Impacto do consumo de alimentos ultraprocessados em desfechos de peso de mulheres com Diabetes Mellitus Gestacional e seus neonatos: um estudo de coorte

Abstract

Although the literature presents the negative health consequences of consuming ultra-processed foods (UPF) in relation to adiposity and the development of chronic non-communicable diseases, there is still a scarcity of studies evaluating the impact of this consumption during the gestational period, especially on obstetric and perinatal outcomes in women with high-risk pregnancies. Therefore, the aim of this study was to assess the association between UPF consumption and weight outcomes in women with Gestational Diabetes Mellitus (GDM) and their newborns. This was an observational, prospective cohort study of 140 women diagnosed with GDM and their newborns at the Januário Cicco Maternity School in Natal, Brazil. The study lasted an average of 25 weeks and three collections were carried out: the first collection at the end of the first or during the second gestational trimester (T1Time 1), the second in the third trimester (T2- Time 2) and the third in the immediate postpartum period (T3- Time 3). Data collection included sociodemographic characteristics, clinical and obstetric data, anthropometric data and food consumption. Food consumption was obtained by 24-hour recall and food categorized according to the Nova classification. Weight outcomes in the mother-child binomial were assessed by gestational weight gain (GWG) at T1 and T2, final GWG (T3) and assessment of birth weight for gestational age. The mother-child binomials were grouped according to tertiles of UPF consumption in grams. The results of the multiple linear regression models and generalized linear models with Poisson adjustment were analysed to ascertain the association between UPF consumption in grams and maternal and neonatal weight outcomes, with adjustments for confounding variables. The significance level assigned to the tests used was p<0.05. Energy consumption was 1960.72 (±460.74) calories, with a PSA contribution of 17.95% (95% CI = 16.24- 19.66), with an intake corresponding to 131.43 (IQR = 90.50- 200.11) grams per day. Most of the women started pregnancy obese (57.10%). GWG at T1 and T2 represented a rapid cumulative gain in 57.10% and 47.60% of pregnant women, respectively. The final GWG (T3) was 6.86 (±6.78) kg, with the majority of women having a high GWG (50.70%). As for the newborns, the average birth weight was 3133.17 (±466.29) grams, with the majority being classified as having an adequate birth weight (91.10%). The multiple linear regression models showed a positive relationship between a greater share of UPF in grams in the pregnant women's diet and cumulative and final BW (β = 0.014; p = 0.002 and β = 0.015; p =-0.023, at T1 and T3, respectively). The generalized linear models with Poisson adjustment showed that increasing the tertile of UPF intake in grams represented a greater risk of high birth weight for age (RR = 3.424; 95%CI = 1.068- 10.974; p = 0.038). In conclusion, the results of this study were sensitive enough to infer that the consumption of UPF has an impact on the GWG of the women with GDM studied and their newborns, and it is important to discourage a diet composed of UPF at this stage.