Relação entre o padrão de consumo alimentar e os depósitos de gordura visceral em gestantes
Palavras-chave:
Consumo alimentar, Gestação, Gordura intra-abdominal, ObesidadeResumo
Objetivo
Avaliar a associação entre padrão de consumo alimentar e gordura visceral materna.
Métodos
Estudo observacional realizado durante consulta pré-natal com gestantes de Porto Alegre, Brasil. O padrão de consumo alimentar gestacional foi estimado através de recordatório alimentar habitual, questionando sobre todos os alimentos consumidos em um dia de semana normal e suas respectivas quantidades. Os depósitos de gordura foram aferidos por ultrassonografia. A correlação entre variáveis simétrica foi avaliada por correlação de Pearson e a acorrelação entre variáveis assimétrica foi avaliada por correlação de Spearman. A associação entre as variáveis foi avaliada por regressão linear multivariada, sendo as variáveis com distribuição assimétricas transformadas em logarítimo.
Resultados
Foram incluídas 154 gestantes, com média da espessura da gordura visceral de 44,17 mm±15,03 e mediana do valor energético total diário de 2149,25 kcal [1676,53–3051,72]. Foi encontrada uma correlação positiva e significativa (p=0,049; r=0,165) entre a espessura da gordura visceral e o consumo de ingredientes culinários.
Conclusão
Os achados do presente estudo sugerem que o consumo de ingredientes culinários processados pode estar diretamente associado aos depósitos de gordura visceral em gestantes.
Referências
Monteiro CA, Cannon G, Moubarac JC, Levy RB, Louzada MLC, Jaime PC. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr. 2018;21(1):5–17. https://doi.org/10.1017/S1368980017000234
Instituto Brasileiro de Geografia e Estatística, organizador. Análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE; 2020. (Pesquisa de orçamentos familiares, 2017-2018 / Ministério da Economia, Instituto Brasileiro de Geografia e Estatística-IBGE, Diretoria de Pesquisas, Coordenação de Trabalho e Rendimento).
Gomes C de B, Malta MB, Louzada ML da C, Benício MHD, Barros AJD, Carvalhaes MA de BL. Ultraprocessed Food Consumption by Pregnant Women: The Effect of an Educational Intervention with Health Professionals. Matern Child Health J [Internet]. 2019 [cited 2021 Oct 21];23(5):692–703. Available from: http://link.springer.com/10.1007/s10995-018-2690-z
Graciliano NG, Silveira JAC da, Oliveira ACM de. Consumo de alimentos ultraprocessados reduz a qualidade global da dieta de gestantes. Cad Saúde Pública [Internet]. 2021 [cited 2021 Oct 21];37(2):e00030120. Available from: http://www.scielo.br/scielo.php? script=sci_arttext&pid=S0102-311X2021000205012&tlng=pt
Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019;30(1):67-77.e3. https://doi.org/10.1016/j.cmet.2019.05.008
Gomes C de B, Malta MB, Benício MHD, Carvalhaes MA de BL. Consumption of ultra-processed foods in the third gestational trimester and increased weight gain: a Brazilian cohort study. Public Health Nutr. 2020;24(11):3304-12. https://doi.org/10.1017/S1368980020001883
Rohatgi KW, Tinius RA, Cade WT, Steele EM, Cahill AG, Parra DC. Relationships between consumption of ultra-processed foods, gestational weight gain and neonatal outcomes in a sample of US pregnant women. PeerJ. 2017;5:e4091. https://doi.org/10.7717/peerj.4091
Silva CFM, Saunders C, Peres W, Folino B, Kamel T, Dos Santos MS, et al. Effect of ultra-processed foods consumption on glycemic control and gestational weight gain in pregnant with pregestational diabetes mellitus using carbohydrate counting. PeerJ. 2021;9:e10514. https://doi.org/10.7717/peerj.10514;
Ministério da Saúde (Brasil). Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. [Internet]. Brasília: Ministério; 2018 [cited 2021 Mar 24]. Available from: https://abeso.org.br/wp-content/uploads/2020/01/vigitel-brasil-2018.pdf
Kretzer DC, Matos S, Von Diemen L, de Azevedo Magalhães JA, Schöffel AC, Goldani MZ, et al.
Anthropometrical measurements and maternal visceral fat during first half of pregnancy: a cross-sectional survey. BMC Pregnancy Childbirth [Internet]. 2020 [cited 2021 Apr 23];20(1):576. Available from: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03258-3
Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, et al. Obesity in adults: a clinical practice guideline. Can Med Assoc J [Internet]. 2020 [2021 Mar 24];192(31):E875–91. Available from: http://www.cmaj.ca/lookup/doi/10.1503/cmaj.191707
Blundell JE, Dulloo AG, Salvador J, Frühbeck G. Beyond BMI - Phenotyping the Obesities. Obes Facts [Internet]. 2014 [cited 24 Mar 2021];7(5):322–8. Available from: https://www.karger.com/Article/FullText/368783
Goossens GH. The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function. Obes Facts [Internet]. 2017 [cited 2021 Mar 24];10(3):207–15. Available from: https://www.karger.com/Article/FullText/471488
Tchernof A, Després JP. Pathophysiology of Human Visceral Obesity: An Update. Physiol Rev [Internet]. 2013 [cited 2021 Mar 24];93(1):359–404. Available from: https://www.physiology.org/doi/10.1152/physrev.00033.2011
Konieczna J, Abete I, Galmés AM, Babio N, Colom A, Zulet MA, et al. Body adiposity indicators and cardiometabolic risk: Cross-sectional analysis in participants from the PREDIMED-Plus trial. Clin Nutr [Internet]. 2019 [cited 2021 Nov 3];38(4):1883–91. Available from: https://linkinghub.elsevier.com/retrieve/pii/S026156141831207X
Bartha JL, Marín-Segura P, González-González NL, Wagner F, Aguilar-Diosdado M, Hervias-Vivancos B. Ultrasound evaluation of visceral fat and metabolic risk factors during early pregnancy. Obesity (Silver Spring). 2007;15(9):2233-9. https://doi.org/10.1038/oby.2007.265
Rocha A da S, Bernardi JR, Matos S, Kretzer DC, Schöffel AC, Goldani MZ, et al. Maternal visceral adipose tissue during the first half of pregnancy predicts gestational diabetes at the time of delivery - a cohort study. PloS One. 2020;15(4):e0232155.
Pimanov S, Bondarenko V, Makarenko E. Visceral fat in different locations assessed by ultrasound: Correlation with computed tomography and cut-off values in patients with metabolic syndrome. Clin Obes [Internet]. 2020 [cited 2021 Sep 28];10(6). Available from: https://onlinelibrary.wiley.com/doi/10.1111/cob.12404
Ray JG, De Souza LR, Park AL, Connelly PW, Bujold E, Berger H. Preeclampsia and Preterm Birth Associated With Visceral Adiposity in Early Pregnancy. J Obstet Gynaecol Can. 2017;39(2):78-81. https://doi.org/10.1016/j.jogc.2016.10.007
Yi SY, Steffen LM, Terry JG, R Jacobs D, Duprez D, Steffen BT, et al. Added sugar intake is associated with pericardial adipose tissue volume. Eur J Prev Cardiol [Internet]. 2020 [cited 2021 Oct 17];27(18):2016–23. Available from: https://academic.oup.com/eurjpc/article/27/18/2016-2023/6125545
Konieczna J, Morey M, Abete I, Bes-Rastrollo M, Ruiz-Canela M, Vioque J, et al. Contribution of ultraprocessed foods in visceral fat deposition and other adiposity indicators: Prospective analysis nested in the PREDIMED-Plus trial. Clin Nutr [Internet]. 2021 [cited 2021 Nov 3];40(6):4290–300. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0261561421000297
Marshall NE, Abrams B, Barbour LA, Catalano P, Christian P, Friedman JE, et al. The importance of nutrition in pregnancy and lactation: lifelong consequences. Am J Obstet Gynecol. 2022;226(5):607-32. https://doi.org/10.1016/j.ajog.2021.12.035
Bagherzadeh R, Gharibi T, Safavi B, Mohammadi SZ, Karami F, Keshavarz S. Pregnancy; an opportunity to return to a healthy lifestyle: a qualitative study. BMC Pregnancy Childbirth. 2021;21(1):751. https://doi.org/10.1186/s12884-021-04213-6
Bernardi JR, Silva Rocha A, Matos S, Kretzer DC, Schöffel AC, Goldani MZ, et al. Modifiable predictors to maternal visceral adipose tissue during pregnancy: A clinical, demographic, and nutritional study. J Obstet Gynaecol Res [Internet]. 2021 [cited 2021 Oct Nov];47(3):1023–30. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jog.14633
Fisberg RM, Marchioni DM, Colucci AC. Avaliação do consumo alimentar e da ingestão de nutrientes na prática clínica. Arq Bras Endocrinol Metab. 2009;53(5):617–24. https://doi.org/10.1590/S0004-27302009000500014
Dekkers AL, Verkaik-Kloosterman J, van Rossum CT, Ocké MC. SPADE, a new statistical program to estimate habitual dietary intake from multiple food sources and dietary supplements. J Nutr. 2014;144(12):2083-91. https://doi.org/10.3945/jn.114.191288.
Verly E, Jr Oliveira DC, Fisberg RM, Marchioni DM. Performance of statistical methods to correct food intake distribution: comparison between observed and estimated usual intake. J Nutr.2016;116(5):897–903. https://doi.org/10.1017/S0007114516002725.
Núcleo de Estudos e Pesquisas em alimentação. Tabela Brasileira de Composição de Alimentos (TACO). Campinas: NEPA/UNICAMP; 2004.
Instituto Brasileiro de Geografia e Estatística. Tabelas de Composição de Alimentos [Internet]. 4th ed. Rio de Janeiro; IBGE; 1996 [cited 2024 Oct 21]. Available from: https://biblioteca.ibge.gov.br/visualizacao/livros/liv82261.pdf
Pinheiro ABV, Lacerda EM de A, Benzecry EH, Gomes MC da S, Costa VM da. Tabela para avaliação de consumo alimentar em medidas caseiras. Atheneu. 2004;(5):131.
Armellini F, Zamboni M, Rigo L, Todesco T, Bosello O, Bergamo-Andreis IA, et al. The contribution of sonography to the measurement of intra-abdominal fat. J Clin Ultrasound. 1990;18(7):563–7. http://doi.wiley.com/10.1002/jcu.1870180707
D’Souza R, Horyn I, Pavalagantharajah S, Zaffar N, Jacob CE. Maternal body mass index and pregnancy outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol MFM [Internet]. 2019 [cited 25 Oct 2021];1(4):100041. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2589933319300722
D’Ambrosi F, Crovetto F, Colosi E, Fabietti I, Carbone F, Tassis B, et al. Maternal Subcutaneous and Visceral Adipose Ultrasound Thickness in Women with Gestational Diabetes Mellitus at 24-28 Weeks’ Gestation. Fetal Diagn Ther. 2018;43(2):143–7.
De Souza LR, Berger H, Retnakaran R, Maguire JL, Nathens AB, Connelly PW, et al. First-Trimester Maternal Abdominal Adiposity Predicts Dysglycemia and Gestational Diabetes Mellitus in Midpregnancy. Diabetes Care [Internet]. 2016 [cited 2021 Mar 1];39(1):61–4. Available from: http://care.diabetesjournals.org/lookup/doi/10.2337/dc15-2027
Martin AM, Berger H, Nisenbaum R, Lausman AY, MacGarvie S, Crerar C, et al. Abdominal Visceral Adiposity in the First Trimester Predicts Glucose Intolerance in Later Pregnancy. Diabetes Care [Internet]. 2009 [cited 28 Sep 2021];32(7):1308–10. Available from: http://care.diabetesjournals.org/cgi/doi/10.2337/dc09-0290
Alves JG, Souza ASR, Figueiroa JN, de Araújo CAL, Guimarães A, Ray JG. Visceral Adipose Tissue Depth in Early Pregnancy and Gestational Diabetes Mellitus - a Cohort Study. Sci Rep. 2020;10(1):2032.
Sartorelli DS, Crivellenti LC, Zuccolotto DCC, Franco LJ. Relationship between minimally and ultra-processed food intake during pregnancy with obesity and gestational diabetes mellitus. Cad Saúde Pública [Internet]. 2019 [cited 2021 Apr 30];35(4):e00049318. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2019000405007&tlng=en
Sartorelli DS, Crivellenti LC, Zuccolotto DCC, Franco LJ. Relationship between minimally and ultra-processed food intake during pregnancy with obesity and gestational diabetes mellitus. Cad Saúde Pública [Internet]. 2019 [cited 2021 Apr 30];35(4):e00049318. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2019000405007&tlng=en
Ministério da Saúde (Brasil). Guia Alimentar para a População Brasileira: promovendo a alimentação saudável. Brasília: Ministério; 2014.
Cioffi CE, Figueroa J, Welsh JA. Added Sugar Intake among Pregnant Women in the United States: National Health and Nutrition Examination Survey 2003-2012. J Acad Nutr Diet [Internet]. 2018 [cited 2021 Oct 21];118(5):886-895.e1. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2212267217317355
Gomes C de B, Vasconcelos LG, Cintra RMG de C, Dias LCGD, Carvalhaes MA de BL. Hábitos alimentares das gestantes brasileiras:revisão integrativa da literatura. Ciênc Saúde Coletiva [Internet]. [cited 2021 Oct 21];24(6):2293–306. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232019000602293&tlng=pt
Goran MI, Plows JF, Ventura EE. Effects of consuming sugars and alternative sweeteners during pregnancy on maternal and child health: evidence for a secondhand sugar effect. Proc Nutr Soc [Internet]. [cited 2021 Oct 20];78(3):262–71. Available from: https://www.cambridge.org/core/product/identifier/S002966511800263X/type/journal_article
DiNicolantonio J, O’Keefe J. Added Sugars Drive Insulin Resistance, Hyperinsulinemia, Hypertension, Type 2 Diabetes and Coronary Heart Disease. Mo Med. 2022;119(6):519-23.
Neeland IJ, Ayers CR, Rohatgi AK, Turer AT, Berry JD, Das SR, et al. Associations of visceral and abdominal subcutaneous adipose tissue with markers of cardiac and metabolic risk in obese adults: Abdominal Fat and Cardiometabolic Risk. Obesity. 2013];21(9):E439– 47.http://doi.wiley.com/10.1002/oby.20135
Izar MC de O, Lottenberg AM, Giraldez VZR, Santos RD dos, Machado RM, Bertolami A, et al. Posicionamento sobre o Consumo de Gorduras e Saúde Cardiovascular – 2021. Arq Bras Cardiol [Internet]. 2021 [cited 2021 Oct 30];116(1):160–212. Available from: http://abccardiol.org/article/posicionamento-sobre-o-consumode-gorduras-e-saude-cardiovascular-2021/
Santos R, Gagliardi A, Xavier H, Magnoni C, Cassani R, Lottenberg A, et al. I Diretriz sobre o consumo de Gorduras e Saúde Cardiovascular. Arq Bras Cardiol. 2013;100(1):01–40. http://www.gnresearch.org/doi/10.5935/abc.2013S003
Lichtenstein AH, Appel LJ, Vadiveloo M, Hu FB, Kris-Etherton PM, Rebholz CM, et al. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation. 2021;144(23):e472-e87. https://www.ahajournals.org/doi/10.1161/CIR.000000000000103
Meisinger C, Rospleszcz S, Wintermeyer E, Lorbeer R, Thorand B, Bamberg F, et al. Isocaloric Substitution of Dietary Carbohydrate Intake with Fat Intake and MRI-Determined Total Volumes of Visceral, Subcutaneous and Hepatic Fat Content in Middle-Aged Adults. Nutrients [Internet]. 2019 [cited 2021 Oct 30];11(5):1151. Available from: https://www.mdpi.com/2072-6643/11/5/1151
Rosqvist F, Iggman D, Kullberg J, Cedernaes J, Johansson HE, Larsson A, et al. Overfeeding Polyunsaturated and Saturated Fat Causes Distinct Effects on Liver and Visceral Fat Accumulation in Humans. Diabetes. 2014;63(7):2356-68. http://diabetes.diabetesjournals.org/cgi/doi/10.2337/db13-1622
Tayyem RF, Al-Radaideh AM, Hammad SS, Al-Hajaj S, Allehdan SS, Agraib LM, et al. Subcutaneous and visceral fat volumes measured by MRI and their relationships with nutrient intakes among adults. Asia Pac J Clin Nutr. 2019;28(2):300–9.
Leone A, Martínez-González MÁ, Craig W, Fresán U, Gómez-Donoso C, Bes-Rastrollo M. Pre-Gestational Consumption of Ultra-Processed Foods and Risk of Gestational Diabetes in a Mediterranean Cohort. The SUN Project. Nutrients [Internet]. 2021 [cited 2021 Nov 3];13(7):2202. Available from: https://www.mdpi.com/2072-6643/13/7/2202
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2025 Daniela Cortés Kretzer, Amanda Silveira da Silva Folador, Salete de Matos, Alexandre da Silva Rocha, José Antônio de Azevedo Magalhães, Juliana Rombaldi Bernardi
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
