Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil.
Graduate Program in Public Health, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil.
Int J Environ Res Public Health. 2023 Jun 6;20(12):6063. doi: 10.3390/ijerph20126063.
Combined deficiencies of nutrients such as iron and folic acid intake during pregnancy are related to nutritional deficiencies risk, such as anemia. The objective of this study was to analyze the association between risk factors (sociodemographic, dietary and lifestyle) and the intake of iron and folate by pregnant women followed up in Primary Health Care (PHC) in the Federal District, Brazil. A cross-sectional observational study was carried out with adult pregnant women of different gestational ages. A semi-structured questionnaire was applied by researchers trained to collect sociodemographic, economic, environmental, and health data. Two nonconsecutive 24-hour recalls (24hr) were carried out to collect data about food consumption. Multivariate linear regression models were used to analyze the association between sociodemographic and dietary risk factors and the consumption of iron and folate. The mean daily energy intake was 1726 kcal (95% CI 1641-1811), with 22.4% (95% CI 20.09-24.66) derived from ultra-processed foods (UPFs). The mean iron and folate intake were 5.28 mg (95% CI 5.09-5.48) and 193.42 µg (95% CI 182.22-204.61), respectively. According to the multivariate model, the highest quintile of ultra-processed foods intake was associated with lower iron (β = -1.15; IC 95%: -1.74; 0.55; < 0.001) and folate intake (β = -63.23; IC 95%: -98.32; -28.15; < 0.001). Pregnant women with high school degree presented higher iron intake (β = 0.74; IC 95%: 0.20; 1.28; = 0.007) and folate intake (β = 38.95; IC 95%: 6.96; 70.95; = 0.017) compared to pregnant women with elementary school degree. Folate consumption was also associated with the second gestational period (β = 39.44; IC 95%: 5.58; 73.30; = 0.023) and pregnancy planning (β = 26.88; IC 95%: 3.58; 50.18; = 0.024). Further research is warranted to enhance evidence on the relationship between the role of processed foods and micronutrients intake to strengthen the nutritional quality of diet of pregnant women attended in Primary Health Care.
妊娠期铁和叶酸等营养素摄入不足与营养缺乏风险有关，如贫血。本研究旨在分析与风险因素（社会人口统计学、饮食和生活方式）相关的因素与巴西联邦区初级卫生保健（PHC）中接受随访的孕妇的铁和叶酸摄入之间的关联。这是一项对不同孕龄的成年孕妇进行的横断面观察性研究。研究人员应用半结构化问卷收集社会人口统计学、经济、环境和健康数据。进行了两次非连续的 24 小时回忆（24hr），以收集有关食物消费的数据。使用多变量线性回归模型分析社会人口统计学和饮食风险因素与铁和叶酸消耗之间的关联。日均能量摄入量为 1726 千卡（95%置信区间 1641-1811），其中 22.4%（95%置信区间 20.09-24.66）来自超加工食品（UPFs）。铁和叶酸的平均摄入量分别为 5.28 毫克（95%置信区间 5.09-5.48）和 193.42 微克（95%置信区间 182.22-204.61）。根据多变量模型，超加工食品摄入量最高的五分位数与较低的铁（β=-1.15；95%置信区间：-1.74；0.55； < 0.001）和叶酸摄入（β=-63.23；95%置信区间：-98.32；-28.15； < 0.001）相关。与具有小学学历的孕妇相比，具有高中学历的孕妇铁摄入（β=0.74；95%置信区间：0.20；1.28； = 0.007）和叶酸摄入（β=38.95；95%置信区间：6.96；70.95； = 0.017）更高。叶酸的摄入量还与妊娠的第二个阶段（β=39.44；95%置信区间：5.58；73.30； = 0.023）和妊娠计划（β=26.88；95%置信区间：3.58；50.18； = 0.024）相关。需要进一步的研究来加强关于加工食品与微量营养素摄入之间关系的证据，以加强在初级卫生保健中接受治疗的孕妇的饮食营养质量。
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