Prepregnancy Dietary Patterns Are Associated with Blood Lipid Level Changes During Pregnancy: A Prospective Cohort Study inRio de Janeiro, Brazil.

BACKGROUND
Physiologic adaptations lead to an increase in blood lipid levels during pregnancy, yet little is known about the influence of prepregnancy dietary patterns.

AIM
To identify whether prepregnancy dietary patterns that explain the consumption of fiber, energy, and saturated fat are associated with blood lipid levels throughout pregnancy.

DESIGN
Prospective cohort study, with data collection at gestational weeks 5 to 13, 20 to 26, and 30 to 36. A food frequency questionnaire was administered at baseline (gestational week 5 to 13).

PARTICIPANTS/SETTING
Women with singleton pregnancy (N=299) aged 20 to 40 years, without infectious/chronic disease (except obesity) were enrolled in the study. One hundred ninety-nine women were included in the final analysis. The study took place at a prenatal service of a public health care center in Rio de Janeiro, Brazil, during the period from 2009 to 2012.

MAIN OUTCOME MEASURES
Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and triglyceride levels, measured at all trimesters.

STATISTICAL ANALYSES PERFORMED
Dietary patterns were derived by reduced rank regression. Fiber density, dietary energy density, and percent energy from saturated fat were response variables. Crude and adjusted longitudinal linear mixed-effects regression models were performed to account for confounders and mediators. Interaction terms between dietary pattern and gestational week were tested.

RESULTS
Fast Food and Candies; Vegetables and Dairy; and Beans, Bread, and Fat patterns were derived. Our Fast Food and Candies pattern was positively associated with triglyceride level (β=4.961, 95% CI 0.945 to 8.977; P=0.015). In the HDL-C rate of change prediction, significant interactions were observed between both the Fast Food and Candies and Vegetables and Dairy patterns and gestational week (β=-.053, 95% CI -0.101 to -0.004; P=0.035 and β=.055, 95% CI -0.002 to 0.112; P=0.060, respectively). The Beans, Bread, and Fat pattern was not associated with blood lipid levels.

CONCLUSIONS
Prepregnancy dietary patterns were associated with gestational blood lipid levels; that is, higher scores for the Fast Food and Candies pattern were associated with higher triglyceride and slower HDL-C rates of change during pregnancy, whereas higher scores for the Vegetables and Dairy dietary patterns were associated with faster HDL-C rates of change over gestational weeks.