Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK.
MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
Obesity (Silver Spring). 2023 Apr;31(4):1159-1169. doi: 10.1002/oby.23706. Epub 2023 Mar 6.
The study aim was to examine the relationships between longitudinal dietary trajectories from early pregnancy to 3 years post delivery and adiposity measures in women with obesity.
The diets of 1208 women with obesity in the UPBEAT (UK Pregnancy Better Eating and Activity Trial) study were assessed using a food frequency questionnaire (FFQ) at 15 to 18 weeks' gestation (baseline), 27 to 28 weeks' gestation, and 34 to 36 weeks' gestation, as well as 6 months and 3 years post delivery. Using factor analysis of the baseline FFQ data, four dietary patterns were identified: fruit & vegetable, African/Caribbean, processed, and snacking. The baseline scoring system was applied to the FFQ data at the four subsequent time points. Group-based trajectory modeling was used to extract longitudinal dietary pattern trajectories. Using adjusted regression, associations between dietary trajectories and log-transformed/standardized adiposity measures (BMI and waist and mid-upper arm circumferences) at 3 years post delivery were examined.
Two trajectories were found to best describe the data for the four individual dietary patterns; these were characterized as high and low adherence. A high adherence to the processed pattern was associated with a higher BMI (β = 0.38 [95% CI: 0.06-0.69]) and higher waist (β = 0.35 [0.03-0.67]) and mid-upper arm circumferences (β = 0.36 [0.04-0.67]) at 3 years post delivery.
In women with obesity, a processed dietary pattern across pregnancy and 3 years post delivery is associated with higher adiposity.
本研究旨在探讨从妊娠早期到产后 3 年的纵向饮食轨迹与肥胖女性肥胖相关指标的关系。
在 UPBEAT（英国妊娠期间改善饮食和活动试验）研究中，对 1208 名肥胖女性的饮食进行了评估，使用食物频率问卷（FFQ）在妊娠 15 至 18 周（基线）、妊娠 27 至 28 周和妊娠 34 至 36 周以及产后 6 个月和 3 年后进行评估。使用基线 FFQ 数据的因子分析，确定了四种饮食模式：水果和蔬菜、非洲/加勒比、加工和零食。将基线评分系统应用于随后四个时间点的 FFQ 数据。使用基于群组的轨迹建模提取纵向饮食模式轨迹。使用调整后的回归分析，研究了饮食轨迹与产后 3 年时对数转换/标准化肥胖指标（BMI 以及腰围和中上臂围）之间的关联。
发现四种个体饮食模式中最好有两种轨迹来描述数据，这些轨迹的特点是高和低依从性。对加工模式的高度依从性与更高的 BMI（β=0.38 [95% CI：0.06-0.69]）和更高的腰围（β=0.35 [0.03-0.67]）和中上臂围（β=0.36 [0.04-0.67]）相关。
在肥胖女性中，妊娠期间和产后 3 年的加工饮食模式与更高的肥胖有关。
