收稿日期: 2024-07-04
录用日期: 2024-11-20
网络出版日期: 2025-01-28
基金资助
上海交通大学医学院大学生创新训练计划(S202410248550)
Research progress in the relationship between ultra-processed food intake and pregnancy outcomes
Received date: 2024-07-04
Accepted date: 2024-11-20
Online published: 2025-01-28
Supported by
Shanghai Jiao Tong University School of Medicine Student Innovation Training Program(S202410248550)
近年来超加工食品（ultra-processed foods，UPFs）在全球范围内消费量迅速增长。UPFs是NOVA分类体系中描述的第四类食品：为工业配方食品，完全或主要由从食物中提取的物质（油、脂肪、糖、淀粉和蛋白质等）、来自食物成分的衍生物（氢化脂肪和改性淀粉等）或多种食品添加剂制成；制造技术包括挤压、成型和预煎炸等。作为高能量密度食品，UPFs通常具有高糖、脂肪和盐，低膳食纤维、蛋白质、维生素和矿物质的特点，营养密度较低。多项研究显示UPFs高摄入能够增加多种慢性疾病的发生风险。孕期营养是影响妊娠结局的重要因素，孕期均衡且充分的营养摄入能够保障母婴的健康。UPFs营养密度有限，孕期对其的高摄入可能不利于母婴健康，但孕期UPFs摄入影响母婴健康的研究有限。该文针对UPFs对妊娠结局影响的相关文献进行了综述，旨在为深入研究UPFs对孕期健康的影响以及进行个性化膳食指导提供研究依据。
糜小扬 , 丁莹 , 陈奕静 , 贾洁 . 孕期超加工食品摄入与妊娠结局关系的研究进展[J]. 上海交通大学学报（医学版）, 2025 , 45(1) : 113 -121 . DOI: 10.3969/j.issn.1674-8115.2025.01.014
In recent years, the global consumption of ultra-processed foods (UPFs) has increased. UPFs are classified as the fourth group of food in the NOVA classification system: industrially formulated foods made entirely or mostly from substances extracted from foods (oils, fats, sugar, starch, proteins, etc), derivatives of food constituents (hydrogenated fats, modified starches, etc), or multiple food additives. Common manufacturing techniques include extrusion, moulding, and pre-frying. As high-energy-density foods, UPFs are typically characterized by high levels of sugar, fat, and salt, and low levels of dietary fiber, protein, vitamins, and minerals, resulting in low nutrient density. Studies have shown that a high intake of UPFs increases the risk of various chronic diseases. Nutrition during pregnancy is a crucial factor influencing pregnancy outcomes, and balanced and adequate nutrient intake is essential for the health of both the mother and child. Given that UPFs have limited nutritional density, high intake during pregnancy may be detrimental to maternal and infant health. However, the impact of consuming UPFs during pregnancy on maternal and infant health is not extensively studied. This article reviews the literature on the effects of UPFs on pregnancy outcomes, aiming to provide a foundation for further research and personalized dietary guidance.
| 1 | MONTEIRO C A, CANNON G, LEVY R B, et al. Ultra-processed foods: what they are and how to identify them[J]. Public Health Nutr, 2019, 22(5): 936-941. |
| 2 | MOODIE R, BENNETT E, KWONG E J L, et al. Ultra-processed profits: the political economy of countering the global spread of ultra-processed foods - A synthesis review on the market and political practices of transnational food corporations and strategic public health responses[J]. Int J Health Policy Manag, 2021, 10(12): 968-982. |
| 3 | TAK M, LAW C, GREEN R, et al. Processed foods purchase profiles in urban India in 2013 and 2016: a cluster and multivariate analysis[J]. BMJ Open, 2022, 12(10): e062254. |
| 4 | JUUL F, PAREKH N, MARTINEZ-STEELE E, et al. Ultra-processed food consumption among US adults from 2001 to 2018[J]. Am J Clin Nutr, 2022, 115(1): 211-221. |
| 5 | COYLE D H, HUANG L P, SHAHID M, et al. Socio-economic difference in purchases of ultra-processed foods in Australia: an analysis of a nationally representative household grocery purchasing panel[J]. Int J Behav Nutr Phys Act, 2022, 19(1): 148. |
| 6 | LATASA P, LOUZADA M L D C, STEELE E M, et al. Added sugars and ultra-processed foods in Spanish households (1990-2010)[J]. Eur J Clin Nutr, 2018, 72(10): 1404-1412. |
| 7 | RICO-CAMPà A, MARTíNEZ-GONZáLEZ M A, ALVAREZ-ALVAREZ I, et al. Association between consumption of ultra-processed foods and all cause mortality: Sun prospective cohort study[J]. BMJ, 2019, 365: l1949. |
| 8 | MONTEIRO C A, CANNON G, MOUBARAC J C, et al. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing[J]. Public Health Nutr, 2018, 21(1): 5-17. |
| 9 | MONTEIRO C A, MOUBARAC J C, CANNON G, et al. Ultra-processed products are becoming dominant in the global food system[J]. Obes Rev, 2013, 14(Suppl 2): 21-28. |
| 10 | ZHANG Y, GIOVANNUCCI E L. Ultra-processed foods and health: a comprehensive review[J]. Crit Rev Food Sci Nutr, 2023, 63(31): 10836-10848. |
| 11 | RAUBER F, CAMPAGNOLO P D B, HOFFMAN D J, et al. Consumption of ultra-processed food products and its effects on children′s lipid profiles: a longitudinal study[J]. Nutr Metab Cardiovasc Dis, 2015, 25(1): 116-122. |
| 12 | MELO I S V, COSTA C A C B, SANTOS J V L D, et al. Consumption of minimally processed food is inversely associated with excess weight in adolescents living in an underdeveloped city[J]. PLoS One, 2017, 12(11): e0188401. |
| 13 | SALOMé M, ARRAZAT L, WANG J H, et al. Contrary to ultra-processed foods, the consumption of unprocessed or minimally processed foods is associated with favorable patterns of protein intake, diet quality and lower cardiometabolic risk in French adults (INCA3)[J]. Eur J Nutr, 2021, 60(7): 4055-4067. |
| 14 | SEDAGHAT F, AKHOONDAN M, EHTESHAMI M, et al. Maternal dietary patterns and gestational diabetes risk: a case-control study[J]. J Diabetes Res, 2017, 2017: 5173926. |
| 15 | BRANTSAETER A L, HAUGEN M, SAMUELSEN S O, et al. A dietary pattern characterized by high intake of vegetables, fruits, and vegetable oils is associated with reduced risk of preeclampsia in nulliparous pregnant Norwegian women[J]. J Nutr, 2009, 139(6): 1162-1168. |
| 16 | DE DEUS MENDON?A R, PIMENTA A M, GEA A, et al. Ultraprocessed food consumption and risk of overweight and obesity: the University of Navarra Follow-Up (SUN) cohort study[J]. Am J Clin Nutr, 2016, 104(5): 1433-1440. |
| 17 | SROUR B, FEZEU L K, KESSE-GUYOT E, et al. Ultraprocessed food consumption and risk of type 2 diabetes among participants of the NutriNet-santé prospective cohort[J]. JAMA Intern Med, 2020, 180(2): 283-291. |
| 18 | NASREDDINE L, TAMIM H, ITANI L, et al. A minimally processed dietary pattern is associated with lower odds of metabolic syndrome among Lebanese adults[J]. Public Health Nutr, 2018, 21(1): 160-171. |
| 19 | DU S T, KIM H, CREWS D C, et al. Association between ultraprocessed food consumption and risk of incident CKD: a prospective cohort study[J]. Am J Kidney Dis, 2022, 80(5): 589-598.e1. |
| 20 | ZHANG S M, GAN S N, ZHANG Q, et al. Ultra-processed food consumption and the risk of non-alcoholic fatty liver disease in the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study[J]. Int J Epidemiol, 2022, 51(1): 237-249. |
| 21 | 杨慧霞, 段涛. 健康与疾病的发育起源: DOHaD在中国[M]. 北京:人民卫生出版社, 2013: 294. |
| YANG H X, DUAN T. The Developmental Origins of Health and Disease: DOHaD in China[M]. Beijing: People′s Medical Publishing House, 2013: 294. | |
| 22 | MARSHALL N E, ABRAMS B, BARBOUR L A, et al. The importance of nutrition in pregnancy and lactation: lifelong consequences[J]. Am J Obstet Gynecol, 2022, 226(5): 607-632. |
| 23 | MARTIN C L, SOTRES-ALVAREZ D, SIEGA-RIZ A M. Maternal dietary patterns during the second trimester are associated with preterm birth[J]. J Nutr, 2015, 145(8): 1857-1864. |
| 24 | ENGLUND-?GGE L, BRANTSAETER A L, SENGPIEL V, et al. Maternal dietary patterns and preterm delivery: results from large prospective cohort study[J]. BMJ, 2014, 348: g1446. |
| 25 | ENGLUND-?GGE L, BRANTS?TER A L, HAUGEN M, et al. Association between intake of artificially sweetened and sugar-sweetened beverages and preterm delivery: a large prospective cohort study[J]. Am J Clin Nutr, 2012, 96(3): 552-559. |
| 26 | RODRIGUES B, AZEREDO V, SILVA A. Relationship between food consumption of pregnant women and birth weight of newborns[J]. Rev Chil Nutr, 2020, 47(1): 80-88. |
| 27 | FERREIRA L B, LOBO C V, DO CARMO A S, et al. Dietary patterns during pregnancy and their association with gestational weight gain and anthropometric measurements at birth[J]. Matern Child Health J, 2022, 26(7): 1464-1472. |
| 28 | VIEIRA E SOUZA R C, MIRANDA C, MAIA DE SOUSA T, et al. Effect of ultra-processed foods consumption and some lifestyle factors during pregnancy on baby′s anthropometric measurements at birth[J]. Nutrients, 2022, 15(1): 44. |
| 29 | SCHRUBBE V, SILVA D L F, ALMEIDA C C B, et al. Ultra-processed food consumption during pregnancy and newborn weight[J]. Rev Bras Saude Mater Infant, 2024, 24: e20230189. |
| 30 | ROCHA G G, ANDRADE-SILVA A, ALVES-SANTOS N H, et al. Association between maternal dietary intake classified according to its degree of processing and sex-specific birth weight for gestational age[J]. Rev Nutr, 2022, 35: e210197. |
| 31 | VICTOR A, GOTINE A R M, FALC?O I R, et al. Association between food environments and fetal growth in pregnant Brazilian women[J]. BMC Pregnancy Childbirth, 2023, 23(1): 661. |
| 32 | LEONE A, MARTíNEZ-GONZáLEZ M á, CRAIG W, et al. Pre-gestational consumption of ultra-processed foods and risk of gestational diabetes in a Mediterranean cohort. the SUN project[J]. Nutrients, 2021, 13(7): 2202. |
| 33 | LAMYIAN M, HOSSEINPOUR-NIAZI S, MIRMIRAN P, et al. Pre-pregnancy fast food consumption is associated with gestational diabetes mellitus among tehranian women[J]. Nutrients, 2017, 9(3): 216. |
| 34 | YISAHAK S F, HINKLE S N, MUMFORD S L, et al. Periconceptional and first trimester ultraprocessed food intake and maternal cardiometabolic outcomes[J]. Diabetes Care, 2022, 45(9): 2028-2036. |
| 35 | ASADI M, SHAHZEIDI M, NADJARZADEH A, et al. The relationship between pre-pregnancy dietary patterns adherence and risk of gestational diabetes mellitus in Iran: a case-control study[J]. Nutr Diet, 2019, 76(5): 597-603. |
| 36 | DONAZAR-EZCURRA M, BURGO C L D, MARTINEZ-GONZALEZ M A, et al. Soft drink consumption and gestational diabetes risk in the SUN project[J]. Clin Nutr, 2018, 37(2): 638-645. |
| 37 | IKEM E, HALLDORSSON T I, BIRGISDóTTIR B E, et al. Dietary patterns and the risk of pregnancy-associated hypertension in the Danish National Birth Cohort: a prospective longitudinal study[J]. BJOG, 2019, 126(5): 663-673. |
| 38 | 胡娅莉. 降低早产发生率: 我们面临的任务[J]. 中国实用妇科与产科杂志, 2023, 39(2): 131-133. |
| HU Y L. Reducing preterm birth rate in China: a task facing us[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2023, 39(2): 131-133. | |
| 39 | GOLDENBERG R L, CULHANE J F, IAMS J D, et al. Epidemiology and causes of preterm birth[J]. Lancet, 2008, 371(9606): 75-84. |
| 40 | BURBACHER T M, GRANT K S, SHEN D D, et al. Chronic maternal methanol inhalation in nonhuman Primates (Macaca fascicularis): reproductive performance and birth outcome[J]. Neurotoxicol Teratol, 2004, 26(5): 639-650. |
| 41 | HASSAN S, JAHANFAR S, INUNGU J, et al. Low birth weight as a predictor of adverse health outcomes during adulthood in twins: a systematic review and meta-analysis[J]. Syst Rev, 2021, 10(1): 186. |
| 42 | SHEN L P, WANG J, DUAN Y F, et al. Prevalence of low birth weight and macrosomia estimates based on heaping adjustment method in China[J]. Sci Rep, 2021, 11(1): 15016. |
| 43 | 张懿敏, 邵树铭, 张晓蕊. 小于胎龄儿神经发育结局的研究进展[J]. 中华预防医学杂志, 2023, 57(6): 935-940. |
| ZHANG Y M, SHAO S M, ZHANG X R. Research progress on neurodevelopmental outcomes of small for gestational age infants[J]. Chinese Journal of Preventive Medicine, 2023, 57(6): 935-940. | |
| 44 | SHINOHARA S, AMEMIYA A, TAKIZAWA M. Association between false positive glucose challenge test results and large-for-gestational-age infants: a retrospective cohort study[J]. BMJ Open, 2020, 10(2): e034627. |
| 45 | 张澳, 苏敏仪, 郑丽娟, 等. 妊娠中期口服葡萄糖耐量试验异常模式与大于胎龄儿的关联分析[J]. 中华妇产科杂志, 2024(3):184-191. |
| ZHANG A, SU M Y, ZHENG L J, et al. Association between abnormal oral glucose tolerance test patterns in the second trimester and large for gestational age newborns[J]. Chinese Journal of Obstetrics and Gynecology, 2024(3): 184-191. | |
| 46 | JUAN J, YANG H X. Prevalence, prevention, and lifestyle intervention of gestational diabetes mellitus in China[J]. Int J Environ Res Public Health, 2020, 17(24): 9517. |
| 47 | YE W R, LUO C, HUANG J, et al. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis[J]. BMJ, 2022, 377: e067946. |
| 48 | 索冬梅, 郭绮棱, 罗彩红, 等. 6230例GDM临床危险因素分析及妊娠和分娩结局观察[J]. 中国妇幼健康研究, 2019, 30(4): 442-447. |
| SUO D M, GUO Q L, LUO C H, et al. Clinical risk factors analysis and pregnancy and childbirth outcomes observation in 6230 cases of gestational diabetes mellitus[J]. Research on maternal and child health in China, 2019, 30(4): 442-447. | |
| 49 | ZHU Y Y, ZHANG C L. Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective[J]. Curr Diabetes Rep, 2016, 16(1): 7. |
| 50 | WU P, GREEN M, MYERS J. Hypertensive disorders of pregnancy[J]. BMJ, 2023, 381: e071653. |
| 51 | ZHANG H G, YANG L, QIAO Z X, et al. Effect of gestational hypertension on fetal growth restriction, endocrine and cardiovascular disorders[J]. Asian J Surg, 2022, 45(4): 1048-1049. |
| 52 | YANG Y Y, RAY I L, ZHU J, et al. Preeclampsia prevalence, risk factors, and pregnancy outcomes in Sweden and China[J]. JAMA Netw Open, 2021, 4(5): e218401. |
| 53 | SILVA C A, SANTOS I D S, SHIVAPPA N, et al. The role of food processing in the inflammatory potential of diet during pregnancy[J]. Rev Saude Publica, 2019, 53: 113. |
| 54 | 吕嘉乐, 刘芳华, 吴琪俊, 等. 超加工食品摄入与成人超重和肥胖关系研究进展[J]. 中国公共卫生, 2021, 37(11): 1691-1694. |
| LV J L, LIU F H, WU Q J, et al. Progress in researches on association of ultra-processed foods with adult overweight and obesity[J]. Chinese Journal of Public Health, 2021, 37(11): 1691-1694. | |
| 55 | ROLFO A, NUZZO A M, AMICIS R D, et al. Fetal-maternal exposure to endocrine disruptors: correlation with diet intake and pregnancy outcomes[J]. Nutrients, 2020, 12(6): 1744. |
| 56 | BAKER B H, MELOUGH M M, PAQUETTE A G, et al. Ultra-processed and fast food consumption, exposure to phthalates during pregnancy, and socioeconomic disparities in phthalate exposures[J]. Environ Int, 2024, 183: 108427. |
| 57 | GUPTA S, HAWK T, AGGARWAL A, et al. Characterizing ultra-processed foods by energy density, nutrient density, and cost[J]. Front Nutr, 2019, 6: 70. |
/
| 〈 |
|
〉 |