Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
Department of Hygiene and Epidemiology, Medical University of Lodz, 90-647 Lodz, Poland.
Int J Environ Res Public Health. 2019 Mar 2;16(5):754. doi: 10.3390/ijerph16050754.
Characterization of dietary patterns represents a valid and meaningful measure of overall diet quality and nutrient intake. The study aims at evaluating the sociodemographic, lifestyle, environmental, and pregnancy-related determinants of maternal dietary patterns during pregnancy. The analysis was conducted on a group of pregnant women from the Polish Mother and Child Cohort (REPRO_PL). During the second trimester of pregnancy, 1306 women filled in a modified version of the validated food frequency questionnaire (FFQ). Dietary patterns were estimated using an exploratory factor analysis. Potential dietary determinants were assessed via a questionnaire or biomarker measurements (saliva cotinine level). : Two dietary patterns were identified. The Prudent dietary pattern was characterized by high consumption of fruit, vegetables, legumes, whole grains, poultry, and low-fat dairy products, while the Western dietary pattern included high intake of refined grains, processed meat, potatoes, and very low intake of whole grains. Clear sociodemographic, environmental, lifestyle, and pregnancy-related determinants of diet quality were established. Older age (β = 0.2; < 0.01), higher educational level (β = 0.3; < 0.01), and socioeconomic status (SES) (β = 0.2; < 0.01), overweight/obesity before (β = 0.3; < 0.01), as well as physical activity during pregnancy (β = 0.2; = 0.01) were positive determinants of a healthier diet (increasing Prudent⁻Western difference in dietary pattern scores). On the other hand, parity (β = -0.2; = 0.04) and living in small cities (β = -0.3; = 0.02) were significantly related to a rather Western dietary pattern. The current study presents evidence on specific factors influencing dietary patterns. They need to be accounted for in educational programs and interventions focused on healthy diet recommendations during pregnancy.
饮食模式的特征代表了整体饮食质量和营养摄入的有效且有意义的衡量标准。本研究旨在评估孕期社会人口统计学、生活方式、环境和与妊娠相关的因素对孕妇饮食模式的影响。该分析基于波兰母婴队列(REPRO_PL)中的一组孕妇进行。在妊娠中期,1306 名女性填写了经过验证的食物频率问卷(FFQ)的修改版。使用探索性因子分析来估计饮食模式。通过问卷调查或生物标志物测量(唾液可替宁水平)评估潜在的饮食决定因素。确定了两种饮食模式。谨慎饮食模式的特点是高水果、蔬菜、豆类、全谷物、家禽和低脂乳制品的消费,而西方饮食模式包括精制谷物、加工肉、土豆和极低的全谷物摄入量。明确了与饮食质量相关的社会人口统计学、环境、生活方式和与妊娠相关的决定因素。较年长的年龄(β=0.2;<0.01)、较高的教育水平(β=0.3;<0.01)和社会经济地位(SES)(β=0.2;<0.01)、超重/肥胖(β=0.3;<0.01)以及妊娠期间的体力活动(β=0.2;=0.01)是更健康饮食的积极决定因素(增加谨慎-西方饮食模式评分差异)。另一方面,多胎(β=-0.2;=0.04)和居住在小城市(β=-0.3;=0.02)与更偏向西方的饮食模式显著相关。本研究提供了特定因素影响饮食模式的证据。在针对妊娠期间健康饮食建议的教育计划和干预措施中,需要考虑这些因素。