验证一种妊娠适应型地中海饮食依从性筛查工具（preg-MEDAS）：一项嵌套于改善母亲产前保健试验（IMPACT BCN）的验证研究。

Validation of a pregnancy-adapted Mediterranean Diet Adherence Screener (preg-MEDAS): a validation study nested in the Improving Mothers for a better PrenAtal Care Trial BarCeloNa (IMPACT BCN) trial.

机构信息

BCNatal | Barcelona Center for Maternal and Fetal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain; Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, Barcelona, Spain.

BCNatal | Barcelona Center for Maternal and Fetal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin, RD21/0012/0001, Instituto de Salud Carlos III, Barcelona, Spain.

出版信息

Am J Clin Nutr. 2024 Aug;120(2):449-458. doi: 10.1016/j.ajcnut.2024.05.025. Epub 2024 Jun 1.

DOI:10.1016/j.ajcnut.2024.05.025

PMID:38830408

Abstract

BACKGROUND

Non-time-consuming and easy-to-administer dietary assessment tools specific for pregnancy are needed.

OBJECTIVES

The aim of this validation study nested in the IMPACT BCN (Improving Mothers for a better PrenAtal Care Trial BarCeloNa) trial is to determine the concurrent validity of the 17-item pregnancy-adapted Mediterranean diet score (preg-MEDAS) and to analyze whether changes in the preg-MEDAS score were associated with maternal favorable dietary and cardiometabolic changes after 3 mo of intervention in pregnant women.

METHODS

Dietary data was collected in 812 participants using the preg-MEDAS and a 151-item validated food frequency questionnaire (FFQ) at baseline (19-23 wk gestation) and final visit (31-34 wk gestation). Concurrent preg-MEDAS validity was evaluated by Pearson and intraclass correlation coefficients, κ statistic, and Bland-Altman methods.

RESULTS

The preg-MEDAS had a good correlation with the FFQ (r = 0.76 and intraclass correlation coefficient 0.75). The agreement of each of the preg-MEDAS items ranged from 40.9% to 93.8% with a substantial agreement mean concordance (κ = 0.61). A 2-point increase in preg-MEDAS was associated with a decrease in maternal mean and systolic blood pressure (β: -0.51 mmHg; 95% confidence interval [CI]: -0.97, -0.04 mmHg and -0.87 mmHg; 95% CI: -1.48, -0.26 mmHg, respectively).

CONCLUSIONS

The preg-MEDAS displays good validity for assessing adherence to the Mediterranean diet, allowing detection of dietary changes over time. In addition, changes observed in preg-MEDAS are significantly associated with a decrease in maternal blood pressure. Therefore, we propose preg-MEDAS as a rapid and simple dietary assessment tool during pregnancy. This trial was registered at clinicaltrials.gov as NCT03166332.

摘要

背景

需要一种非耗时且易于管理的专门针对妊娠的饮食评估工具。

目的

本验证研究嵌套在 IMPACT BCN（改善母亲产前保健试验巴塞隆纳）试验中，旨在确定 17 项妊娠适应型地中海饮食评分（preg-MEDAS）的同时效度，并分析 preg-MEDAS 评分的变化是否与孕妇干预 3 个月后母体有利的饮食和心血管代谢变化相关。

方法

在基线（19-23 孕周）和最终访视（31-34 孕周）时，使用 preg-MEDAS 和经过验证的 151 项食物频率问卷（FFQ）收集 812 名参与者的饮食数据。通过 Pearson 和组内相关系数、κ 统计量和 Bland-Altman 方法评估 preg-MEDAS 的同时效度。

结果

preg-MEDAS 与 FFQ 具有良好的相关性（r = 0.76，组内相关系数 0.75）。preg-MEDAS 中每个项目的一致性范围从 40.9%到 93.8%，具有实质性的一致性平均一致性（κ=0.61）。preg-MEDAS 增加 2 分与母体平均血压和收缩压下降相关（β：-0.51mmHg；95%置信区间 [CI]：-0.97，-0.04mmHg 和-0.87mmHg；95%CI：-1.48，-0.26mmHg，分别）。

结论

preg-MEDAS 可用于评估地中海饮食的依从性，显示出良好的有效性，可检测随时间的饮食变化。此外，preg-MEDAS 观察到的变化与母体血压下降显著相关。因此，我们建议 preg-MEDAS 作为妊娠期间快速简便的饮食评估工具。该试验在 clinicaltrials.gov 上注册为 NCT03166332。