Longitudinal dietary trajectories from pregnancy to 3 years post delivery in women with obesity: relationships with adiposity

Objective: The study aim was to examine the relationships between longitudinal dietary trajectories from early pregnancy to 3 years post delivery and adiposity measures in women with obesity.

Methods: The diets of 1208 women with obesity in the UPBEAT (UK Pregnancy Better Eating and Activity Trial) study were assessed using a food frequency questionnaire (FFQ) at 15⁺⁰ to 18⁺⁶ weeks' gestation (baseline), 27⁺⁰ to 28⁺⁶ weeks' gestation, and 34⁺⁰ to 36⁺⁰ weeks' gestation, as well as 6 months and 3 years post delivery. Using factor analysis of the baseline FFQ data, four dietary patterns were identified: fruit & vegetable, African/Caribbean, processed, and snacking. The baseline scoring system was applied to the FFQ data at the four subsequent time points. Group-based trajectory modeling was used to extract longitudinal dietary pattern trajectories. Using adjusted regression, associations between dietary trajectories and log-transformed/standardized adiposity measures (BMI and waist and mid-upper arm circumferences) at 3 years post delivery were examined.

Results: Two trajectories were found to best describe the data for the four individual dietary patterns; these were characterized as high and low adherence. A high adherence to the processed pattern was associated with a higher BMI (β = 0.38 [95% CI: 0.06-0.69]) and higher waist (β = 0.35 [0.03-0.67]) and mid-upper arm circumferences (β = 0.36 [0.04-0.67]) at 3 years post delivery.

Conclusions: In women with obesity, a processed dietary pattern across pregnancy and 3 years post delivery is associated with higher adiposity.