Department of Nutrition, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Human Nutrition Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
PLoS One. 2020 Nov 25;15(11):e0242150. doi: 10.1371/journal.pone.0242150. eCollection 2020.
The prevalence of gestational hypertension and diabetes in pregnancy is increasing worldwide. Diet is a modifiable factor that may influence these conditions, but few studies have examined the association between diet quality and blood pressure and glucose profiles among pregnant women. Data are especially scarce for women in low- and middle-income countries (LMICs), where 90% of global pregnancies occur, and in urban settings. We, therefore, assessed these associations among 174 pregnant women in the Asian megacity of Jakarta in a cross-sectional study of the Brain Probiotic and LC-PUFA Intervention for Optimum Early Life (BRAVE) project.
Trained field-enumerators collected socio-demographic characteristics, measured Mid-Upper Arm Circumference (MUAC), and assessed diet by two 24-hour recalls, which were used to calculate the Alternate Healthy Eating Index for Pregnancy (AHEI-P). Blood pressure was measured by automated sphygmomanometer, and fasting blood glucose by capillary glucometer. General linear models were used to identify associations.
The median AHEI-P score was 47.4 (IQR 19.1-76.6). The middle tertile of the AHEI-P score (39.59-56.58) was associated with a 0.4 SD (standardized effect size, 95% CI -0.7 to -0.06; p = 0.02) lower diastolic blood pressure compared with the lowest tertile (<39.59), after adjustment for level of education, smoking status, MUAC, gestational age, history of hypertension, and family history of hypertension. However, no associations were found between the AHEI-P score and systolic blood pressure and blood glucose.
Higher diet quality was associated with lower diastolic blood pressure among pregnant women in an urban LMIC community, but not with systolic blood pressure and blood glucose. A behavioral change intervention trial would be warranted to confirm the influence of diet quality on blood pressure and glucose levels and among pregnant women, and even before pregnancy.
妊娠高血压和糖尿病在全球范围内的患病率不断上升。饮食是一个可改变的因素，可能会影响这些情况，但很少有研究调查孕妇的饮食质量与血压和血糖谱之间的关系。数据对于中低收入国家（LMICs）和城市地区的孕妇来说尤其稀缺，全球 90%的妊娠都发生在这些地区。因此，我们在亚洲特大城市雅加达的一项“脑益生菌和 LC-PUFA 干预以优化生命早期（BRAVE）”项目的横断面研究中，评估了 174 名孕妇的这些关联。
经过培训的现场调查员收集了社会人口统计学特征，测量了中臂围（MUAC），并通过两次 24 小时回顾来评估饮食，这两次回顾用于计算妊娠期替代健康饮食指数（AHEI-P）。血压通过自动血压计测量，空腹血糖通过毛细血管血糖仪测量。使用一般线性模型来确定关联。
AHEI-P 评分的中位数为 47.4（IQR 19.1-76.6）。与最低三分位数（<39.59）相比，AHEI-P 评分的中间三分位数（39.59-56.58）与舒张压降低 0.4 SD（标准化效应大小，95%CI -0.7 至 -0.06；p=0.02）相关，调整教育水平、吸烟状况、MUAC、妊娠年龄、高血压病史和高血压家族史后。然而，AHEI-P 评分与收缩压和血糖之间没有关联。
在城市 LMIC 社区中，较高的饮食质量与孕妇的舒张压较低相关，但与收缩压和血糖无关。需要进行行为改变干预试验来证实饮食质量对血压和血糖水平的影响，甚至在怀孕之前。
