Influência do consumo de alimentos ultraprocessados em indicadores nutricionais de vitamina E de mulheres lactantes

Abstract

The intake of ultra-processed foods can lead to the onset of chronic noncommunicable diseases, inadequate micronutrient intake, among other outcomes. Therefore, it is important to assess this consumption during lactation and its impact on milk composition and maternal nutritional status, as maternal nutrition must ensure an adequate nutritional composition of milk, avoiding the establishment of deficiencies, such as vitamin E deficiency (VED). Thus, this study aimed to evaluate the influence of the participation of the intake of ultra-processed foods in the vitamin E intake and vitamin E concentration in milk and serum of lactating women. The study was crosssectional with 294 lactating women attended at university hospitals in Rio Grande do Norte, Brazil. Blood and breast milk collection was performed around 90 days postpartum, while fasting, and the vitamin E concentration (alpha-tocopherol) was analyzed by High Performance Liquid Chromatography (HPLC). The vitamin E profile of breast milk was evaluated considering the projection of the amount of the vitamin found in the estimated volume of daily consumption (780 mL/day) and compared to the recommendation for infants (4 mg/day). The women's food intakes were obtained through three 24-hour recalls (with an interval of 30 days) and the foods were classified according to NOVA into unprocessed or minimally processed, processed culinary ingredients, processed and ultra-processed foods. Energy intake, total, saturated, monounsaturated, polyunsaturated and vitamin E intake were also analyzed. Participants were grouped according to the energy contribution tertiles of ultraprocessed foods. The Kruskal-Wallis test was used to compare the groups divided by the tertiles and a multiple linear regression test was performed, without and with adjustment for family income, to assess the relationship between the consumption of ultra-processed foods and the nutritional indicators of the vitamin. The intake of unprocessed or minimally processed foods contributed with 51% of energy intake and ultra-processed foods with 16%. All lactating women had a dietary intake of vitamin E below the recommended amount (<16 mg/day) and about 27% of this consumption was ultra-processed foods. Alpha-tocopherol in maternal serum was 1144 (344) µg/dL, with 5% (n = 11) VED (<517 µg/dL), and in breast milk, mean values of 362 (170) µg/dL were found , being 78% below the recommended daily value estimate for infants. The greater participation of ultra-processed foods in the diet was associated with lower concentrations of alpha-tocopherol in serum (β=-0.163, p=0.006) and the inadequate vitamin E profile of breast milk (β=-0.144, p=0.014). The main findings of this study revealed a negative impact of the greater participation of the consumption of ultraprocessed foods in the profile of vitamin E indicators in lactating women, alerting to the possible reduction in maternal circulating levels of vitamin and its supply to infants via breast milk. Thus, the current dietary guidelines for the lactating population are reinforced, with regard to avoiding the consumption of ultra-processed foods, aiming at the promotion of an adequate and healthy diet and prevention of EVD during this period of life.