Dietary patterns of women during the first year postpartum in an area of high socioeconomic vulnerability: a cohort study
Keywords: dietary patterns; postpartum period; maternal nutrition; food insecurity; cohort studies.
The study aims to identify dietary patterns of women during the first year postpartum and evaluate the effect of food insecurity, age and education on adherence to dietary patterns. This is a longitudinal study with data from a prospective cohort conducted in Brazil between the years 2017-2018. Analysis of the main components was carried out to identify dietary patterns, based on three food frequency questionnaires, applied to women in the third (n= 207), sixth (n= 195) and twelfth (n= 183) month postpartum, through home visits. To evaluate the effect of food insecurity and demographic factors on adherence to the identified dietary patterns, generalized logistic regression models, with mixed, fixed and random effects, were developed. We identified two dietary patterns with different composition: the first dietary pattern identified was composed of predominantly healthy and traditional foods from the study region, named Predominant Healthy (PHDP); the second dietary pattern was composed of mostly ultra-processed foods, being named Predominant Ultra-processed (PUPDP). Dietary patterns did not show temporal variation during the analyzed period. The effect on greater adherence to PAPS remained, increasing age (OR=1.08; p= 0.032), greater access to education (OR=1.18; p= 0.026) and lower food insecurity score (OR= 0.85; p= 0.009). Regarding adherence to PUPDP, we observed an inverse association with age (OR=0.92; p=0.033) and access to education (OR=0.84; p= 0.029) and with higher food insecurity scores (OR=1.18; p= 0.010). We observed a negative association between PHDP adherence and the level of food insecurity. This relationship with PUPDP was positive. The higher the age and level of education, the greater the adherence to PAPS. Conversely, the lower the age and level of education, the greater the adherence to PAPUP. We recommend resolute responses, aiming at food security and the human right to adequate food, especially in the most vulnerable populations.