Insufficient choline intake during pregnancy: cohort study

Autores

  • Caroline de Barros GOMES Universidade Estadual Paulista Júlio de Mesquita Filho
  • Maria Antonieta de Barros Leite CARVALHAES Universidade Estadual Paulista Júlio de Mesquita Filho

Palavras-chave:

Choline, Food Consumption, Pregnant women, Prenatal nutrition

Resumo

Objective
To investigate the intake of choline during pregnancy and associated factors.
Methods
Cohort study with 353 pregnant women recruited from the primary health care network in an inland city of the State of São Paulo. In-house interviews were conducted in each of the gestational trimesters. In each of these points in time, a 24-hour dietary recall was collected. Subsequently, a new dietary recall collection was performed by telephone in the same trimester on a non-consecutive day, differentiating weekday versus weekend/holiday. Dietary intake data were included in the Nutrition Data System for Research software, and the habitual food intake throughout pregnancy was determined, with intra-individual variation correction in the MSM software. The influence of socioeconomic, obstetric and lifestyle factors, and of the actual diet, on choline intake during pregnancy was assessed using linear regression models, that were developed with the Stata software version 14.2, at a significance level of 95%.
Results
Choline intake (281.1±68.6 milligrams) was below the recommended adequate intake, and only energy was positively associated with this micronutrient intake.
Conclusion
Choline intake in the population studied fell far short of current recommendations, and only higher energy intake was found as a factor associated with a higher intake.

Referências

Institute of Medicine (United States). Dietary reference intakes for thiamin, riboflavin, niacin, vitamin b6, folate, vitamin b12, pantothenic acid, biotin, and choline. Washington: National Academies Press; 1998. https://doi.org/10.17226/6015

Zeisel S. Choline, other methyl-donors and epigenetics. Nutrients. 2017;9:445. https://doi.org/10.3390/nu9050445

Korsmo HW, Jiang X, Caudill MA. Choline: exploring the growing science on its benefits for moms and babies. Nutrients. 2019;11:1823. https://doi.org/10.3390/nu11081823

Blusztajn JK, Slack BE, Mellott TJ. Neuroprotective actions of dietary choline. Nutrients. 2017;9:815. https://doi.org/10.3390/nu9080815

Li K, Wahlqvist M, Li D. Nutrition, one-carbon metabolism and neural tube defects: a review. Nutrients. 2016;8:741. https://doi.org/10.3390/nu8110741

Jacobson SW, Carter RC, Molteno CD, Stanton ME, Herbert JS, Lindinger NM, et al. Efficacy of maternal choline supplementation during pregnancy in mitigating adverse effects of prenatal alcohol exposure on growth and cognitive function: a randomized, double-blind, placebo-controlled clinical trial. Alcohol Clin Exp Res. 2018;42:1327-41. https://doi.org/10.1111/acer.13769

McGee M, Bainbridge S, Fontaine-Bisson B. A crucial role for maternal dietary methyl donor intake in epigenetic programming and fetal growth outcomes. Nutr Rev. 2018;76:469-78. https://doi.org/10.1093/nutrit/nuy006

Freedman R, Hunter SK, Law AJ, Wagner BD, D’Alessandro A, Christians U, et al. Higher gestational choline levels in maternal infection are protective for infant brain development. J Pediatr. 2019;208:198-206.e2. https://doi.org/10.1016/j.jpeds.2018.12.010

Wiedeman A, Barr S, Green T, Xu Z, Innis S, Kitts D. Dietary choline intake: current state of knowledge across the life cycle. Nutrients. 2018;10:1513. https://doi.org/10.3390/nu10101513

Wallace TC, Blusztajn JK, Caudill MA, Klatt KC, Natker E, Zeisel SH, et al. Choline: the undersconsumed and underappreciated essential nutrient. Nutr Today. 2018;53:240-53. https://doi.org/10.1097/NT.0000000000000302

Lutter CK, Iannotti LL, Stewart CP. The potential of a simple egg to improve maternal and child nutrition. Matern Child Nutr. 2018;14:e12678. https://doi.org/10.1111/mcn.12678

Wallace T, Fulgoni V. Usual choline intakes are associated with egg and protein food consumption in the United States. Nutrients. 2017;9:839. https://doi.org/10.3390/nu9080839

Carter RC, Jacobson SW, Booley S, Najaar B, Dodge NC, Bechard LJ, et al. Development and validation of a quantitative choline food frequency questionnaire for use with drinking and non-drinking pregnant women in Cape Town, South Africa. Nutr J. 2018;17:108. https://doi.org/10.1186/s12937-018-0411-5

Malta MB, Carvalhaes MABL, Takito MY, Tonete VLP, Barros AJD, Parada CMGL, et al. Educational intervention regarding diet and physical activity for pregnant women: changes in knowledge and practices among health professionals. Bmc Pregnancy Childbirth. 2016;16:175. https://doi.org/10.1186/s12884-016-0957-1

Institute of Medicine; National Research Council (United States). Weight gain during pregnancy: reexamining the guidelines. Washington: The National Academies Press; 2009.

Moshfegh AJ, Rhodes DG, Baer DJ, Murayi T, Clemens JC, Rumpler WV, et al. The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr. 2008;88:324-32. https://doi.org/10.1093/ajcn/88.2.324

Nutrition Coordinating Center. Nutrition Data System for Research Software 2019. Minnesota: University of Minnesota; 2019 [cited 2020 Jan 7]. Available from: http://www.ncc.umn.edu/products/

Oken E, Kleinman KP, Olsen SF, Rich-Edwards JW, Gillman MW. Associations of seafood and elongated n-3 fatty acid intake with fetal growth and length of gestation: results from a US pregnancy cohort. Am J Epidemiol. 2004;160:774-83. https://doi.org/10.1093/aje/kwh282

Moore CJ, Perreault M, Mottola MF, Atkinson SA. Diet in early pregnancy: focus on folate, vitamin b12, vitamin d, and choline. Can J Diet Pract Res. 2020;81:58-65. https://doi.org/10.3148/cjdpr-2019-025

Caudill MA, Strupp BJ, Muscalu L, Nevins JEH, Canfield RL. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study. Faseb J. 2018;32:2172-80. https://doi.org/10.1096/fj.201700692RR

Magalhães EIS, Maia DS, Pereira Netto M, Lamounier JA, Rocha DS. Prevalência de anemia e determinantes da concentração de hemoglobina em gestantes. Cad Saúde Coletiva. 2018;26:384-90. https://doi.org/10.1590/1414-462x201800040085

Barnabé A, Aléssio ACM, Bittar LF, Moraes Mazetto B, Bicudo AM, Paula EV, et al. Folate, vitamin b12 and homocysteine status in the post-folic acid fortification era in different subgroups of the Brazilian population attended to at a public health care center. Nutr J. 2015;14:19. https://doi.org/10.1186/s12937-015-0006-3

Ministério da Saúde (Brasil). Atenção ao pré-natal de baixo risco. Brasília: Ministério; 2012.

Klatt KC, McDougall MQ, Malysheva OV, Brenna JT, Robertson MS, Caudill MA. Reproductive state and choline intake influence enrichment of plasma lysophosphatidylcholine-DHA: a post-hoc analysis of a controlled feeding trial. Br J Nutr. 2020;123:120. https://doi.org/10.1017/S0007114519003003

Jacobson SW, Carter RC, Molteno CD, Meintjes EM, Senekal MS, Lindinger NM, et al. Feasibility and acceptability of maternal choline supplementation in heavy drinking pregnant women: a randomized, double-blind, placebo controlled clinical trial. Alcohol Clin Exp Res. 2018;42:1315-26. https://doi.org/10.1111/acer.13768

Ministério da Saúde (Brasil). Guia alimentar para a população brasileira. Brasília: Ministério; 2014.

Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes. Jama. 2017;317:2207. https://doi.org/10.1001/jama.2017.3635

Núcleo de Estudos e Pesquisas em Alimentação. Tabela Brasileira de Composição dos Alimentos. 4a. ed. Campinas: Universidade Estadual de Campinas; 2011.

Lutter CK, Morris SS. Eggs: a high potential food for improving maternal and child nutrition. Matern Child Nutr. 2018;14:e12666. https://doi.org/10.1111/mcn.12666

Gomes CB, Malta MB, Papini SJ, Benício MHDA, Corrente JE, Carvalhaes MABL. Adherence to dietary patterns during pregnancy and association with maternal characteristics in pregnant Brazilian women. Nutrition. 2019;62:85-92. https://doi.org/10.1016/j.nut.2018.10.036

Louzada ML da C, Martins APB, Canella DS, Baraldi LG, Levy RB, Claro RM, et al. Ultra-processed foods and the nutritional dietary profile in Brazil. Rev Saúde Pública. 2015;49. https://doi.org/10.1590/S0034-8910.2015049006132

Rocha ARC, da Rocha A, Rocha E. Classifying and classified: an interpretive study of the consumption of cruises by the “new” Brazilian middle class. Int Bus Rev. 2016;25:624-32. https://doi.org/10.1016/j.ibusrev.2015.02.006.

Leal MDC, Szwarcwald CL, Almeida PVB, Aquino EML, Barreto ML, Barros F, et al. Saúde reprodutiva, materna, neonatal e infantil nos 30 anos do Sistema Único de Saúde (SUS). Ciênc Saúde Coletiva. 2018;23:1915-28. https://doi.org/10.1590/1413-81232018236.03942018

Downloads

Publicado

07-07-2022

Como Citar

de Barros GOMES, C. ., & de Barros Leite CARVALHAES, M. A. . (2022). Insufficient choline intake during pregnancy: cohort study. Revista De Nutrição, 34, 1–11. Recuperado de https://periodicos.puc-campinas.edu.br/nutricao/article/view/6231

Edição

Seção

ARTIGOS ORIGINAIS