University of Turku and Turku University Hospital, Department of Obstetrics and Gynecology, Finland.
University of Turku, Institute of Biomedicine, Finland.
Clin Nutr. 2019 Aug;38(4):1613-1619. doi: 10.1016/j.clnu.2018.08.029. Epub 2018 Aug 31.
BACKGROUND & AIMS: Excessive adiposity and gestational weight gain (GWG) have been linked with maternal and offspring morbidity. We investigated the relation of maternal diet, physical activity and GWG on body composition in overweight and obese pregnant women.
Fat mass (FM) and fat free mass (FFM) of 110 overweight and obese pregnant women were measured by air displacement plethysmography in early and late pregnancy (mean 13.5 and 35.3 gestational weeks). At the same time points, the quality of overall diet was assessed by validated index of diet quality (IDQ) questionnaire (score < 10/15 denotes poor dietary quality and score ≥ 10/15 denotes good dietary quality), nutrient intakes by 3-day food diaries, and physical activity by questionnaire. Weight gain between early and late pregnancy was compared to the gestational weight gain guidelines issued by Institute of Medicine.
Of the women, 77% gained more weight than recommended; this was related to greater dietary fat consumption (80 ± 21 g/day vs. 67 ± 11 g/day, p = 0.010) and greater increase in FM (2.7 ± 3.0 kg vs. -1.0 ± 2.4 kg, p < 0.001) compared to women with ideal GWG. Dietary protein intake (g) correlated positively with FFM at both time points (early pregnancy: r = 0.31, p < 0.002, late pregnancy: r = 0.39, p < 0.001). Women with higher dietary quality index score had more FFM, compared to women with lower dietary quality (early pregnancy FFM: 48.8 ± 5.8 kg vs. 45.8 ± 4.7 kg, p = 0.004, late pregnancy FFM: 56.1 ± 6.4 kg vs. 53.4 ± 5.6 kg, p = 0.025). No correlations were detected between total energy intake or physical activity and FM or FFM at early or late pregnancy.
Body composition changes from early to late pregnancy were related to the amount of weight gained and overall dietary quality during pregnancy. Higher dietary quality and protein intake were associated with greater FFM, while dietary fat intake was related to excess weight gain. Identification of these dietary determinants of body composition and weight offers new targets for dietary counseling of pregnant women and thus potential for ensuing health benefits through reduced adiposity.
超重和妊娠体重增加（GWG）与母婴发病率有关。我们研究了超重和肥胖孕妇的饮食、体力活动和 GWG 与身体成分的关系。
110 名超重和肥胖孕妇在妊娠早期和晚期（平均 13.5 和 35.3 周妊娠）通过空气置换体积描记法测量脂肪质量（FM）和去脂肪质量（FFM）。同时，通过验证的饮食质量指数（IDQ）问卷评估整体饮食质量（得分<10/15 表示饮食质量差，得分≥10/15 表示饮食质量好）、3 天食物日记中的营养素摄入量和问卷调查中的体力活动。将妊娠早期和晚期的体重增加与医学研究所发布的妊娠体重增加指南进行比较。
77%的女性体重增加超过推荐值；这与饮食中脂肪摄入增加（80±21 克/天 vs. 67±11 克/天，p=0.010）和 FM 增加更大（2.7±3.0 千克 vs. -1.0±2.4 千克，p<0.001）有关。与 GWG 理想的女性相比，饮食蛋白质摄入量（g）与两个时间点的 FFM 呈正相关（妊娠早期：r=0.31，p<0.002，妊娠晚期：r=0.39，p<0.001）。与饮食质量指数得分较低的女性相比，饮食质量指数得分较高的女性 FFM 更高（妊娠早期 FFM：48.8±5.8 千克 vs. 45.8±4.7 千克，p=0.004，妊娠晚期 FFM：56.1±6.4 千克 vs. 53.4±5.6 千克，p=0.025）。妊娠早期和晚期，总能量摄入或体力活动与 FM 或 FFM 之间均无相关性。
从妊娠早期到晚期的身体成分变化与怀孕期间体重增加量和整体饮食质量有关。较高的饮食质量和蛋白质摄入量与更大的 FFM 相关，而饮食脂肪摄入量与体重增加过多有关。确定这些身体成分和体重的饮食决定因素为孕妇的饮食咨询提供了新的目标，并通过减少肥胖带来了潜在的健康益处。
