The relationship of flavonoid intake during pregnancy with excess body weight and gestational diabetes mellitus

ABSTRACT Objective: To investigate the relationship of flavonoid intake during pregnancy with maternal excessive body weight and gestational diabetes mellitus (GDM). Subjects and methods: A cross-sectional study was conducted among 785 adult women in singleton pregnancies, and data were collected at the time of the oral glucose tolerance test. For the body mass index (BMI) classification according to the gestational age, the criteria of Atalah was used, and the diagnosis of GDM was based on the World Health Organization of 2014. Two 24-hour dietary recalls were obtained, and the usual intake was determined by the Multiple Source Method. Adjusted multinomial logistic regression was used to investigate the relationship of the flavonoids with overweight and obesity, and adjusted non-conditional logistic regression for the relationship of the flavonoids with GDM. Results: The mean (SD) age of the women was 28 (5) years, 32.1% were overweight, 24.6% were obese and 17.7% were diagnosed with GDM. The median (P25, P75) of total flavonoid intake was 50 (31,75) mg/day. Considering the eutrophic women as the reference, the pregnant women with a higher total flavonoid intake [OR 0.62 (95% CI 0.38; 0.96)] and anthocyanidin intake [OR 0.62 (95% CI 0.40; 0.99)] were less likely to be obese when compared to the women with lower intakes. No association of the flavonoids intake with overweight or GDM was found. Conclusion: A very low intake of flavonoids was observed. The data suggest that the intake of foods naturally rich in total flavonoids and anthocyanidin has a beneficial role regarding obesity among pregnant women.

摘要 研究目的：探讨妊娠期类黄酮摄入与母体体质量过度增加及妊娠糖尿病（GDM）的相关性。研究对象与方法：本研究针对785名单胎妊娠成年女性开展横断面研究，数据采集于口服葡萄糖耐量试验实施当日。针对基于胎龄的体重指数（BMI）分类，采用Atalah制定的标准；妊娠糖尿病（GDM）的诊断依据2014年世界卫生组织标准。通过两次24小时膳食回顾法收集膳食数据，并采用多来源法（Multiple Source Method）确定受试者的日常类黄酮平均摄入量。采用校正后的多项逻辑回归模型分析类黄酮摄入与超重、肥胖的关联，采用校正后的非条件逻辑回归模型分析类黄酮摄入与GDM的关联。研究结果：受试者的平均（标准差）年龄为28（5）岁，其中32.1%存在超重，24.6%为肥胖，17.7%被确诊为GDM。总类黄酮日摄入量的中位数（四分位间距P25、P75）为50（31,75）mg/天。以营养正常的孕妇作为参照组，与较低总类黄酮摄入组相比，总类黄酮摄入较高组[比值比（Odds Ratio, OR）0.62，95%置信区间（Confidence Interval, CI）0.38~0.96]及花青素摄入较高组[OR 0.62，95%CI 0.40~0.99]的孕妇发生肥胖的风险显著降低。未观察到类黄酮摄入与超重或GDM存在显著关联。研究结论：本研究队列中受试者的类黄酮摄入水平普遍偏低。数据提示，日常摄入富含总类黄酮与花青素的天然食物，对妊娠期女性的肥胖防控具有有益作用。