The relationship between self perceived food environment and fruit and vegetable intake by pregnant women.

Author(s)

Daniela Cristina Candelas Zuccolotto

• Document type: Master's Dissertation
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC)
• Defense date: 2013-06-14

Examining board members

Daniela Saes Sartorelli; Rosa Wanda Diez Garcia; Patrícia Constante Jaime

• Advisor: Daniela Saes Sartorelli

Abstract

Introduction: The adequate intake of fruits and vegetables (FV) during pregnancy has a positive impact on the health of women and children. Environmental factors associated with eating behavior have received attention in the context of public health by directly affecting individuals health. However, unaware of the existence of studies that investigated the relationship between self perceived food environment and fruit and vegetable intake in pregnant women. Objective: To evaluate the reliability of a self perceived questionnaerie about the food environment and for the consumption of fruit and vegetable in pregnant women (manuscript 1). To evaluate the relationship between self perceived food environment and the adequate consumption of fruits and vegetables in pregnant women (manuscript 2). Methods: The study was conducted in 2010 among 48 pregnant women attended by the public health service of Ribeirão Preto, SP. The questionnaire consists of 12 multiple choice questions which include the perception of the food environment and consumption of FV. To investigate the reproducibility of the questionnaire, it was administered twice, between 15 and 45 days apart. The agreement between the responses was assessed using the Kappa or Kappa weighted (manuscript 1). A cross-sectional study was conducted in 2012 among 282 adult pregnant women. Fruit and vegetable intake during pregnancy was assessed by a food frequency questionnaire, and 2 dietary recalls. The Multiple Source Method approach was applied to estimate usual FV intake. Self perceived food environment was assessed by a structured questionnaire. For the present analysis, we examined the association of self perceived food environment and the adequate intake of fruit and vegetable (400g/daily) in logistic regression models [OR (95% CI)], adjusted by maternal age, socioeconomic class, and educational level (manuscript 2). Results: Manuscript 1 describes the reliability of a self perceived questionnaire about the food environment and for the consumption of fruits and vegetables in pregnant women. There was strong agreement (Kappa: 0,6 to 0,79) for: meals per day, habit of eating at work, distance between the residence and places to purchase fruit and vegetable, quality of fruit and vegetable at the purchase place. Moderate agreement (Kappa 0,4 to 0,59): habit of eating out of home, habit of eating in self service restaurant, habit of eating in fast food restaurant, purchase food at grocery stores, convenience stores or bakery, variety of fruits and vegetables available and family support for healthy eating. Weak agreement (Kappa 0,2 to 0,39): habit of eating in friends or family house, purchase food at supermarket or FV specialized food market and perception of FV price. All the questions that had weak agreement were reformulated prior to use it. The manuscript 2 showed that 35% of the women intervied reported adequate intake of FV during pregnancy, with no association between self perceived food environment and adequate FV intake. However, a higher meal frequency was associated with a better chance of daily adequate intake of fruit and vegetable [OR 2.01 (95% CI 1.03, 3.91) p 0.04]. Moreover, the habit of buying fruit and vegetable in Abstract specialized food market was associated with the daily intake of 400g of fruit and vegetable [OR 1.68 (IC95% 1.01, 2.80) p 0.05]. Conclusion: The questionnaire of the perceived food environment and for the consumption of fruits and vegetables showed good precision among pregnant women. No association between self-perceived food environment and the adequate intake of FV among pregnant women was found. (AU)

• FAPESP's process: 11/03558-7 - The relation between self perceived food environment and fruit and vegetable intake by pregnant women.
• Grantee: Daniela Cristina Candelas Zuccolotto
• Support Opportunities: Scholarships in Brazil - Master