Department of Epidemiology, School of Public Health University of Pittsburgh Pittsburgh PA.
Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of Pittsburgh Pittsburgh PA.
J Am Heart Assoc. 2024 Aug 20;13(16):e035555. doi: 10.1161/JAHA.124.035555. Epub 2024 Aug 19.
The period around pregnancy is a critical window in the primordial prevention of cardiovascular disease, but little is known about the role of dietary patterns in cardiometabolic health. Our objective was to determine the association between alignment of periconceptional diet with the 2020 to 2025 Dietary Guidelines for Americans and the risk of metabolic syndrome.
We used data from the Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-Be Heart Health Study, a pregnancy cohort study that followed pregnant participants to a median of 3 years postpartum (n=4423). Usual dietary intake in the 3 months around conception was estimated from a Food Frequency Questionnaire. Alignment with the Dietary Guidelines was measured using the Healthy Eating Index-2020, where higher scores represent greater alignment. Postpartum metabolic syndrome was defined using the American Heart Association/National Heart, Lung, and Blood Institute guideline. The prevalence of metabolic syndrome at 3 years postpartum was 20%. After adjusting for confounders, the prevalence of metabolic syndrome was flat up to a periconceptional Healthy Eating Index-2020 total score of ≈60, and then declined steeply as scores increased. Compared with a Healthy Eating Index-2020 score of 60, having scores of 70, 80, and 90 were associated with 2, 4, and 7 fewer cases of metabolic syndrome per 100 individuals, respectively (prevalence differences: -0.02 [95% CI, -0.03, 0]; -0.04 [-0.08, -0.1]; -0.07 [-0.13, -0.02]).
Dietary interventions around conception and systems-level changes to support high diet quality may be important for improving postpartum cardiometabolic health, and helping to reverse or slow the decline in women's cardiometabolic health.
妊娠前后时期是心血管疾病一级预防的关键窗口，但人们对饮食模式在心脏代谢健康中的作用知之甚少。我们的目的是确定围孕期饮食与 2020-2025 年美国饮食指南一致与代谢综合征风险之间的关系。
我们使用了来自 Nulliparous Pregnancy Outcomes Study：monitoring mothers-to-Be Heart Health Study 的数据，这是一项妊娠队列研究，对怀孕参与者进行了中位数为 3 年的产后随访（n=4423）。受孕前 3 个月的常规饮食摄入量是通过食物频率问卷来估计的。饮食与饮食指南的一致性是通过使用健康饮食指数-2020 来衡量的，其中较高的分数表示更高的一致性。产后代谢综合征是根据美国心脏协会/美国国立心肺血液研究所指南定义的。产后 3 年代谢综合征的患病率为 20%。在调整混杂因素后，在围孕期健康饮食指数-2020 总分为约 60 之前，代谢综合征的患病率持平，然后随着分数的增加急剧下降。与健康饮食指数-2020 得分为 60 相比，得分分别为 70、80 和 90 时，每 100 人中分别有 2、4 和 7 例代谢综合征的病例减少（患病率差异：-0.02[95%CI，-0.03，0]；-0.04[-0.08，-0.1]；-0.07[-0.13，-0.02]）。
妊娠前后的饮食干预和支持高饮食质量的系统级变化可能对改善产后心脏代谢健康以及帮助逆转或减缓女性心脏代谢健康下降至关重要。
