No CrossRef data available.
Article contents
Exposure to ultra-processed foods during pregnancy and ultrasound fetal growth parameters
Published online by Cambridge University Press: 16 May 2023
Abstract
Periconceptional maternal ultra-processed food (UPF) consumption impairs embryonic growth. Impacts of exposure to UPF on distinct components of fetal growth in late pregnancy are unknown. We investigated the influence of frequency of UPF consumption during pregnancy on fetal head circumference (HC), abdominal circumference (AC) and femur length (FL). This study included 417 live-born singleton pregnancies prospectively followed-up since the antenatal period in the MINA-Brazil Study, with an available ultrasound scan at >24 gestational weeks. Frequency of food groups consumption in the previous month was categorised as no/monthly, weekly or daily. Ultrasound scans were conducted at 27·8 (sd: 1·7) gestational weeks. HC, AC and FL z-scores were calculated for gestational age using the INTERGROWTH-21st Project standards. Simultaneous-quantile regression models were fitted at the 10th, 50th and 90th percentiles of the distribution of each ultrasound parameter according to UPF consumption, with adjustment for potential confounders. Participants were aged on average 24·7 (sd: 6·5) years, 44·8 % were primiparous, and 26·9 % and 24·9 %, respectively, had weekly and daily UPF consumption. Compared with no/monthly intake, daily UPF consumption impaired HC across its distribution, with significant effect sizes varying from –0·24 to –0·40 z-score. Weekly UPF consumption decreased HC at the 90th percentile by –0·39 z-score (95 % CI: –0·78, –0·01) and FL at the 50th percentile by –0·32 z-score (95 % CI: –0·60, –0·04). No association was noted with AC. Frequency of UPF consumption was negatively associated with skeletal components of fetal growth in late pregnancy. Infant body composition may benefit from healthy food practices since pregnancy.
- Type
- Research Article
- Information
- Copyright
- © The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society
Footnotes
†
A full list of members of the MINA-Brazil Study Group is provided in the Acknowledgements.
References
Benjamin-Chung, J, Mertens, A, Colford, JM, et al. (2021) Early Childhood Linear Growth Faltering in Low- and Middle-Income Countries. MedRxiv. https://www.medrxiv.org/content/10.1101/2020.06.09.20127001v2 (accessed May 2023).CrossRefGoogle Scholar
Roth, DE, Krishna, A, Leung, M, et al. (2017) Early childhood linear growth faltering in low-income and middle-income countries as a whole-population condition: analysis of 179 Demographic and Health Surveys from 64 countries (1993–2015). Lancet Glob Health 5, e1249–e1257.CrossRefGoogle ScholarPubMed
Stang, J & Huffman, LG (2016) Position of the academy of nutrition and dietetics: obesity, reproduction, and pregnancy outcomes. J Acad Nutr Diet 116, 677–691.CrossRefGoogle Scholar
Victora, CG, Christian, P, Vidaletti, LP, et al. (2021) Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda. Lancet 397, 1388–1399.CrossRefGoogle ScholarPubMed
Martínez-Hortelano, JA, Cavero-Redondo, I, Álvarez-Bueno, C, et al. (2020) Monitoring gestational weight gain and prepregnancy BMI using the 2009 IOM guidelines in the global population: a systematic review and meta-analysis. BMC Pregnancy Childbirth 20, 649.CrossRefGoogle ScholarPubMed
Wang, D, Wang, M, Darling, AM, et al. (2020) Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data. BMJ Glob Health 5, e003423.CrossRefGoogle ScholarPubMed
Monteiro, CA, Cannon, G, Levy, RB, et al. (2019) Ultra-processed foods: what they are and how to identify them. Public Health Nutr 22, 936–941.CrossRefGoogle Scholar
Martini, D, Godos, J, Bonaccio, M, et al. (2021) Ultra-processed foods and nutritional dietary profile: a meta-analysis of nationally representative samples. Nutrients 13, 3390.CrossRefGoogle ScholarPubMed
Ben-Avraham, S, Kohn, E, Tepper, S, et al. (2023) Ultra-processed food (UPF) intake in pregnancy and maternal and neonatal outcomes. Eur J Nutr (Epublication ahead of print version 6 January 2023).CrossRefGoogle ScholarPubMed
Baker, P, Machado, P, Santos, T, et al. (2020) Ultra-processed foods and the nutrition transition: global, regional and national trends, food systems transformations and political economy drivers. Obes Rev 21, e13126.CrossRefGoogle ScholarPubMed
Srour, B, Kordahi, MC, Bonazzi, E, et al. (2022) Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights. Lancet Gastroenterol Hepatol 7, 1128–1140.CrossRefGoogle ScholarPubMed
Smit, AJP, Hojeij, B, Rousian, M, et al. (2022) A high periconceptional maternal ultra-processed food consumption impairs embryonic growth: the Rotterdam periconceptional cohort. Clin Nutr 41, 1667–1675.CrossRefGoogle ScholarPubMed
Cardoso, MA, Matijasevich, A, Malta, MB, et al. (2020) Cohort profile: the Maternal and Child Health and Nutrition in Acre, Brazil, birth cohort study (MINA-Brazil). BMJ Open 10, e034513.CrossRefGoogle ScholarPubMed
Lourenço, BH, Lima, DL, Vivanco, E, et al. (2020) Agreement between antenatal gestational age by ultrasound and clinical records at birth: a prospective cohort in the Brazilian Amazon. PLoS One 15, e0236055.CrossRefGoogle ScholarPubMed
Filmer, D & Pritchett, LH (2001) Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India. Demography 38, 115–132.Google ScholarPubMed
World Health Organization (1995) Committee on Physical Status: Physical status: The Use and Interpretation of Anthropometry: Report of a WHO Expert Committee. Geneva: WHO.Google Scholar
de Onis, M, Onyango, AW, Borghi, E, et al. (2007) Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 85, 660–667.CrossRefGoogle ScholarPubMed
Institute of Medicine (US), National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines, Rasmussen, KM, et al. (editors) (2009) Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: National Academies Press (US).Google Scholar
Institute of Medicine (US) & National Research Council (US) (2013) Implementing Guidelines on Weight Gain and Pregnancy. Washington, DC: National Academies Press (US).Google Scholar
Augusto, RA, Cobayashi, F & Cardoso, MA (2015) Associations between low consumption of fruits and vegetables and nutritional deficiencies in Brazilian schoolchildren. Public Health Nutr 18, 927–935.CrossRefGoogle ScholarPubMed
Cardoso, MA, Tomita, LY & Laguna, EC (2010) Assessing the validity of a food frequency questionnaire among low-income women in São Paulo, southeastern Brazil. Cad Saude Publica 26, 2059–2067.CrossRefGoogle Scholar
Sato, PM, Couto, MT, Wells, J, et al. (2020) Mothers’ food choices and consumption of ultra-processed foods in the Brazilian Amazon: a grounded theory study. Appetite 148, 104602.CrossRefGoogle ScholarPubMed
Malta, MB, Neves, PAR, Lourenço, BH, et al. (2022) Leisure-time physical activity in Amazonian pregnant women and offspring birth weight: a prospective cohort study. PLoS One 17, e0265164.CrossRefGoogle ScholarPubMed
Salomon, LJ, Bernard, JP, Duyme, M, et al. (2006) Feasibility and reproducibility of an image-scoring method for quality control of fetal biometry in the second trimester. Ultrasound Obstet Gynecol 27, 34–40.CrossRefGoogle ScholarPubMed
Papageorghiou, AT, Sarris, I, Ioannou, C, et al. (2013) Ultrasound methodology used to construct the fetal growth standards in the INTERGROWTH-21st Project. BJOG 120, 27–32.CrossRefGoogle ScholarPubMed
Papageorghiou, AT, Ohuma, EO, Altman, DG, et al. (2014) International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. Lancet 384, 869–879.CrossRefGoogle ScholarPubMed
StataCorp (2017) Stata: Release 15. Statistical Software. College Station, TX: StataCorp LLC.Google Scholar
Drouillet, P, Kaminski, M, De Lauzon-Guillain, B, et al. (2009) Association between maternal seafood consumption before pregnancy and fetal growth: evidence for an association in overweight women. The EDEN mother-child cohort. Paediatr Perinat Epidemiol 23, 76–86.CrossRefGoogle ScholarPubMed
Heppe, DH, van Dam, RM, Willemsen, SP, et al. (2011) Maternal milk consumption, fetal growth, and the risks of neonatal complications: the Generation R Study. Am J Clin Nutr 94, 501–509.CrossRefGoogle ScholarPubMed
Jang, W, Kim, H, Lee, BE, et al. (2018) Maternal fruit and vegetable or vitamin C consumption during pregnancy is associated with fetal growth and infant growth up to 6 months: results from the Korean Mothers and Children’s Environmental Health (MOCEH) cohort study. Nutr J 17, 105.CrossRefGoogle ScholarPubMed
Gomes, CB, Malta, MB, Papini, SJ, et al. (2019) Adherence to dietary patterns during pregnancy and association with maternal characteristics in pregnant Brazilian women. Nutrition 62, 85–92.CrossRefGoogle ScholarPubMed
Naspolini, NF, Machado, PP, Fróes-Asmus, CIR, et al. (2021) Food consumption according to the degree of processing, dietary diversity and socio-demographic factors among pregnant women in Rio de Janeiro, Brazil: the Rio Birth Cohort Study of Environmental Exposure and Childhood Development (PIPA project). Nutr Health 27, 79–88.CrossRefGoogle Scholar
Julia, C, Baudry, J, Fialon, M, et al. (2022) Respective contribution of ultra-processing and nutritional quality of foods to the overall diet quality: results from the NutriNet-Santé study. Eur J Nutr (Epublication ahead of print version 4 August 2022).Google Scholar
Sonnenburg, ED, Smits, SA, Tikhonov, M, et al. (2016) Diet-induced extinctions in the gut microbiota compound over generations. Nature 529, 212–215.CrossRefGoogle ScholarPubMed
Grech, A, Collins, CE, Holmes, A, et al. (2021) Maternal exposures and the infant gut microbiome: a systematic review with meta-analysis. Gut Microbes 13, 1–30.CrossRefGoogle ScholarPubMed
Zaretsky, J, Griess-Fishheimer, S, Carmi, A, et al. (2021) Ultra-processed food targets bone quality via endochondral ossification. Bone Res 9, 14.CrossRefGoogle ScholarPubMed
Ohuma, EO, Villar, J, Feng, Y, et al. (2021) Fetal growth velocity standards from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. Am J Obstet Gynecol 224, 208.e1–208.e18.CrossRefGoogle Scholar
Silva, CCV, El Marroun, H, Sammallahti, S, et al. (2021) Patterns of fetal and infant growth and brain morphology at age 10 years. JAMA Netw Open 4, e2138214.CrossRefGoogle ScholarPubMed
Qian, L, Gao, F, Yan, B, et al. (2021) Mendelian randomization suggests that head circumference, but not birth weight and length, associates with intelligence. Brain Behav 11, e02183.CrossRefGoogle Scholar
Lee, W, Balasubramaniam, M, Deter, RL, et al. (2009) Fetal growth parameters and birth weight: their relationship to neonatal body composition. Ultrasound Obstet Gynecol 33, 441–446.CrossRefGoogle ScholarPubMed
D’Ambrosio, V, Vena, F, Marchetti, C, et al. (2019) Midtrimester isolated short femur and perinatal outcomes: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 98, 11–17.CrossRefGoogle ScholarPubMed
Rohatgi, KW, Tinius, RA, Cade, WT, et al. (2017) Relationships between consumption of ultra-processed foods, gestational weight gain and neonatal outcomes in a sample of US pregnant women. PeerJ 5, e4091.CrossRefGoogle Scholar
Griess-Fishheimer, S, Zaretsky, J, Travinsky-Shmul, T, et al. (2022) Nutritional approaches as a treatment for impaired bone growth and quality following the consumption of ultra-processed food. Int J Mol Sci 23, 841.CrossRefGoogle ScholarPubMed
Gomes, CB, Malta, MB, Louzada, MLDC, et al. (2019) Ultra-processed food consumption by pregnant women: the effect of an educational intervention with health professionals. Matern Child Health J 23, 692–703.CrossRefGoogle ScholarPubMed
Brazil Ministry of Health, Secretariat of Health Care & Primary Health Care Department (2015) Dietary Guidelines for the Brazilian Population. Brasília: Ministry of Health of Brazil. https://bvsms.saude.gov.br/bvs/publicacoes/dietary_guidelines_brazilian_population.pdf (accessed May 2023).Google Scholar
Catherine, NLA, Lever, R, Marcellus, L, et al. (2020) Retaining participants in community-based health research: a case example on standardized planning and reporting. Trials 21, 393.CrossRefGoogle ScholarPubMed
Pereira, PP, Da Mata, FA, Figueiredo, AC, et al. (2017) Maternal active smoking during pregnancy and low birth weight in the Americas: a systematic review and meta-analysis. Nicotine Tob Res 19, 497–505.CrossRefGoogle ScholarPubMed
Minami, M, J-P, NA, Noguchi, S, et al. (2022) Gestational weight gain mediates the effects of energy intake on birth weight among singleton pregnancies in the Japan Environment and Children’s Study. BMC Pregnancy Childbirth 22, 568.CrossRefGoogle ScholarPubMed