PDF herunterladen
CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(01): 004-010
DOI: 10.1055/s-0038-1676096
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Association between Dietary Glycemic Index and Excess Weight in Pregnant Women in the First Trimester of Pregnancy

Associação entre o índice glicêmico dietético e o excesso de peso em gestantes no primeiro trimestre de gestação
Thais Helena de Pontes Ellery
1   Group of Research in Nutrition and Chronic Diseases, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
,
Helena Alves de Carvalho Sampaio
1   Group of Research in Nutrition and Chronic Diseases, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
,
Antônio Augusto Ferreira Carioca
2   Department of Nutrition, Universidade de Fortaleza, Fortaleza, Ceará, Brazil
,
Bruna Yhang da Costa Silva
1   Group of Research in Nutrition and Chronic Diseases, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
3   Department of Nutrition, Instituto Federal de Educação, Ciência e Tecnologia do Ceará, Limoeiro do Norte, CE, Brazil
,
Júlio Augusto Gurgel Alves
4   Department of Maternal and Child, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
,
Fabrício Da Silva Costa
5   Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
6   Department of Obstetrics and Gynecology, Monash University, Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia
,
Edward Araujo Júnior 
7   Department of Obstetrics, Paulista School of Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil
8   Medicine Course, Universidade Municipal de São Caetano do Sul, São Paulo-SP, Brazil
,
Maria Luísa Pereira de Melo
1   Group of Research in Nutrition and Chronic Diseases, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

19. März 2018

10. Oktober 2018

Publikationsdatum:
12. Dezember 2018 (online)

   Lizenzen und Reprints

Erratum zu diesem Artikel:

Erratum – Association between Dietary Glycemic Index and Excess Weight in Pregnant Women in the First Trimester of PregnancyRev Bras Ginecol Obstet 2019; 41(03): 209-210
DOI: 10.1055/s-0039-1685226

Abstract

Objective To assess the association between dietary glycemic index (GI) and excess weight in pregnant women in the first trimester of pregnancy.

Methods A cross-sectional study in a sample of 217 pregnant women was conducted at the maternal-fetal outpatient clinic of the Hospital Geral de Fortaleza, Fortaleza, state of Ceará, Brazil, for routine ultrasound examinations in the period between 11 and 13 weeks + 6 days of gestation. Weight and height were measured and the gestational body mass index (BMI) was calculated. The women were questioned about their usual body weight prior to the gestation, considering the prepregnancy weight. The dietary GI and the glycemic load (GL) of their diets were calculated and split into tertiles. Analysis of variance (ANOVA) or Kruskal-Walls and chi-squared (χ2) statistical tests were employed. A crude logistic regression model and a model adjusted for confounding variables known to influence biological outcomes were constructed. A p-value < 0.05 was considered significant for all tests employed.

Results The sample group presented a high percentage of prepregnancy and gestational overweight (39.7% and 40.1%, respectively). In the tertile with the higher GI value, there was a lower dietary intake of total fibers (p = 0.005) and of soluble fibers (p = 0.008). In the third tertile, the dietary GI was associated with overweight in pregnant women in the first trimester of gestation, both in the crude model and in the model adjusted for age, total energy intake, and saturated fatty acids. However, this association was not observed in relation to the GL.

Conclusion A high dietary GI was associated with excess weight in women in the first trimester of pregnancy.

Resumo

Objetivo Avaliar a associação entre índice glicêmico (IG) dietético e presença de excesso de peso em gestantes no primeiro trimestre de gestação.

Métodos Estudo transversal realizado com 217 gestantes atendidas no Ambulatório de Medicina Materno-Fetal do Hospital Geral de Fortaleza, Fortaleza, CE, para realização de exames ultrassonográficos de rotina no período entre 11 e 13 semanas e 6 dias de gestação. Peso e altura foram obtidos para o cálculo do índice de massa corporal (IMC) gestacional. As mulheres foram questionadas quanto ao peso corporal habitual anterior à gestação, considerado o peso pré-gestacional. O IG e a carga glicêmica (CG) das suas dietas foram calculados e divididos em tercis. As associações foram investigadas por análise de variância (ANOVA, na sigla em inglês) ou pelos testes Kruskal-Walls e qui-quadrado (χ2).

Resultados O grupo tinha alto percentual de excesso de peso pré-gestacional (39,7%) e gestacional (40,1%). Houve menor consumo de fibras totais (p = 0,005) e fibras insolúveis (p = 0,008) no tercil de maior valor de IG. No terceiro tercil, o IG da dieta foi associado ao excesso de peso das mulheres no primeiro trimestre de gestação, tanto no modelo bruto como no modelo ajustado para idade, consumo total de energia e de ácidos graxos saturados. No entanto, não se observou esta associação em relação à CG.

Conclusão O alto IG da dieta consumida foi associado ao excesso de peso das mulheres no primeiro trimestre da gestação.

Keywords

pregnancy - glycemic index - glycemic load - excess weight

Palavras-chave

gestação - índice glicêmico - carga glicêmica - excesso de peso

Contributors

Ellery T. H. P., Sampaio H. A. C., Carioca A. A. F., Silva B. Y. C., Alves J. A. G., Costa F. S., Araujo Júnior E. and Melo M. L. P. contributed with the project, the interpretation of data, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.


 

  • References

  • 1 Mattar R, Torloni MR, Betrán AP, Merialdi M. [Obesity and pregnancy]. Rev Bras Ginecol Obstet 2009; 31 (03) 107-110 Doi: 10.1590/S0100-72032009000300001
    PubMedSuche in Google Scholar
  • 2 Carvalhaes MA, Gomes CdeB, Malta MB, Papini SJ, Parada CM. [Prepregnancy overweight is associated with excessive weight gain during pregnancy]. Rev Bras Ginecol Obstet 2013; 35 (11) 523-529 Doi: 10.1590/S0100-72032013001100008
    PubMedSuche in Google Scholar
  • 3 Nast M, de Oliveira A, Rauber F, Vitolo MR. [Excessive gestational weight gain is risk factor for overweight among women]. Rev Bras Ginecol Obstet 2013; 35 (12) 536-540 Doi: 10.1590/S0100-72032013001200002
    CrossrefPubMedSuche in Google Scholar
  • 4 Vernini JM, Moreli JB, Magalhães CG, Costa RAA, Rudge MVC, Calderon IMP. Maternal and fetal outcomes in pregnancies complicated by overweight and obesity. Reprod Health 2016; 13 (01) 100-119 Doi: 10.1186/s12978-016-0206-0
    CrossrefPubMedSuche in Google Scholar
  • 5 Khan MN, Rahman MM, Shariff AA, Rahman MM, Rahman MS, Rahman MA. Maternal undernutrition and excessive body weight and risk of birth and health outcomes. Arch Public Health 2017; 75: 12 Doi: 10.1186/s13690-017-0181-0
    CrossrefPubMedSuche in Google Scholar
  • 6 Sampaio HA, Silva BY, Sabry MO, Almeida PC. Glycemic index and glycemic load of diets consumed by obese individuals. Rev Nutr 2007; 20: 615-624 Doi: 10.1590/S1415-52732007000600004
    CrossrefPubMedSuche in Google Scholar
  • 7 Augustin LS, Kendall CW, Jenkins DJ. , et al. Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis 2015; 25 (09) 795-815 Doi: 10.1016/j.numecd.2015.05.005
    CrossrefPubMedSuche in Google Scholar
  • 8 Guttierres APM, Alfenas RdeC. [Effects of glycemic index on energy balance]. Arq Bras Endocrinol Metabol 2007; 51 (03) 382-388 Doi: 10.1590/S0004-27302007000300005
    CrossrefPubMedSuche in Google Scholar
  • 9 Juanola-Falgarona M, Salas-Salvadó J, Buil-Cosiales P. , et al; PREvencion con DIeta MEDiterranea Study Investigators. Dietary glycemic index and glycemic load are positively associated with risk of developing metabolic syndrome in middle-aged and elderly adults. J Am Geriatr Soc 2015; 63 (10) 1991-2000 Doi: 10.1111/jgs.13668
    CrossrefPubMedSuche in Google Scholar
  • 10 Brand-Miller J, Wolever TMS, Colagiuri S, Foster-Powell K. The Glucose Revolution: the Authoritative Guide to the Glycemic Index—the Groundbreaking Medical Discovery. Boston, MA: Da Capo; 1999
    Suche in Google Scholar
  • 11 Atkinson FS, Foster-Powell K, Brand-Miller JC. International tables of glycemic index and glycemic load values: 2008. Diabetes Care 2008; 31 (12) 2281-2283 Doi: 10.2337/dc08-1239
    CrossrefPubMedSuche in Google Scholar
  • 12 Nadeau KJ, Anderson BJ, Berg EG. , et al. Youth-onset type 2 diabetes consensus report: current status, challenges, and priorities. Diabetes Care 2016; 39 (09) 1635-1642 Doi: 10.2337/dc16-1066
    CrossrefPubMedSuche in Google Scholar
  • 13 Giugliano D, Maiorino MI, Bellastella G, Esposito K. Comment on American Diabetes Association. Approaches to Glycemic Treatment. Sec. 7. In Standards of Medical Care in Diabetes-2016. Diabetes Care 2016;39(Suppl. 1):S52-S59. Diabetes Care 2016; 39 (06) e86-e87 Doi: 10.2337/dc15-2829
    CrossrefPubMedSuche in Google Scholar
  • 14 Rasmussen KM, Yaktine AL. Institute of Medicine, National Research Council, Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: National Academies Press; 2009
    Suche in Google Scholar
  • 15 Atalah E, Castillo C, Castro R, Aldea A. [Proposal of a new standard for the nutritional assessment of pregnant women]. Rev Med Chil 1997; 125 (12) 1429-1436
    PubMedSuche in Google Scholar
  • 16 Pinheiro ABV, Lacerda EMA, Benzecry EH, Gomes MCS, Costa VM. Tabela para Avaliação de Consumo Alimentar em Medidas Caseiras. 5a ed. São Paulo, SP: Atheneu; 2008
    Suche in Google Scholar
  • 17 Willett WC, Howe GR, Kushi LH. Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 1997; 65 (4, Suppl) 1220S-1228S, discussion 1229S–1231S Doi: 10.1093/ajcn/65.4.1220S
    CrossrefPubMedSuche in Google Scholar
  • 18 Brand-Miller J, Nantel G, Slama G, Lang V. Glycaemic Index and Health: the Quality of the Evidence. Paris: John Libbey Eurotex; 2001
    Suche in Google Scholar
  • 19 Brand-Miller J, Foster-Powell K, Atkinson F. The Shopper's Guide to GI Values: The Authoritative Source of Glycemic Index Values for More Than 1,200 Foods. Boston, MA: Da Capo; 2015
    Suche in Google Scholar
  • 20 Lau C, Faerch K, Glümer C. , et al; Inter99 study. Dietary glycemic index, glycemic load, fiber, simple sugars, and insulin resistance: the Inter99 study. Diabetes Care 2005; 28 (06) 1397-1403
    CrossrefPubMedSuche in Google Scholar
  • 21 Harttig U, Haubrock J, Knüppel S, Boeing H. ; EFCOVAL Consortium. The MSM program: web-based statistics package for estimating usual dietary intake using the Multiple Source Method. Eur J Clin Nutr 2011; 65 (Suppl. 01) S87-S91 Doi: 10.1038/ejcn.2011.92
    CrossrefPubMedSuche in Google Scholar
  • 22 FAO/WHO. Human Energy Requirements: Report of a Joint FAO/WHO/UNU Expert Consultation. Rome: Food and Agriculture Organization; 2004
    Suche in Google Scholar
  • 23 Goldberg GR, Black AE, Jebb SA. , 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
    PubMedSuche in Google Scholar
  • 24 Liu P, Xu L, Wang Y. , et al. Association between perinatal outcomes and maternal pre-pregnancy body mass index. Obes Rev 2016; 17 (11) 1091-1102 Doi: 10.1111/obr.12455
    CrossrefPubMedSuche in Google Scholar
  • 25 Tovar A, Must A, Bermudez OI, Hyatt RR, Chasan-Taber L. The impact of gestational weight gain and diet on abnormal glucose tolerance during pregnancy in Hispanic women. Matern Child Health J 2009; 13 (04) 520-530 Doi: 10.1007/s10995-008-0381-x
    CrossrefPubMedSuche in Google Scholar
  • 26 Knudsen VK, Heitmann BL, Halldorsson TI, Sørensen TI, Olsen SF. Maternal dietary glycaemic load during pregnancy and gestational weight gain, birth weight and postpartum weight retention: a study within the Danish National Birth Cohort. Br J Nutr 2013; 109 (08) 1471-1478 Doi: 10.1017/S0007114512003443
    CrossrefPubMedSuche in Google Scholar
  • 27 Widen EM, Whyatt RM, Hoepner LA. , et al. Excessive gestational weight gain is associated with long-term body fat and weight retention at 7 y postpartum in African American and Dominican mothers with underweight, normal, and overweight prepregnancy BMI. Am J Clin Nutr 2015; 102 (06) 1460-1467 Doi: 10.3945/ajcn.115.116939
    CrossrefPubMedSuche in Google Scholar
  • 28 Galgani J, Aguirre C, Díaz E. Acute effect of meal glycemic index and glycemic load on blood glucose and insulin responses in humans. Nutr J 2006; 5: 22 Doi: 10.1186/1475-2891-5-22
    CrossrefPubMedSuche in Google Scholar
  • 29 DeFronzo RA, Ferrannini E. Influence of plasma glucose and insulin concentration on plasma glucose clearance in man. Diabetes 1982; 31 (8 Pt 1): 683-688 Doi: 10.2337/diab.31.8.683
    CrossrefPubMedSuche in Google Scholar
  • 30 Sheard NF, Clark NG, Brand-Miller JC. , et al. Dietary carbohydrate (amount and type) in the prevention and management of diabetes: a statement by the american diabetes association. Diabetes Care 2004; 27 (09) 2266-2271 Doi: 10.2337/diacare.27.9.2266
    CrossrefPubMedSuche in Google Scholar
  • 31 McGowan CA, McAuliffe FM. The influence of maternal glycaemia and dietary glycaemic index on pregnancy outcome in healthy mothers. Br J Nutr 2010; 104 (02) 153-159 Doi: 10.1017/S0007114510000425
    CrossrefPubMedSuche in Google Scholar
  • 32 Moses RG, Luebcke M, Davis WS. , et al. Effect of a low-glycemic-index diet during pregnancy on obstetric outcomes. Am J Clin Nutr 2006; 84 (04) 807-812 Doi: 10.1093/ajcn/84.4.807
    CrossrefPubMedSuche in Google Scholar
  • 33 Walsh JM, McGowan CA, Mahony R, Foley ME, McAuliffe FM. Low glycaemic index diet in pregnancy to prevent macrosomia (ROLO study): randomised control trial. BMJ 2012; 345: e5605 Doi: 10.1136/bmj.e5605
    CrossrefPubMedSuche in Google Scholar
  • 34 Hill RJ, Davies PSW. The validity of self-reported energy intake as determined using the doubly labelled water technique. Br J Nutr 2001; 85 (04) 415-430 Doi: 10.1079/BJN2000281
    CrossrefPubMedSuche in Google Scholar
  • 35 Rhodes ET, Pawlak DB, Takoudes TC. , et al. Effects of a low-glycemic load diet in overweight and obese pregnant women: a pilot randomized controlled trial. Am J Clin Nutr 2010; 92 (06) 1306-1315 Doi: 10.3945/ajcn.2010.30130
    CrossrefPubMedSuche in Google Scholar
  • 36 Zhang R, Han S, Chen GC. , et al. Effects of low-glycemic-index diets in pregnancy on maternal and newborn outcomes in pregnant women: a meta-analysis of randomized controlled trials. Eur J Nutr 2018; 57 (01) 167-177 Doi: 10.1007/s00394-016-1306-x
    CrossrefPubMedSuche in Google Scholar