Association of dietary patterns and degree of food processing with feelings of depression in pregnancy

Abstract Objectives: to investigate the relationship of dietary patterns and degree of food processing with feelings of depression in pregnancy. Methods: cross-sectional study conducted with 784 adult pregnant women in Ribeirão Preto, SP, between 2011 and 2012. Feelings of depression were obtained through a structured questionnaire. Two 24-hour dietary recalls were obtained (24th-39th weeks of gestation) and adjusted through the Multiple Source Method. Four dietary patterns were determined: “Brazilian traditional”,“snacks”, “coffee”, and “healthy”. Adjusted logistic regression models were used to assess the relationship ofthe tertiles of dietary patterns and energy contribution (% E) of foods according to the degree of industrial processing with feelings of depression (always/most of the time vs. sometimes/never). Results: 12% of the women reported feelings of depression during the pregnancy. Women with greater adherence to “Brazilian traditional”[OR= 0.54 (CI95%= 0.30-0.97)] and “healthy” patterns [0.53 (0.30-0.94)] and with higher % E from minimally processed foods [0.51 (0.28-0.93)] presented a lower chance of feelings of depression. A higher % E from ultra-processed foods [2.39 (1.29-4.41)] was directly associated with the outcome. No associations with the other patterns were found. Conclusions: greater adherence to the“Brazilian traditional” and “healthy” dietary patterns was inversely associated with feelings of depression during pregnancy, possibly mediated by the degree of industrial processing of the foods.

摘要
研究目的：探讨妊娠期饮食模式与食品加工程度和抑郁情绪之间的关联。
方法：本研究为横断面研究，于2011至2012年间在圣保罗州里贝朗普雷图市纳入784名成年孕妇开展。采用结构化问卷收集孕妇的抑郁情绪相关数据；于妊娠第24~39周期间完成两次24小时膳食回顾调查，并通过多源法（Multiple Source Method）对膳食数据进行校正。最终确定四类饮食模式：「巴西传统型」、「零食型」、「咖啡型」以及「健康型」。采用校正后的logistic回归模型，评估饮食模式三分位数以及按食品工业加工程度划分的食物能量供能比（%E）与抑郁情绪（几乎一直/多数时间出现vs.有时/从未出现）之间的关联。
结果：12%的孕妇报告在妊娠期存在抑郁情绪。对「巴西传统型」饮食模式依从性更高的孕妇[比值比（OR）=0.54，95%置信区间（CI）=0.30~0.97]、对「健康型」饮食模式依从性更高的孕妇[OR=0.53，95%CI=0.30~0.94]，以及摄入轻度加工食品能量占比更高的孕妇[OR=0.51，95%CI=0.28~0.93]，其发生抑郁情绪的风险显著降低；而超加工食品能量占比更高的孕妇[OR=2.39，95%CI=1.29~4.41]，其抑郁情绪发生风险显著升高。未观察到其余两类饮食模式与抑郁情绪存在显著关联。
结论：妊娠期对「巴西传统型」与「健康型」饮食模式的更高依从性，与抑郁情绪呈负相关，该关联可能由食品的工业加工程度所介导。