Avaliação do consumo alimentar no período reprodutivo e variação de peso no pós-parto

• Autor(a) principal: Castro, Maria Beatriz Trindade de
• Data de Publicação: 2008
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/4604
• topic: Repeated measurements; Obesity; Reproductive period; Body weight change and diet; Medidas repetidas; Obesidade; Ciclo reprodutivo; Variação de peso e dieta; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA

The central focus of the present study is the body weight change and food intake of women during the reproductive cycle. The study constitutes the final work in the author s Doctorate degree. It was divided in three parts: i) revision of the scientific literature regarding the main determinants in the development of maternal obesity; ii) longitudinal comparability of quantity and quality of the mothers diet (energy, nutrients and food intake) during pregnancy and postpartum; and iii) prospective evaluation of the effects of a high-protein (HP) diet (&#8805; 1.2 g/kg) versus a low-protein (LP) diet (< 1.2 g/kg) on body weight loss (BWL) during postpartum. Study population was constituted of a cohort of postpartum women, who underwent four follow-up evaluations (at 0.5, 2, 6, and 9 months) following delivery. These data were obtained from May 1999 to April 2001 (15 months recruitment and 9 mo. of follow up) at a primary healthy service Marcolino Candau Municipal Health Center in Rio de Janeiro City, Brazil. Participants were recruited: 1) during routine prenatal care at the Municipal Health Center; 2) at the time of routine Bacillus Calmette-Guérin immunization of the newborn at the same health center; and 3) at the main maternity hospital in the study area, one to three days following delivery. Among 709 women that were invited to participate in the research, 479 accepted. Eligibility criteria for enrollment in the cohort were: age between 15 to 45 years, less than 30 days following the delivery on the date of the first interview (approximately at 0.5 mo), absence of chronic diseases, no history of actual twin birth, gestational age at delivery &#8805; 35 weeks, and household address within the area of the local health center. Women aged < 18 years (n = 47) were excluded from the analyses. All study protocols met the guidelines of the Research Ethics Committee, and were approved by the Center for Collective Health Studies of the Federal University of Rio de Janeiro (NESC/UFRJ). The first part of the study, namely the revision of scientific literature, indicated the main risk factors for body weight change during postpartum: gestational weight gain, pre-pregnancy weight, diet, physical activity, breastfeeding, age, schooling, income, parity, and race. The second part of the study was aimed at accessing the dietary composition of women during pregnancy and postpartum., For that end, a semi-quantitative food frequency questionnaire (FFQ) which had been previously validated (Sichieri & Everhart, 1998) was applied during interview with the participants in their first visit to the health center (at the second or third trimester of pregnancy), and at six months following delivery. Two hundred and seventy-six women took part in both interview stages. Results showed that women in their gestational period have a higher intake of energy in their diet, and that women who restrained their energy intake the most presented a higher protein density in their diet during postpartum. Prospective analysis to evaluate the effects of a HP diet on BWL considered 430 participants at the first interview. Results showed that women with a HP diet lost more weight over time than women with a LP diet (226 g/month versus 123 g/month).