Increased consumption of ultra-processed foods during pregnancy is associated with sociodemographic, behavioral, and obstetric factors: A cohort study

A diet based on ultra-processed food (UPF) does not meet nutritional needs, especially dur-ing pregnancy. The aim of this study is to assess the change in UPF consumption from pre-conception to pregnancy and associated factors. Our hypothesis is that women tend to adopt a healthier eating pattern during pregnancy, decreasing the intake of UPF and increasing the intake of unprocessed/minimally processed foods. A prospective cohort study with 326 par-ticipants was carried out from 2016 to 2019 in 2 health units in Rio de Janeiro, Brazil. Preges-tational food consumption assessed using the food frequency questionnaire in the prenatal interview in women up to 20 gestational weeks and gestational consumption in the inter-view 2 months after delivery. Food items classified according to the NOVA system. For the mean variation from preconception to gestational UPF consumption, we used the general-ized estimating equations model with linear distribution. Control of confounding variables was based on the literature on factors associated with UPF consumption, using a 3-level hi-erarchical model. The proportion of UPF energy consumption was 28.9% in preconception and 33% during pregnancy. Older and more educated women had a lower mean variation in the consumption of UPF during the pregnancy. A higher average consumption of UPF ob-served among women physically inactive before pregnancy, who smoked during pregnancy, were multiparous, and with had a low pregestational weight. These results reflect similar behavior to that of the general population, aggravated by a significant increase during preg-nancy. However, older and more educated women and those with healthy behaviors showed lower UPF intake in pregnancy. (c) 2023 Elsevier Inc. All rights reserved.