Dietary Patterns and Gestational Weight

Gain in the Alberta Pregnancy Outcomes

and Nutrition Study
1. Megan Jarman1,
2. Rhonda C Bell1 and
3. Paula J Robson1,2
+Author Affiliations
1. 1AFNS, University of Alberta, Edmonton, AB, Canada
2. 2Cancer Measurement, Outcomes, Research and Evaluation, Alberta Health Services, Edmonton,
AB, Canada

Abstract

Inappropriate weight gain during pregnancy is associated with adverse health outcomes for both mother and baby. In
2010, Health Canada adopted the Institute of Medicines guidelines on gestational weight gain (GWG). This study
explored the extent to which dietary patterns reported in the 2ndtrimester of pregnancy were associated with adherence
to Health Canadas (2010) guidelines for total GWG. The Alberta Pregnancy Outcomes and Nutrition study (APrON)
is a prospective cohort of women recruited and followed through pregnancy and the post-partum period. Total GWG
for each woman (n=2067) was calculated by subtracting pre-pregnancy weight from highest weight in pregnancy.
Women were categorized by pre-pregnancy BMI (self-reported pre-pregnancy weight (kg)/measured height (m)2) and
whether total GWG was below, met or exceeded the guidelines. Diet was assessed by 24-hour recall in the
2nd trimester and foods/beverages were coded into 51 food groups based on nutritional similarity. Principal
components analysis was run on the energy adjusted food groups. For components which accounted for the greatest
variance, a dietary pattern score was calculated by multiplying each womans standardized consumption (g/day) of
each food group by the corresponding coefficient for the component and summing. Scores were expressed as a z-
score, with a mean of zero and standard deviation of one. Associations between dietary pattern scores and adherence
to GWG guidelines were assessed using multinomial logistic regression. Table 1 shows proportions of women who
were below, met or exceeded the guidelines by pre-pregnancy BMI group. Three main dietary patterns were identified
in this cohort: (i) Healthy, (3.8% of the variance) was characterized by higher intakes of fruits, vegetables,
wholemeal bread, and lower intakes of high-energy soft drinks, processed meat and white-bread; (ii) Refined Carbs
(3.3% of the variance) was characterized by higher intakes of rice and pasta, added sugar, breakfast cereal and white
bread, and lower intakes of wholemeal bread; and (iii) Tea and Toast (3.1% of the variance), was characterized by
higher intakes of tea and coffee, added sugar, full-fat milk and white bread. In the unadjusted models, relative to
women who met the guidelines, the odds of exceeding the guidelines were lower in women with higher healthy diet
scores (OR 0.71, 95% CI: 0.52, 0.96). This association was observed only in women with a pre-pregnancy BMI in the
overweight group, and it became non-significant when adjusted for educational attainment. Neither the Refined
Carbs nor Tea and Toast patterns were associated with GWG in any of the pre-pregnancy BMI categories. Dietary
patterns analysis can be a useful tool in observational studies. However, assessing the impact of diet on GWG is
challenging and further research is needed to account for measurement error when using single 24 hour recalls for
dietary assessment.

April 2016The FASEB Journalvol. 30 no. 1 Supplement1150.14