Singapore Institute of Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.
Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore.
Eur J Nutr. 2019 Apr;58(3):1081-1094. doi: 10.1007/s00394-018-1623-3. Epub 2018 Feb 13.
To examine the associations of energy, macronutrient and food intakes with GWG on 960 pregnant women from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) mother-offspring cohort.
Dietary intake was assessed at 26-28 weeks' gestation with a 24-hour recall and 3-day food diary. GWG z-scores were calculated from first (4-13 weeks' gestation) and last (30-40 weeks gestation) measured weights; inadequate and excessive GWG were defined using the Institute of Medicine recommendations based on weights between 15 and 35 weeks' gestation. Associations were examined using substitution models for macronutrient composition, with linear or multinomial logistic regressions.
Mean ± SD daily energy intake was 1868 ± 598 kcal, and percentage energy intakes were 51.8 ± 8.9% from carbohydrate, 15.7 ± 3.9% from protein and 32.6 ± 7.7% from fat. Higher energy intake (per 500 kcal increment) was associated with 0.18 SD higher GWG. In isocaloric diets, higher-carbohydrate and lower-fat intakes (at 5% energy substitution) were associated with 0.07 SD higher GWG, and 14% higher likelihood of excessive GWG. Concordantly, the highest tertile of carbohydrate-rich foods intake was associated with 0.20 SD higher GWG, but the highest tertile of fruit and vegetable intake was independently associated with 60% lower likelihood of inadequate GWG. Additionally, the highest tertile of dairy intake was associated with 0.18 SD lower GWG; and the highest tertile of plant-based protein foods intake was associated with 60% and 34% lower likelihood of inadequate and excessive GWG.
Balancing the proportions of carbohydrates and fat, and a higher intake of plant-based protein foods may be beneficial for achieving optimal GWG.
在来自新加坡成长至健康结局（GUSTO）母婴队列的 960 名孕妇中，研究能量、宏量营养素和食物摄入量与 GWG 的相关性。
在妊娠 26-28 周时通过 24 小时回忆和 3 天食物日记评估饮食摄入。GWG z 分数是根据首次（妊娠 4-13 周）和最后（妊娠 30-40 周）测量的体重计算得出的；根据 15-35 周妊娠期间的体重，采用基于医学研究所建议的不足和过多 GWG 定义。使用宏量营养素组成的替代模型，通过线性或多项逻辑回归来检查关联。
平均每日能量摄入量为 1868±598kcal，能量摄入量百分比为碳水化合物 51.8±8.9%，蛋白质 15.7±3.9%，脂肪 32.6±7.7%。能量摄入每增加 500 千卡，GWG 增加 0.18 SD。在等热量饮食中，较高的碳水化合物和较低的脂肪摄入量（5%能量替代）与 GWG 增加 0.07 SD 相关，以及过度 GWG 的可能性增加 14%。相应地，富含碳水化合物食物摄入量最高三分位与 GWG 增加 0.20 SD 相关，但水果和蔬菜摄入量最高三分位与不足 GWG 的可能性降低 60%独立相关。此外，最高三分位的乳制品摄入量与 GWG 降低 0.18 SD 相关；而植物性蛋白质食物摄入量最高三分位与不足和过度 GWG 的可能性降低 60%和 34%相关。
平衡碳水化合物和脂肪的比例，以及增加植物性蛋白质食物的摄入可能有益于实现最佳 GWG。
