American Diabetes Association
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Periconceptional and First Trimester Ultraprocessed Food Intake and Maternal Cardiometabolic Outcomes

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posted on 2022-07-19, 13:05 authored by Samrawit F. Yisahak, Stefanie N. Hinkle, Sunni L. Mumford, Jessica L. Gleason, Katherine L. Grantz, Cuilin Zhang, Jagteshwar Grewal


OBJECTIVE: Ultraprocessed foods (UPFs) have been linked with obesity and cardiometabolic diseases in the general population, but are understudied in pregnancy. We examined associations of UPF intake with gestational weight gain (GWG), glycemic, and blood pressure outcomes in pregnancy.

RESEARCH DESIGN AND METHODS: Pregnant women (n=1948) in a prospective US cohort self-reported past 3-month diet using a food frequency questionnaire (FFQ) at 8-13 weeks of gestation. The intake quantity (grams/day) of foods and beverages identified as UPFs was ranked into quartiles. Associations of UPFs were evaluated, after adjusting for confounders, with second and third trimester Institute of Medicine (IOM) GWG categories, gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (GHTN). Secondary outcomes included GWG rate, glucose challenge test 1-hour glucose, and blood pressure trajectories from linear mixed models.

RESULTS: Four hundred ninety-two (25.2%) and 699 (35.9%) women had 2nd and 3rd trimester excessive GWG , respectively. Eighty-five (4.4%) women had GDM and 63(3.2%) had severe hypertension or preeclampsia. UPF intake was not associated with higher odds of excessive GWG (quartile 4 vs. 1: ORadj= 0.68 [0.44, 1.05], P-trend =0.10 for second trimester) or GDM risk (quartile 4 vs. 1: RRadj = 0.99 [0.46, 2.11], P-trend =0.85). Although UPF intake was positively associated with minor differences BP trajectories, associations with GHTN were null. 

CONCLUSIONS: The expected unfavorable association of higher UPF intake with excessive GWG, GDM, and GHTN was not observed in our cohort of low-risk pregnant women. These results are based on a limited sample size and require replication. 


This work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD. Contracts: HHSN275200800013C, HHSN275200800002I, HHSN27500006, HHSN275200800003IC, HHSN275200800014C, HHSN275200800012C, HHSN275200800028C, and HHSN275201000009C.


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