Nutrition Science, Baylor University, One Bear Place 97346, Waco, TX, 76798-7346, USA.
Department of Biology, Baylor University, One Bear Place 97346, Waco, TX, 76798-7346, USA.
Matern Child Health J. 2022 Apr;26(4):882-894. doi: 10.1007/s10995-021-03198-0. Epub 2021 Aug 30.
To conduct an exploratory examination of dietary patterns and quality during pregnancy in African-American women who were class I, II, or III obese, and those women with normal pre-pregnancy body mass index (pBMI), as well to identify dietary factors associated with GWG, and changes in the distal gut microbiome. African American women represent the largest group affected by pre-pregnancy obesity, a risk factor for several adverse birth outcomes.
This prospective study investigated the association between diet, distal gut microbiome, and GWG among African-American women (n = 21) with obesity (n = 15) compared to women with a normal pre-pregnancy body mass index (pBMI) (n = 6) at two time points, 27-29 and 37-39 weeks gestation. Dietary patterns associated with obesity severity and GWG gain were assessed using Welch's T-test and Mann-Whitney U. The association between the gut microbiome and dietary patterns was assessed using a regression-based kernel association test and the adaptive microbiome-based sum of powered score test.
In early pregnancy, dietary intake of Total Fruits and Greens and Beans was significantly different between pBMI and GWG groups; significance was 0.022 and 0.028 respectively. Women with Class II/III obesity and those with GWG above guidelines had Healthy Eating Index (HEI) scores below 50, meeting less than 75% of dietary guidelines, and did not meet recommendations for fruit and vegetable or fiber intake. We found no significant associations between the microbiome composition and diet (HEI Scores).
Overall, the results indicate that women with pBMI obesity are not meeting minimum dietary guidelines for nutrient intakes during pregnancy, specifically fruits, vegetables, and fiber, regardless of GWG. Interventions for African-American women with pre-pregnancy obesity, with a focus on increasing consumption of fruits and vegetables, would be beneficial to control GWG and improve birth outcomes.
探讨 I 类、II 类或 III 类肥胖的非裔美国女性和孕前体重指数（pBMI）正常的女性在怀孕期间的饮食模式和质量，并确定与 GWG 相关的饮食因素以及远端肠道微生物组的变化。非裔美国女性是受孕前肥胖影响最大的群体，而孕前肥胖是多种不良分娩结局的一个危险因素。
这项前瞻性研究调查了肥胖的非裔美国女性（n=15）与孕前体重指数正常的女性（n=6）在 27-29 周和 37-39 周妊娠两个时间点之间的饮食、远端肠道微生物组与 GWG 之间的关联。使用 Welch T 检验和 Mann-Whitney U 检验评估与肥胖严重程度和 GWG 增加相关的饮食模式。使用基于回归的核关联检验和自适应基于微生物组的幂和得分检验评估肠道微生物组与饮食模式之间的关联。
在孕早期，pBMI 和 GWG 组之间的总水果和蔬菜及豆类的饮食摄入量存在显著差异；显著性分别为 0.022 和 0.028。II/III 类肥胖的女性和 GWG 超过指南的女性的健康饮食指数（HEI）评分低于 50，满足不到 75%的饮食指南，并且不符合水果和蔬菜或纤维摄入的建议。我们没有发现微生物组组成和饮食（HEI 评分）之间存在显著关联。
总体而言，研究结果表明，即使 GWG 不同，pBMI 肥胖的女性在怀孕期间也没有满足最低饮食指南的营养素摄入量，特别是水果、蔬菜和纤维。针对有孕前肥胖的非裔美国女性的干预措施，重点是增加水果和蔬菜的摄入量，将有利于控制 GWG 和改善分娩结局。
