Crivellenti Lívia Castro, Zuccolotto Daniela Cristina Candelas, Sartorelli Daniela Saes
Programa de Pós-Graduação em Saúde na Comunidade, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Rev Saude Publica. 2018;52:59. doi: 10.11606/s1518-8787.2018052000184. Epub 2018 May 17.
To develop a Diet Quality Index Adapted for Pregnant Women (IQDAG) and to evaluate its relation with the characteristics of women treated at the Brazilian Unified Health System.
The data on food intake come from a cross-sectional study carried out with 785 adult pregnant women in the city of Ribeirão Preto, state of São Paulo, Brazil, between 2011 and 2012. The index was based on the recommendations of the Brazilian Ministry of Health, previous national dietary indexes, and the new Dietary Guidelines for the Brazilian Population. We used the ANOVA, Kruskal-Wallis, and chi-square tests to describe the quality of the diet according to the characteristics of the mother.
The IQDAG has nine components, and it is represented by three food groups (in servings/1,000 kcal), five nutrients, and a moderator component. A high proportion of pregnant women reached the maximum score for the components of legumes and vegetables. However, few women reached the maximum score for consumption of fresh fruits, fiber, omega-3, calcium, folate, iron, and ultra-processed foods. We verified a better quality of diet among older and eutrophic pregnant women who reported practicing more physical activity and taking dietary supplements. We also observed the highest index score among women with higher intake of carbohydrates, proteins, vitamins C, E, and A, and minerals calcium, folate, and iron, as well as among those with lower intake of total fats and saturated fats.
This dietary index is unprecedented in incorporating the recommendation of the new Dietary Guidelines for the Brazilian Population regarding the moderation of the consumption of ultra-processed foods. It was useful in evaluating the quality of the diet of pregnant women and we verified a higher score among older and eutrophic women who reported a healthy lifestyle. Strategies are needed to promote a higher consumption of fresh fruits, foods high in fiber, omega-3, calcium, folate, iron, and minimally processed foods in pregnant women.
制定适用于孕妇的饮食质量指数（IQDAG），并评估其与巴西统一卫生系统中接受治疗的女性特征之间的关系。
食物摄入数据来自2011年至2012年在巴西圣保罗州里贝朗普雷图市对785名成年孕妇进行的一项横断面研究。该指数基于巴西卫生部的建议、以往的国家饮食指数以及巴西人口新饮食指南。我们使用方差分析、克鲁斯卡尔 - 沃利斯检验和卡方检验，根据母亲的特征描述饮食质量。
IQDAG有九个组成部分，由三类食物（每份/1000千卡）、五种营养素和一个调节成分表示。很大比例的孕妇在豆类和蔬菜成分上达到了最高分。然而，很少有女性在新鲜水果、纤维、ω-3、钙、叶酸、铁和超加工食品的摄入量上达到最高分。我们发现年龄较大且营养良好的孕妇，若报告进行更多体育活动并服用膳食补充剂，其饮食质量更好。我们还观察到，碳水化合物、蛋白质、维生素C、E和A以及矿物质钙、叶酸和铁摄入量较高的女性，以及总脂肪和饱和脂肪摄入量较低的女性，其指数得分最高。
该饮食指数在纳入巴西人口新饮食指南中关于适度食用超加工食品的建议方面是前所未有的。它有助于评估孕妇的饮食质量，并且我们发现报告有健康生活方式的年龄较大且营养良好的女性得分更高。需要采取策略来促进孕妇更多地食用新鲜水果、高纤维食物、ω-3、钙、叶酸、铁以及最少加工的食品。
