Consumo de alimentos ultraprocessados por gestantes assistidas na Atenção Primária à Saúde de um município no norte de Minas Gerais, Brasil

Abstract

Pregnancy is a phase that requires special care, which includes nutrition, since the nutritional status of the pregnant woman can influence the outcome of pregnancy, childbirth and the postpartum period. However, the diet of the world's population, including this group of women, has undergone major changes, with a reduction in the consumption of fresh or minimally processed foods, and an increase in the intake of ultra-processed foods. Considering that pregnant women's dietary patterns are an important subject of study in epidemiology, in order to promote maternal and child health, this work sought to analyze the consumption of ultra-processed foods by pregnant women assisted in the Primary Health Care network in a municipality in the north of Minas Gerais, Brazil. This is an epidemiological, population-based, analytical cross-sectional study. Data collection took place between 2018 and 2019, with the participation of 1.279 pregnant women registered in the teams of the Family Health Strategy in the municipality of Montes Claros. Food consumption items, collected through the Food Consumption Frequency Questionnaire (QFA), were organized according to the NOVA classification, which considers the extent and purpose of industrial food processing. The first manuscript of the dissertation analyzed the consumption of ultra processed foods (in kilocalories) and its association with body image, nutritional status and physical activity of the interviewees. It showed that the caloric intake from ultra-processed foods represented 32.0% of the daily diet of pregnant women, being associated with physical activity (β=-0,08; p<0,01), pre-pregnancy nutritional status (β=-0,12; p<0,01) and body image (β=0,08; p=0,01). The second manuscript analyzed the consumption of ultra-processed products (in consumption score) and its association with sociodemographic, clinical and nutritional characteristics of pregnant women. It was found that the prevalence of high consumption (scores ≥ 5) of ultra-processed foods was 78,3%. There was an association of this consumption with the following characteristics: being between the age groups of up to 20 years old (RP=1,26; p<0,001) and from 21 to 30 years old (RP=1,14; p=0,001), having a higher income to 1 minimum wage (RP=0,89; p= 0,005); not having arterial hypertension (RP= 1,40; p=0,024), nor diabetes mellitus (RP=1,32; p=0,009), and presenting depressive symptoms (RP=1,06; p=0,050); not having dieted during pregnancy (RP=1,33; p=0,001) and eating less than 3 meals a day (RP=1,14; p=0,029). The third study aimed to report the experience regarding the operationalization, construction and dissemination of the Podcast 13 Saber para Nascer.cast, a technical product developed in this dissertation, as an educational tool to promote the health of pregnant and postpartum women. The Podcast, launched on the Spotify platform in 2022, included eleven episodes, with an average duration of 30 minutes. The episodes had the participation of guests (teachers, health professionals and pregnant women) to clarify important points regarding various topics addressed about the pregnancy puerperal period. A high prevalence of consumption of ultra-processed foods was observed among pregnant women in a municipality in the north of Minas Gerais. Sociodemographic, clinical, nutritional and lifestyle aspects such as having a family income greater than one minimum wage, being younger, having a lower level of physical activity, negative body image, high pre-pregnancy nutritional status, having depressive symptoms, not having high blood pressure and diabetes mellitus, not having dieted during pregnancy and eating less than three meals a day were associated with the consumption of ultra-processed foods. In this perspective, it is verified the importance of health professionals developing educational actions, such as the Podcast Saber para Nascer.cast, with the objective of providing pregnant women with greater guidance and clarification on the different themes that permeate the pregnancy-puerperal period, among them taking care of eating habits.