、南亚人[START（南亚出生队列）-加拿大]或原住民[ABC（原住民出生队列）]。儿童研究使用了基于弗雷德·哈钦森癌症研究中心先前验证过的工具设计的多民族FFQ，而家庭、START和ABC研究分别使用了专门为欧洲白人、南亚人和原住民设计的问卷。将4份FFQ中各食物项目的食用量和食用频率进行协调，并汇总为36个常见食物组。主成分分析用于识别饮食模式，这些模式通过自我报告的素食状态进行内部验证，并通过改良的替代健康饮食指数（mAHEI）进行外部验证。
确定了三种孕产妇饮食模式——“以植物为基础”、“西方”和“注重健康”，它们共同解释了NutriGen联盟中观察到的饮食习惯总变异的29%。这些模式与自我报告的素食状态密切相关（比值比：3.85；95%置信区间：3.47，4.29；r = 0.30，P < 0.001；对于以植物为基础的饮食），并且在mAHEI第四四分位数的参与者中，对以植物为基础饮食的平均依从性高于第一四分位数（平均差异：46.1%；r = 0.81，P < 0.001）。
通过FFQ收集的不同种族孕妇的饮食数据可以进行协调，以识别常见的饮食模式，用于调查孕产妇饮食摄入与健康结局之间的关联。
