CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(02): 091-099
DOI: 10.1055/s-0041-1741454
Original Article
Obstetrics

Estimate of Dietary Total Antioxidant Capacity of Pregnant Women and Associated Factors

Estimativa da capacidade antioxidante total da dieta de gestantes e fatores associados
1   Department of Social Medicine, Public Health Program, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
1   Department of Social Medicine, Public Health Program, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
2   Department of Social Medicine, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
› Author Affiliations

Abstract

Objective To investigate the dietary total antioxidant capacity (DTAC) of pregnant women, and associated factors.

Methods Cross-sectional study conducted with 785 pregnant adult women attended in primary health care centers of Ribeirão Preto, state of São Paulo, Brazil. Two 24-hour dietary recalls were obtained, and the usual intake was estimated through the Multiple Source Method. The DTAC was estimated using the ferric reducing antioxidant power assay. The relationship between the higher DTAC estimate (≥ median of 4.3 mmol/day) and associated factors was investigated using adjusted logistic models with backward selection.

Results In total, 25% of the pregnant women were classified as overweight, and 32% as obese. The median (P25, P75) DTAC was 4.3 (3.3–5.6) mmol/day. Through adjusted logistic regression models with backward selection, a higher chance of DTAC estimates above the median among pregnant women aged ≥ 35 years old (2.01 [1.24–3.27]) was verified when compared with younger pregnant women. Women with prepregnancy overweight (0.63 [0.45–0.89]) and obesity (0.59 [0.40–0.88]) presented a lower chance of DTAC estimates above the median when compared with eutrophic pregnant women. A higher DTAC estimate was positively associated with the use of dietary supplements (1.39 [1.03–1.88]), and negatively associated with total dietary energy (0.59 [0.42–0.85]).

Conclusion The DTAC estimate over the median was associated with greater age, adequate body weight, use of dietary supplements, and lower energy intake.

Resumo

Objetivo Investigar a capacidade antioxidante total da dieta (CATd) de gestantes e os fatores associados.

Métodos Estudo transversal conduzido entre 785 gestantes adultas em acompanhamento de pré-natal em Unidades Básicas de Saúde de Ribeirão Preto, São Paulo, Brasil. Para a estimativa da dieta usual, 2 inquéritos recordatórios de 24 horas foram obtidos e ajustados empregando-se o Multiple Source Method. A CATd foi estimada com base no ensaio de potência de redução de ferro. Para investigar a relação entre a maior estimativa de CATd (≥ mediana de 4,3 mmol/dia) e os fatores associados, foram empregados modelos de regressão logística ajustados em função backward.

Resultados No total, 25% das gestantes foram classificadas com sobrepeso e 32% com obesidade. A mediana (P25; P75) da CATd foi de 4,3 (3,3–5,6) mmol/dia. Em modelos de regressão logística ajustados em função backward, verificou-se maior chance da estimativa da CATd acima da mediana entre gestantes com idade ≥ 35 anos (2,01 [1,24–3,27]), quando comparadas às gestantes de menor idade. Mulheres com sobrepeso (0,63 [0,45–0,89]) e obesidade (0,59 [0,40; 0,88]) no período pré-gestacional apresentaram menor chance da estimativa da CATd acima da mediana, quando comparadas às eutróficas. A estimativa da CATd foi positivamente associada ao uso de suplementos dietéticos (1,39 [1,03–1,88]) e negativamente associada à energia total da dieta (0,59 [0,42–0,85]).

Conclusão A estimativa da CATd acima da mediana foi positivamente associada à maior idade, eutrofia, ao uso de suplementos dietéticos e à menor ingestão energética.

Contributions

Carvalho M. R., Crivellenti L. C. and Sartorelli D. S. contributed to the design and planning of the study. Data collection was performed by Crivellenti L. C. and Sartorelli D. S.. The analysis and interpretation of the data was performed by Carvalho M. R. and Sartorelli D. S.. The first version of the manuscript was written by Carvalho M. R. and was revised by Crivellenti L. C. and Sartorelli D. S.. All authors approved the final version of the manuscript and are responsible for the content of the article.




Publication History

Received: 22 February 2021

Accepted: 05 October 2021

Article published online:
25 February 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Chia AR, Chen LW, Lai JS, Wong CH, Neelakantan N, van Dam RM. et al. Maternal dietary patterns and birth outcomes: a systematic review and meta-analysis. Adv Nutr 2019; 10 (04) 685-695 DOI: 10.1093/advances/nmy123.
  • 2 Kibret KT, Chojenta C, Gresham E, Tegegne TK, Loxton D. Maternal dietary patterns and risk of adverse pregnancy (hypertensive disorders of pregnancy and gestational diabetes mellitus) and birth (preterm birth and low birth weight) outcomes: a systematic review and meta-analysis. Public Health Nutr 2018; 22 (03) 1-15 DOI: 10.1017/S1368980018002616.
  • 3 Roth DE, Leung M, Mesfin E, Qamar H, Watterworth J, Papp E. Vitamin D supplementation during pregnancy: state of the evidence from a systematic review of randomised trials. BMJ 2017; 359: j5237 DOI: 10.1136/bmj.j5237.
  • 4 Jamilian M, Mirhosseini N, Eslahi M, Bahmani F, Shokrpour M, Chamani M. et al. The effects of magnesium-zinc-calcium-vitamin D co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. BMC Pregnancy Childbirth 2019; 19 (01) 107 DOI: 10.1186/s12884-019-2258-y.
  • 5 Aouache R, Biquard L, Vaiman D, Miralles F. Oxidative stress in preeclampsia and placental diseases. Int J Mol Sci 2018; 19 (05) 1496 DOI: 10.3390/ijms19051496.
  • 6 Birben E, Sahiner UM, Sackesen C, Erzurum S, Kalayci O. Oxidative stress and antioxidant defense. World Allergy Organ J 2012; 5 (01) 9-19 DOI: 10.1097/WOX.0b013e3182439613.
  • 7 Li Y, Guo H, Wu M, Liu M. Serum and dietary antioxidant status is associated with lower prevalence of the metabolic syndrome in a study in Shanghai, China. Asia Pac J Clin Nutr 2013; 22 (01) 60-68 DOI: 10.6133/apjcn.2013.22.1.06.
  • 8 Carlsen MH, Halvorsen BL, Holte K, Bøhn SK, Dragland S. et al. The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Nutr J 2010; 9: 3 DOI: 10.1186/1475-2891-9-3.
  • 9 Puchau B, Zulet MA, de Echávarri AG, Hermsdorff HH, Martínez JA. Dietary total antioxidant capacity: a novel indicator of diet quality in healthy young adults. J Am Coll Nutr 2009; 28 (06) 648-656 DOI: 10.1080/07315724.2009.10719797.
  • 10 Parohan M, Anjom-Shoae J, Nasiri M, Khodadost M, Khatibi SR, Sadeghi O. Dietary total antioxidant capacity and mortality from all causes, cardiovascular disease and cancer: a systematic review and dose-response meta-analysis of prospective cohort studies. Eur J Nutr 2019; 58 (06) 2175-2189 DOI: 10.1007/s00394-019-01922-9.
  • 11 Sartorelli DS, Carvalho MR, da Silva Santos I, Crivellenti LC, Souza JP, Franco LJ. Dietary total antioxidant capacity during pregnancy and birth outcomes. Eur J Nutr 2021; 60 (01) 357-367 DOI: 10.1007/s00394-020-02251-y.
  • 12 Gomes CDB, Vasconcelos LG, Cintra RMGDC, Dias LCGD, Carvalhares MADBL. Hábitos alimentares das gestantes brasileiras: revisão integrativa da literatura. Ciênc Saúde Coletiva 2019; 24 (06) 2293-2306 DOI: 10.1590/1413-81232018246.14702017.
  • 13 Zuccolotto DCC, Crivellenti LC, Franco LJ, Sartorelli DS. Dietary patterns of pregnant women, maternal excessive body weight and gestational diabetes. Rev Saude Publica 2019; 53: 52 DOI: 10.11606/s1518-8787.2019053000909.
  • 14 Barbieiri P, Nunes JC, Torres AG, Nishimura RY, Zuccolotto DCC, Crivellenti LC. et al. Indices of dietary fat quality during midpregnancy is associated with gestational diabetes. Nutrition 2016; 32 (06) 656-661 DOI: 10.1016/j.nut.2015.12.002.
  • 15 Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes Res Clin Pract 2014; 103 (03) 341-363 DOI: 10.1016/j.diabres.2013.10.012.
  • 16 Trujillo J, Vigo A, Duncan BB, Falavigna M, Wendland EM, Campos MA. et al. Impact of the International Association of Diabetes and Pregnancy Study Groups criteria for gestational diabetes. Diabetes Res Clin Pract 2015; 108 (02) 288-295 DOI: 10.1016/j.diabres.2015.02.007.
  • 17 Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 1996; 49 (12) 1373-1379 DOI: 10.1016/s0895-4356(96)00236-3.
  • 18 Johnson RK, Soultanakis RP, Matthews DE. Literacy and body fatness are associated with underreporting of energy intake in US low-income women using the multiple-pass 24-hour recall: a doubly labeled water study. J Am Diet Assoc 1998; 98 (10) 1136-1140 DOI: 10.1016/S0002-8223(98)00263-6.
  • 19 Universidade Estadual de Campinas. Núcleo de Estudos e Pesquisas em Alimentação. Tabela brasileira de composição de alimentos: TACO. 2. ed.. Campinas: NEPA-UNICAMP; 2006
  • 20 Goldberg GR, Black AE, Jebb SA, Cole JT, Murgatroyd PR, Coward WA. et al. Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr 1991; 45 (12) 569-581
  • 21 Rufino MS, Alves RE, Brito ES, Pérez-Jiménez J, Saura-Calixto F, Mancini-Filho J. Bioactive compounds and antioxidant capacities of 18 non-traditional tropical fruits from Brazil. Food Chem 2010; 121 (04) 996-1002 DOI: 10.1016/j.foodchem.2010.01.037.
  • 22 Harttig U, Haubrock J, Knüppel S, Boeing H. The MSM program: web-based statistics package for estimating usual dietary intake using the Multiple Source Method. Eur J Clin Nutr 2011; 65 (Suppl 1) S87-S91 DOI: 10.1038/ejcn.2011.92.
  • 23 Willett WC. Nutritional epidemiology. 2nd ed. New York: Oxford University Press; 1998
  • 24 Ministério da Saúde. Secretaria de Vigilância em Saúde. Vigitel Brasil 2011: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2011 [Internet]. Brasília (DF): Ministério da Saúde. 2012 [cited 2021 Feb 15]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2011_fatores_risco_doencas_cronicas.pdf
  • 25 Suitor CW. Perspectives on nutrition during pregnancy: Part I, Weight gain; Part II, Nutrient supplements. J Am Diet Assoc 1991; 91 (01) 96-98 DOI: 10.1016/S0002-8223(21)01073-7.
  • 26 Henríquez-Sánchez P, Sánchez-Villegas A, Ruano-Rodríguez C, Gea A, Lamuela-Raventós RM, Estruch R. et al. Dietary total antioxidant capacity and mortality in the PREDIMED study. Eur J Nutr 2016; 55 (01) 227-236 DOI: 10.1007/s00394-015-0840-2.
  • 27 Bastide N, Dartois L, Dyevre V, Dossus L, Fagherazzi G, Serafini M. et al. Dietary antioxidant capacity and all-cause and cause-specific mortality in the E3N/EPIC cohort study. Eur J Nutr 2017; 56 (03) 1233-1243 DOI: 10.1007/s00394-016-1172-6.
  • 28 Malta MB, Carvalhaes MA, Parada CM, Corrente JE. Utilização das recomendações de nutrientes para estimar prevalência de consumo insuficiente das vitaminas C e E em gestantes. Rev Bras Epidemiol 2008; 11 (04) 573-583 DOI: 10.1590/S1415-790X2008000400006.
  • 29 Amine EK, Baba NH, Belhadj M. et al. Diet, nutrition and the prevention of chronic diseases. Geneva: WHO; 2003. . (World Health Organization Technical Report Series; no. 916).
  • 30 Kobayashi S, Asakura K, Suga H, Sasaki S. Three-generation Study of Women on Diets and Health Study Groups. Inverse association between dietary habits with high total antioxidant capacity and prevalence of frailty among elderly Japanese women: a multicenter cross-sectional study. J Nutr Health Aging 2014; 18 (09) 827-839 DOI: 10.1007/s12603-014-0478-4.
  • 31 Rhee J, Kim R, Kim Y, Tam M, Lau Y, Keum N. et al. Maternal caffeine consumption during pregnancy and risk of low birth weight: a dose-response meta-analysis of observational studies. PLoS One 2015; 10 (07) e0132334 DOI: 10.1371/journal.pone.0132334.
  • 32 Laraia BA, Bodnar LM, Siega-Riz AM. Pregravid body mass index is negatively associated with diet quality during pregnancy. Public Health Nutr 2007; 10 (09) 920-926 DOI: 10.1017/S1368980007657991.
  • 33 Shin D, Lee KW, Song WO. Dietary patterns during pregnancy are associated with gestational weight gain. Matern Child Health J 2016; 20 (12) 2527-2538 DOI: 10.1007/s10995-016-2078-x.
  • 34 Ledikwe JH, Blanck HM, Kettel Khan L, Serdula MK, Seymour JD, Tohill BC. et al. Dietary energy density is associated with energy intake and weight status in US adults. Am J Clin Nutr 2006; 83 (06) 1362-1368 DOI: 10.1093/ajcn/83.6.1362.
  • 35 McGowan CA, McAuliffe FM. Maternal nutrient intakes and levels of energy underreporting during early pregnancy. Eur J Clin Nutr 2012; 66 (08) 906-913 DOI: 10.1038/ejcn.2012.15.