Association of Prepregnancy Dietary Patterns and Anxiety Symptoms from Midpregnancy to Early Postpartum in a Prospective Cohort of Brazilian Women

Journal of the Academy of Nutrition and Dietetics

Volume 115, Issue 10, October 2015, Pages 1626–1635

Research

• Ana Amélia F. Vilela, MSc,
• Thatiana de J.P. Pinto, MSc,
• Fernanda Rebelo, MSc,
• Camila Benaim, RD,
• Jaqueline Lepsch, MSc,
• Christian Henrique Dias-Silva,
• Maria Beatriz T. Castro, PhD,
• Gilberto Kac, PhD^,

 

doi:10.1016/j.jand.2015.01.007

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Abstract

Background

Adherence to unhealthy dietary patterns may alter the risk of mental disorders during pregnancy and the postpartum period.

Objective

To analyze the association between prepregnancy dietary patterns and prospective variations on anxiety symptoms from midpregnancy to early postpartum.

Methods

A prospective cohort of 207 healthy pregnant women was followed at 5 to 13, 20 to 26, and 30 to 36 gestational weeks, and once at 30 to 45 days postpartum. The State-Trait Anxiety Inventory was used to evaluate anxiety symptoms at the second and third gestational trimesters and during the postpartum period. Dietary intake was assessed using a food frequency questionnaire administered during the first trimester of pregnancy that referred to the 6 months before pregnancy. Principal components analysis was used to identify dietary patterns and three prepregnancy dietary patterns were identified: common-Brazilian, healthy, and processed. Three longitudinal mixed-effect models were estimated to verify the association between dietary patterns and anxiety symptoms, adjusted for confounding variables.

Results

The mean anxiety symptom scores were 40.4, 40.5, and 37.2 for the second trimester, third trimester, and postpartum, respectively. The rate of variation of the State-Trait Anxiety Inventory score was 0.535 (95% CI –0.035 to 1.107; P=0.066) and –0.010 (95% CI –0.018 to –0.002; P=0.019) when accounting for gestational age and quadratic gestational age, respectively. The common-Brazilian pattern, comprised mainly of rice and beans (β=–1.200, 95% CI –2.220 to –0.181; P=0.021), and the healthy pattern comprised mostly of vegetables, fruits, fish, and tea (β=–1.290, 95% CI –2.438 to –0.134; P=0.029), were negatively associated with prospective changes in anxiety symptoms.

Conclusions

High adherence to the common-Brazilian or healthy patterns was negatively associated with higher anxiety symptom scores from mid-pregnancy to early postpartum in this group of Brazilian women.

Keywords

• Anxiety;
• Food consumption;
• Factor Analysis-Statistical;
• Pregnancy;
• Cohort study

STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

FUNDING/SUPPORT This study was funded by Carlos Chagas Filho Research Foundation from the State of Rio de Janeiro (grant no. E-26/110.681/2012), National Council for Scientific and Technological Development, and the Brazilian Coordination Body for the Training of University Level Personnel.

Address correspondence to: Gilberto Kac, PhD, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Avenida Carlos Chagas Filho, 367, CCS – Bloco J – 2° andar, sala 29 Cidade Universitária – Ilha do Fundão, Rio de Janeiro, RJ, 21941-590, Brazil.

Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A. A. F. Vilela is a doctoral student, Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, and Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.

C. Benaim is a master's degree student, Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, and Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.

J. Lepsch is a doctoral student, Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, and Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.

G. Kac is a professor, Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, and Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.

T. J. P. Pinto is a doctoral student, National School of Public Health, Oswaldo Cruz Foundation, Nutritional Epidemiology Observatory, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.

F. Rebelo is a doctoral student, National School of Public Health, Oswaldo Cruz Foundation, Nutritional Epidemiology Observatory, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.

C. H. D. Silva is an undergraduate student, Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.

M. B. T. Castro is a professor, Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.