Kadawathagedara Manik, Ahluwalia Namanjeet, Dufourg Marie-Noelle, Forhan Anne, Charles Marie Aline, Lioret Sandrine, de Lauzon-Guillain Blandine
Université de Paris, CRESS, INSERM, INRAE, Paris, France.
UREN, Faculty of Medicine, University of Paris 13, Paris, France.
Matern Child Nutr. 2021 Jul;17(3):e13140. doi: 10.1111/mcn.13140. Epub 2021 Feb 2.
Better adherence to dietary guidelines during pregnancy is supposed to result in healthier perinatal outcomes. We aim to characterize the diets of pregnant women by hypothesis-driven and exploratory approaches and describe potential social determinants. Analyses included 12 048 mothers from the French nationwide ELFE birth cohort. Dietary intake over the last three months of the pregnancy was assessed by a food frequency questionnaire. Two hypothesis-driven scores (the Diet Quality score, based on benchmarks derived from the National Health and Nutrition Program Guidelines, and the PANDiet score, based on nutrient intake) were calculated. Exploratory dietary patterns were also identified by principal component analysis. Multiple linear regressions were used to assess associations of maternal social characteristics with dietary patterns, accounting for the possible effect modification by their migration status. Five dietary patterns were identified: the Western, Balanced, Bread and toppings, Processed products, and Milk and breakfast cereals. Younger maternal age, single motherhood, unemployment and the presence of older children in the household were related to a suboptimal diet during pregnancy. The less acculturated the women were, the healthier and less processed their diets were, independent of their socio-economic position. Several social determinants of the quality of women's diets were however moderated by their migration status. These findings shed light on the relations between indicators of social vulnerability, such as single motherhood and unemployment, and poorer diet quality. Given the reduced diet quality that accompanies the acculturation process, it is of paramount importance to identify the specific factors or obstacles that affect migrant women in maintaining their diet quality advantage over the majority population.
孕期更好地遵循饮食指南理应带来更健康的围产期结局。我们旨在通过假设驱动和探索性方法描述孕妇的饮食，并描述潜在的社会决定因素。分析纳入了来自法国全国性ELFE出生队列的12048名母亲。通过食物频率问卷评估孕期最后三个月的饮食摄入量。计算了两个假设驱动的得分（基于国家健康与营养计划指南得出的基准的饮食质量得分，以及基于营养摄入的PANDiet得分）。还通过主成分分析确定了探索性饮食模式。使用多元线性回归评估母亲社会特征与饮食模式之间的关联，并考虑其移民身份可能产生的效应修正。确定了五种饮食模式：西方型、均衡型、面包加配料型、加工食品型以及牛奶和早餐谷物型。母亲年龄较小、单身母亲身份、失业以及家中有年长子女与孕期饮食欠佳有关。女性的文化适应程度越低，其饮食就越健康且加工程度越低，这与她们的社会经济地位无关。然而，女性饮食质量的若干社会决定因素受到其移民身份的调节。这些发现揭示了社会脆弱性指标（如单身母亲身份和失业）与较差饮食质量之间的关系。鉴于文化适应过程伴随着饮食质量下降，识别影响移民女性保持其相对于大多数人群的饮食质量优势的具体因素或障碍至关重要。
