Protein intake and weight gain among low-income pregnant women from Mesquita County, Rio de Janeiro, Brazil

Autores

  • Maria CABRAL Universidade do Porto
  • Rosely SICHIERI Universidade do Estado do Rio de Janeiro
  • Camilla Medeiros Macedo da ROCHA Universidade Federal do Rio de Janeiro
  • Maria Beatriz Trindade de CASTRO Universidade Federal do Rio de Janeiro

Palavras-chave:

Pregnancy, Protein intake, Weight gain

Resumo

Objective
To evaluate the effect of protein intake on body weight gain at pregnancy.

Methods
A cross-sectional study was carried out with 297 women who delivered a child at the maternity ward of Municipal Hospital Leonel de Moura Brizola in Mesquita city in the state of Rio de Janeiro. Sociodemographic and anthropometric data were collected through the use of a structured questionnaire at fi rst week after delivery. Food intake was assessed by a food frequency questionnaire. Protein intake per kilogram of body weight (g/kg per day) during pregnancy was categorized as high or low protein intake according to overall medianlevels. Hierarchical multiple linear regression was fitted to estimate the effect of protein intake per kg during pregnancy on weight gain.

Results
Women presented an average weight gain of 12.8kg (SD=6.34) and 26.8kg/m2 (SD=4.78) of Body Mass Index. Those who consumed a diet with high levels of protein content significantly presented less weight at postpartum (p<0.01) lower Early-Pregnancy Body Mass Index (p<0.01). In the hierarchical linear regression, it was found a negative association of protein intake per kg and Weight gain (b=-4.3025; IC95%=-6.0215; -2.5836; p<0.01). In the final model, all others covariates (energy, schooling, family income and gestational age) were significantly associated with the outcome (p<0.05). The additional model showed a negatively association between Early-Pregnancy Body Mass Index and weight gain (b=-0.2951; IC95%= -0.4987; -0.0915; p<0.01).

Conclusion
Higher levels of protein intake per kg of body weight during pregnancy were associated with lower weight gain. 

Referências

Rooney BL, Schaubergerm CW. Excess pregnancy weight gain and long-term obesity: One decade later. Obstet Gynecol. 2002;100(2):245-52.

Institute of Medicine. Weight gain during pregnancy: Reexamining the guidelines. Washington (DC): National Academic Press; 2009.

Castro PS, Castro MBTC, Kac G. Aderência às recomendações dietéticas do Institute of Medicine (Estados Unidos) e o seu efeito no peso durante a gestação. Cad Saúde Pública. 2013;29(7):1311-21. http://dx.doi.org/10.1590/S0102-311X2013000700006

Kac G, Benício MHDA, Velasquez-Melendez G, Valente JG. Nine months postpartum weight retention predictors for Brazilian women. Public Health Nutr. 2004;7(5):621-8.http://dx.doi.org/10.1079/PHN2003579

Castro MBT, Kac G, Sichieri R. Determinantes nutricionais e sócio-demográficos da variação de peso no pós-parto: uma revisão da literatura. Rev Bras Saúde Mater Infant. 2009;(9):125-37.

Hickey CA. Sociocultural and behavioral influences on weight gain during pregnancy. Am J Clin Nutr. 2000;71(5Suppl):1364S-70S.

Olson CM, Strawderman MS, Hinton PS, Pearson TA. Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1 y postpartum. Int J Obes. 2003;27(1):117-27.

Melo ASO, Assunção PL, Gondim SSR, Carvalho DF, Amorim MMR, Benício MHDA, et al. Estado nutricional materno, ganho de peso gestacional e peso ao nascer. Rev Bras Epidemiol. 2007;10(2):249-57.

Institute of Medicine. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). Washington (DC): National Academic Press; 2005.

Imhoff-Kunsch B, Martorell R. Nutrition interventions during pregnancy and maternal, newborn and child health outcomes. Paediatr Perinat Epidemiol. 2012;(Suppl1):1-3.

Lai JS, Soh SE, Loy SL, Colega M, Kramer MS, Chan JKY, et al. Macronutrient composition and food groups associated with gestational weight gain: The GUSTO study. Eur J Nutr. 2018;1-14. http://dx.doi.org/10.1007/s00394-018-1623-3

Clifton PM, Condo D, Keogh JB. Long term weight maintenance after advice to consume low carbohydrate, higher protein diets: A systematic review and meta-analysis nutrition, metabolism, and cardiovascular diseases. Nutr Metab Cardiovasc Dis.2014;24(3):224-35.

Diemert A, Lezius S, Pagenkemper M, Hansen G, Drozdowska A, Hecher K, et al. Maternal nutrition, inadequate gestational weight gain and birth weight: Results from a prospective birth cohort. BMC Pregnancy Childbirth. 2016;16(1):224.

Tielemans MJ, Garcia AH, Peralta Santos A, Bramer WM, Luksa N, Luvizotto MJ, et al. Macronutrient composition and gestational weight gain: A systematic review. Am J Clin Nutr. 2016;113(1):83-99.

Castro MBT, Kac G, Sichieri R. Assessment of protein intake during pregnancy using food frequency questionnaire and the effecy on postpartum body weight variation. Cad Saúde Pública. 2010;26(11):2112-20. http://dx.doi.org/10.1590/S0102-311X2010001100012

Castro MBT, Vilela AAF, Oliveira ASD, Cabral M, Souza RAG, Kac G, et al. Sociodemographic characteristics determine dietary pattern adherence during pregnancy. Public Health Nutr. 2015;19(7):1245-51. http://dx.doi.org/10.1017/S1368980015002700

Pedersen A, Kondrup J, Børsheim E. Health effects of protein intake in healthy adults: A systematic literature review. Food Nutr Res. 2013;57(1):21245.

Colangelo LA, He K, Whooley MA, Daviglus ML, Liu K. Higher dietary intake of long-chain -3 polyunsaturated fatty acids is inversely associated with depressive symptoms in women. Nutrition. 2009;25(10):1011-119.

Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign: Human Kinetics Books; 1988.

Institute of Medicine. Nutrition during pregnancy: A implementation guide. Washington (DC): National Academy Press; 1992.

Sichieri R, Everhart JE. Validity of Brazilian food frequency questionnaire against dietary recalls and estimated energy intake. Nutr Res. 1998;18(10):1649-59.

Pinheiro ABV. Tabela para avaliação de consumo alimentar em medidas caseiras. 3a ed. Rio de Janeiro: Editora Atheneu; 1996.

Núcleo de Estudos e Pesquisas em Alimentação. Tabela Brasileira de Composição de Alimentos. 2a ed.Unicamp, 2006 [acesso 2010 jul 10].Disponível em: http://www.nepa.unicamp.br/taco/ tabela.php?ativo=tabela

Sichieri R. Epidemiologia da obesidade. Rio de Janeiro: Editora Universidade Estadual do Rio de Janeiro;1998.

SAS Institute. SAS version 9.3 Software. Statistical Analysis System Institute: Cary, 2018 [cited 2016Jan 18]. Available from: http://www.sas.com/en_us/software/sas9.html

Vioque J, Navarrete-Muñoz E-M, Gimenez-Monzó D, Garcia-de-la-Hera M, Granado F, Young IS, et al. Reproducibility and validity of a food frequency questionnaire among pregnant women in a Mediterranean area. Nutr J. 2013;12(1):26-35.

Molag ML, Vrieg JHM, Ocké MC, Dagnelie PC, van den Brandt PA, Jansen MCJF, et al. Design characteristics of food frequency questionnaires in relation to their validity. Epidemiology. 2007;166(12):1468-78.

Olinto MT, Victora CG, Barros FC, Tomasi E. Determinants of malnutrition in a low-income population: Hierarchical analytical model. Cad Saúde Pública. 1993;9(Suppl1):14-27.

von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The strengthening the reporting of observational

studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9.

Erkkola M, Karppinen M, Javanainen J, Räsänen L, Knip M,Virtanen SM. Validity and reproducibility of food frequency questionnaire for pregnant finish women. Am J Epidemiol. 2001;154(5):466-76.

Bunin GR, Gyllstrom ME, Brown JE, Kahn EB, Kushi LH. Recall of diet during a past pregnancy. Am J Epidemiol. 2001;154(12):1136-42.

George GC, Hanss-Nuss H, Milani TJ, FreelandGraves JH. Food choices of low-income women during pregnancy and postpartum. J Am Diet Assoc. 2005;105(6):899-907.

Kesa H, Oldewagw-Theron W. Anthropometric indications and nutritional intake of women in Vaal triangle, South Africa. Public Health. 2005;119(4):294-300.

Kramer MS, Kakuma R. Energy and protein intake in pregnancy. Cochrane Database Syst Rev. 2003;(4):CD000032. http://dx.doi.org/10.1002/14651858.CD000032

Soenen S, Bonomi AG, Lemmens SGT, Scholte J, Thijseen MA, van Berkum F, et al. Relatively highprotein or ‘low-carb’ energy-restricted diets for body weight loss and body weight maintenance? Phys Behav. 2012;107(3):374-80.

Ota E, Tobe-Gai R, Mori R, Farrar D. Antenatal dietary advice and supplementation to increase energy and protein intake. Cochrane Database Syst Rev. 2012; (9):CD000032. http://dx.doi.org/10.1002/14651858.CD000032.pub2.

Maslova E, Halldorsson TI, Astrup A, Olsen SF. Dietary protein-to-carbohydrate ratio and added sugar as determinants of excessive gestational weight gain: A prospective cohort study. BMJ Open. 2015;5:e005839. http://dx.doi.org/10.1136/bmjopen-2014-005839

Noakes M, Keogh JB, Foster PR, Clifton PM. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional highcarbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. Am J Clin Nutr.2005;81(86):1298-306.

Wycherley TP, Moran LJ, Clifton PM, Noakes M, Brinkworth GD. Effects of energy-restricted highprotein, low-fat compared with standard-protein, low-fat diets: A meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012;96(6):1281-98.

Martens EA, Lemmens SG, Westerterp-Plantenga MS. Protein leverage affects energy intake of high-protein diets in humans. Am J Clin Nutr. 2013;97(1):86-93.

Anderson JW, Johnstone BM, Cook-Newell ME. Meta-Analysis of the effects of soy protein intake on serum lipids. N Engl J Med. 1995;333(5):276-82.

Castro MBT, Kac G, Leon AP, Sichieri R. High-protein diet promotes a moderate postpartum weight loss in a prospective cohort of Brazilian women. Nutrition. 2009b;25(11):1120-8.

Yang Y, Wei Q, Yu H, Wang P, Xia W, Huang R, et al. Higher pre-pregnancy body mass index is associated with excessive gestational weight gain in normal weight Chinese mothers with gestational diabetes. J Obstet Gynaecol Res. 2016;42(5):511-8. http://dx.doi.org/10.1111/jog.12934

Campbell EE, Dworatzek PND, Penava D, deVrijer B, Gilliland J, Matthews JI, et al. Factors that influence excessive gestational weight gain: Moving beyond assessment and counselling. J Mater Fetal Neonatal Med. 2016;29(21):3527-31.

Begum F, Colman I, McCargar LJ, Bell RC. Gestational weight gain and early postpartum weight retention in a prospective cohort of Alberta women. J Obstet Gynaecol Can. 2012;34(7):637-47.

Scholl TO, Hediger ML, Schall JI, Ances IG, Smith WK. Gestational weight gain, pregnancy outcome, and postpartum weight retention. Obstet Gynecol. 1995;86(3):423-7.

Paulino DSM, Surita FG, Peres GB, Nascimento SL, Morais SS. Association between parity, pre-pregnancy body mass index and gestational weight gain. J Mater Fetal Neonatal Med. 2016;29(6):880-8.

Ade MS, Pereira RA, Yokoo EM, Levy RB, Sichieri R. Most consumed foods in Brazil: NationalDietary Survey 2008-2009. Rev Saúde Pública. 2013;47(Suppl1):190S-9S.

Moratoya E, Carvalhaes G, Wander A, Almeida L. Mudanças no padrão de consumo alimentar no Brasil e no mundo. Rev Pol Agrícola. 2013;22(1):72-84.

Gaspareto N, Previdelli AN, Aquino AC. Factors associated with protein consumption in elderly. Rev Nutr. 2017;30(6):805-16. http://dx.doi.org/10.1590/1678-98652017000600012

Ricardo CZ, Claro RM. Custo da alimentação e densidade energética da dieta no Brasil, 2008-2009. Cad Saúde Pública. 2012;28(12):2349-61.

Tavares MP, Devincenzi MU, Sachs A, Abrão ACFV. Nutritional status and diet quality of nursing mothers on exclusive breastfeeding. Acta Paul Enferm. 2013;26(3):294-8.

Alves ALS, Olinto MTA, Costa JSD, Bairros FS, Balbinotti MAA. Padrões alimentares de mulheres adultas residentes em área urbana no Sul do Brasil. Rev Saúde Pública. 2006;40(5):865-73.

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Publicado

08-03-2023

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CABRAL, M. ., SICHIERI, R. ., Medeiros Macedo da ROCHA, C., & Trindade de CASTRO, M. B. . (2023). Protein intake and weight gain among low-income pregnant women from Mesquita County, Rio de Janeiro, Brazil. Revista De Nutrição, 31(3). Recuperado de https://periodicos.puc-campinas.edu.br/nutricao/article/view/7654

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