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基于最低限度加工食物的营养咨询干预对超重孕妇体重增加的效果:一项随机对照试验。

Effectiveness of a minimally processed food-based nutritional counselling intervention on weight gain in overweight pregnant women: a randomized controlled trial.

机构信息

Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

出版信息

Eur J Nutr. 2023 Feb;62(1):443-454. doi: 10.1007/s00394-022-02995-9. Epub 2022 Sep 10.

DOI:10.1007/s00394-022-02995-9
PMID:36087136
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9463499/
Abstract

PURPOSE

This study aimed at evaluating the effectiveness of a nutritional counselling intervention based on encouraging the consumption of unprocessed and minimally processed foods, rather than ultra-processed products, and the practice of physical activities to prevent excessive gestational weight gain in overweight pregnant women.

METHODS

This was a two-armed, parallel, randomized controlled trial conducted in primary health units of a Brazilian municipality from 2018 to 2021. Overweight, adult pregnant women (n = 350) were randomly assigned to control (CG) or intervention groups (IG). The intervention consisted of three individualized nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods rather than ultra-processed products, following the NOVA food classification system, and the practice of physical activities. The primary outcome was the proportion of women whose weekly gestational weight gain (GWG) exceeded the Institute of Medicine guidelines. Adjusted logistic regression models were employed.

RESULTS

Complete data on weight gain were available for 121 women of the IG and 139 of the CG. In modified intention-to-treat analysis, there was a lower chance of the IG women having excessive GWG [OR 0.56 (95% CI 0.32, 0.98), p = .04], when compared to the CG. No between-group differences were observed for the other maternal outcomes investigated.

CONCLUSION

The present study was unprecedented in demonstrating that nutritional counselling based on the NOVA food classification system, together with encouraging the practice of physical activity, is effective in preventing excessive weight gain in overweight pregnant women.

TRIAL REGISTRATION

Registered on July 30th 2018 at Brazilian Registry of Clinical Trials (RBR-2w9bhc).

摘要

目的

本研究旨在评估基于鼓励食用未加工和最低限度加工食品而不是超加工产品以及进行体育活动以预防超重孕妇过度妊娠体重增加的营养咨询干预措施的有效性。

方法

这是一项在巴西一个市的基层卫生单位进行的双臂、平行、随机对照试验。2018 年至 2021 年,超重成年孕妇(n=350)被随机分配到对照组(CG)或干预组(IG)。干预措施包括三次个体化营养咨询会议,基于鼓励食用未加工和最低限度加工食品而不是超加工产品,遵循 NOVA 食品分类系统,并进行体育活动。主要结局是每周妊娠体重增加(GWG)超过医学研究所指南的女性比例。采用调整后的逻辑回归模型。

结果

IG 组的 121 名妇女和 CG 组的 139 名妇女的体重增加数据完整。在改良意向治疗分析中,IG 组妇女发生过度 GWG 的可能性较低[比值比 0.56(95%置信区间 0.32,0.98),p=0.04],与 CG 组相比。在其他研究的产妇结局方面,两组之间没有差异。

结论

本研究是首例证明基于 NOVA 食品分类系统的营养咨询,结合鼓励体育活动的实践,可有效预防超重孕妇体重过度增加。

试验注册

于 2018 年 7 月 30 日在巴西临床试验注册处(RBR-2w9bhc)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a62/9463499/4df649140a6f/394_2022_2995_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a62/9463499/4df649140a6f/394_2022_2995_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a62/9463499/4df649140a6f/394_2022_2995_Fig1_HTML.jpg

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Does the concept of "ultra-processed foods" help inform dietary guidelines, beyond conventional classification systems? NO.“超加工食品”的概念是否有助于指导膳食,超越传统的分类系统?否。
Am J Clin Nutr. 2022 Dec 19;116(6):1482-1488. doi: 10.1093/ajcn/nqac123.
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Associations of ultra-processed food intake with maternal weight change and cardiometabolic health and infant growth.超加工食品摄入与产妇体重变化及心血管代谢健康和婴儿生长的关系。
Int J Behav Nutr Phys Act. 2022 May 26;19(1):61. doi: 10.1186/s12966-022-01298-w.
3
Prevalence of and risk factors for excess weight gain in pregnancy: a cross-sectional study using survey data.
孕期超加工食品摄入及其对母体饮食质量和体重变化的影响:观察性研究的系统评价。
Curr Nutr Rep. 2024 Dec;13(4):800-814. doi: 10.1007/s13668-024-00580-6.
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Relationship between paternal excessive weight and neonatal anthropometry in a clinical trial of nutritional counseling for pregnant women with overweight.超重孕妇营养咨询临床试验中父亲体重过重与新生儿人体测量学的关系。
Int J Obes (Lond). 2024 Dec;48(12):1831-1838. doi: 10.1038/s41366-024-01639-8. Epub 2024 Sep 24.
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Ultra-processed foods consumption and health-related outcomes: a systematic review of randomized controlled trials.超加工食品的消费与健康相关结果:随机对照试验的系统评价
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