ABSTRACT BACKGROUND: The identification and understanding of dietary factors and other characteristics that influence gestational weight gain can contribute to the formulation of strategies to promote healthy eating habits before and during pregnancy. OBJECTIVE: To investigate the association between dietary patterns, sociodemographic and obstetric characteristics, and health-related behaviors in pregnant women. DESIGN AND SETTING: A cross-sectional study was conducted on women undergoing prenatal care in the Unified Health System of Colombo, Paraná, Brazil, from February 2018 to September 2019. METHOD: A weekly food frequency questionnaire was administered, and dietary patterns were identified through factor analysis. Median regression models were constructed to identify the associations between dietary pattern scores and variables. RESULTS: Complete data were obtained from 495 pregnant women. Three dietary patterns were identified: 1) “healthy,” with higher factor loadings for the weekly consumption of raw vegetables, cooked vegetables, and fresh fruits; 2) “Western,” including soft drinks or artificial juice, candies, milk, and dairy products, and processed cold meat; and 3) “traditional,” beans and meat. Pregnant women aged 30 years or older (coefficient [Coef.] 0.86, 95% confidence interval [CI] 0.38–1.33) with moderate/intense physical activity (Coef. 0.32, 95% CI 0.02–0.62) had higher adherence to the “healthy” pattern. Adolescents and smokers adhered more to the “traditional” pattern (Coef. 0.17, 95% CI 0.01–0.33). CONCLUSION: Age, smoking status, and physical activity were associated with dietary patterns in pregnant women. BACKGROUND pregnancy OBJECTIVE healthrelated health related SETTING crosssectional cross sectional Colombo Paraná Brazil 201 2019 METHOD administered analysis variables RESULTS 49 1 healthy, “healthy, vegetables fruits 2 Western, Western “Western, juice candies milk products meat 3 traditional, traditional “traditional, coefficient Coef. Coef [Coef. 086 0 86 0.86 95 [CI 0.38–1.33 038133 38 33 moderateintense moderate intense (Coef 032 32 0.32 0.02–0.62 002062 02 62 “healthy “traditional 017 17 0.17 0.01–0.33. 001033 0.01–0.33 . 01 0.01–0.33) CONCLUSION Age status 20 4 “Western [Coef 08 8 0.8 9 0.38–1.3 03813 03 0.3 0.02–0.6 00206 6 0.1 00103 0.01–0.3 0. 0.38–1. 0381 0.02–0. 0020 0010 0.01–0. 0.38–1 038 0.02–0 002 001 0.01–0 0.38– 0.02– 00 0.01– 0.38 0.02 0.01 0.0

Abstract Adolescents from 30 state schools in Curitiba, State of Paraná, reported total screen time, namely television, video games and laptops. Diet quality was assessed by the frequency of food consumption. The income of the school environment was taken from the Census. The built environment for physical activity was investigated by systematic observation of the school surroundings. Multilevel Poisson Regression was used to estimate associations with the exposure variables. Among 1,200 adolescents, 50.9% being male, and 74.4% were found to be exposed to excessive screen time. Excessive TV screen time (56.5%) was associated with poor diet quality. Excessive video game time (22.0%) was lower among females (PR 0.25; 95%CI 0.18;0.36), associated with poor diet quality, lower school environment income, and the worst classification of the built environment for physical activity. Excessive use of portable screens (53.2%) tended to increase with the income of the school environment. Excessive use of TV and laptops was widespread among adolescents, with different demographic and contextual variables associated according to the type of device used. 3 Curitiba Paraná television consumption Census surroundings 1200 1 200 1,20 adolescents 509 50 9 50.9 male 744 74 4 74.4 56.5% 565 56 5 (56.5% 22.0% 220 22 0 (22.0% PR 0.25 025 25 95CI CI 95 0.180.36, 018036 0.18 0.36 , 18 36 0.18;0.36) 53.2% 532 53 2 (53.2% 120 20 1,2 50. 7 74. 56.5 (56.5 22.0 (22.0 0.2 02 180 0.180.36 01803 018 0.1 036 0.3 0.18;0.36 53.2 (53.2 12 1, 56. (56. 22. (22. 0. 0.180.3 0180 01 03 0.18;0.3 53. (53. (56 (22 0.180. 0.18;0. (53 (5 (2 0.180 0.18;0 ( 0.18;

Resumo Objetivou-se investigar a associação entre o tempo de uso excessivo de diferentes telas, a qualidade da dieta em adolescentes e características do entorno escolar. Adolescentes de 30 escolas estaduais de Curitiba/PR relataram tempo de tela: televisão, videogame e portáteis. A qualidade da dieta foi avaliada pela frequência de consumo de alimentos. A renda do entorno escolar foi obtida do Censo. O ambiente construído para atividade física investigado por observação sistemática do entorno escolar. A regressão de Poisson multinível foi empregada para estimar associações com as variáveis de exposição. Entre 1.200 adolescentes, 50,9% do sexo masculino, 74,4% tiveram tempo excessivo de tela. O tempo excessivo de TV (56,5%) esteve associado à pior qualidade da alimentação. O tempo excessivo de videogame (22,0%) foi menor no sexo feminino (RP 0,25; IC95% 0,18;0,36), associado à pior qualidade da alimentação, à menor renda do entorno escolar, e à pior classificação do ambiente construído para atividade física. O tempo excessivo de telas portáteis (53,2%) apresentou tendência de aumento com a renda do entorno escolar. O uso excessivo de TV e telas portáteis foi amplamente praticado por adolescentes, com diferentes variáveis demográficas e contextuais associadas de acordo com o tipo de dispositivo utilizado. Objetivouse Objetivou se 3 CuritibaPR Curitiba PR tela televisão alimentos Censo exposição 1200 1 200 1.20 509 50 9 50,9 masculino 744 74 4 74,4 56,5% 565 56 5 (56,5% alimentação 22,0% 220 22 0 (22,0% RP 0,25 025 25 IC95 IC 0,180,36, 018036 0,18 0,36 , 18 36 0,18;0,36) 53,2% 532 53 2 (53,2% utilizado 120 20 1.2 50, 7 74, 56,5 (56,5 22,0 (22,0 0,2 02 IC9 180 0,180,36 01803 018 0,1 036 0,3 0,18;0,36 53,2 (53,2 12 1. 56, (56, 22, (22, 0, 0,180,3 0180 01 03 0,18;0,3 53, (53, (56 (22 0,180, 0,18;0, (53 (5 (2 0,180 0,18;0 ( 0,18;

Abstract Adolescents from 30 state schools in Curitiba, State of Paraná, reported total screen time, namely television, video games and laptops. Diet quality was assessed by the frequency of food consumption. The income of the school environment was taken from the Census. The built environment for physical activity was investigated by systematic observation of the school surroundings. Multilevel Poisson Regression was used to estimate associations with the exposure variables. Among 1,200 adolescents, 50.9% being male, and 74.4% were found to be exposed to excessive screen time. Excessive TV screen time (56.5%) was associated with poor diet quality. Excessive video game time (22.0%) was lower among females (PR 0.25; 95%CI 0.18;0.36), associated with poor diet quality, lower school environment income, and the worst classification of the built environment for physical activity. Excessive use of portable screens (53.2%) tended to increase with the income of the school environment. Excessive use of TV and laptops was widespread among adolescents, with different demographic and contextual variables associated according to the type of device used.

Resumo Objetivou-se investigar a associação entre o tempo de uso excessivo de diferentes telas, a qualidade da dieta em adolescentes e características do entorno escolar. Adolescentes de 30 escolas estaduais de Curitiba/PR relataram tempo de tela: televisão, videogame e portáteis. A qualidade da dieta foi avaliada pela frequência de consumo de alimentos. A renda do entorno escolar foi obtida do Censo. O ambiente construído para atividade física investigado por observação sistemática do entorno escolar. A regressão de Poisson multinível foi empregada para estimar associações com as variáveis de exposição. Entre 1.200 adolescentes, 50,9% do sexo masculino, 74,4% tiveram tempo excessivo de tela. O tempo excessivo de TV (56,5%) esteve associado à pior qualidade da alimentação. O tempo excessivo de videogame (22,0%) foi menor no sexo feminino (RP 0,25; IC95% 0,18;0,36), associado à pior qualidade da alimentação, à menor renda do entorno escolar, e à pior classificação do ambiente construído para atividade física. O tempo excessivo de telas portáteis (53,2%) apresentou tendência de aumento com a renda do entorno escolar. O uso excessivo de TV e telas portáteis foi amplamente praticado por adolescentes, com diferentes variáveis demográficas e contextuais associadas de acordo com o tipo de dispositivo utilizado.