Schtscherbyna Annie, Saraiva Débora Ayres, de Nathalie Silva, Corcino Carolina Martins, Louro Tatiana Martins Benvenuto, Vaisman Mario, Horta Paula Martins, Dos Patrícia de Fátima
Programa de Pós-graduação em Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Arch Endocrinol Metab. 2025 Jul 7;69(3):e240164. doi: 10.20945/2359-4292-2024-0164.
Conditions related to iodine status (IS) during pregnancy should be addressed to improve public health strategies. The aim of this study was to analyze the relationship between diet quality (DQ), assessed by the adapted Healthy Eating Index-2015 (HEI-2015), and IS in pregnant women from a Brazilian coastal state where public health policies assure iodine-fortified table salt in concentrations ranging from 15 to 45 mg/kg.
In a cross-sectional study, 199 participants were evaluated on three different days during their first trimester of pregnancy. At every visit, a urinary spot sample was requested to assess the urinary iodine concentration (UIC), and a 24-hour dietary recall related to the time at which the urine was collected was also performed. Total and component scores were estimated for the HEI-2015. The association between DQ and the IS was evaluated, considering an adequate UIC (150-249 μg/L) as the reference group (RG).
The median total score for the HEI-2015 was 45.8 points, which was slightly better (48.1 points) in the insufficient UIC (UIC <150-249 μg/L) than in the RG (41.3 points). In the "more than adequate" and "excessive" IS groups, the scores were 40.7 and 44.6 points, respectively.
Pregnant women with insufficient IS had better DQ and higher consumption of fruits and vegetables, as did those with lower intake of refined grains. We suppose that these groups benefit from iodine supplementation during pregnancy even when they live in a coastal state where table salt is fortified with iodine. In contrast, excessive UIC was related to worse intake of "whole fruits", "total fruits" and "total vegetables". The results suggest that diet quality is related to iodine status in the studied population. Pregnant women with better diet quality, especially those with high consumption of total protein foods, fruits and vegetables and low consumption of refined grains, may be at risk for iodine insufficiency. The necessity of iodine supplementation for pregnant women should be better explored even in regions where iodine-fortified table salt is adopted as a public health policy.
应关注与孕期碘状态（IS）相关的情况，以改进公共卫生策略。本研究旨在分析采用改良版2015年健康饮食指数（HEI - 2015）评估的饮食质量（DQ）与巴西一个沿海州孕妇的IS之间的关系，该州的公共卫生政策确保碘强化食盐的浓度在15至45毫克/千克之间。
在一项横断面研究中，对199名参与者在孕早期的三个不同日期进行了评估。每次就诊时，要求采集一次尿样以评估尿碘浓度（UIC），并进行与尿液采集时间相关的24小时饮食回顾。估算了HEI - 2015的总分及各成分得分。以充足的UIC（150 - 249微克/升）作为参照组（RG），评估DQ与IS之间的关联。
HEI - 2015的总得分中位数为45.8分，UIC不足（UIC <150 - 249微克/升）组略高于参照组（RG）（48.1分比41.3分）。在“碘摄入充足及以上”和“碘摄入过量”组中，得分分别为40.7分和44.6分。
IS不足的孕妇饮食质量较好，水果和蔬菜的摄入量较高，精制谷物摄入量较低的孕妇也是如此。我们推测，即使这些人群生活在食盐加碘的沿海州，孕期补充碘对他们仍有益处。相比之下，UIC过高与“完整水果”“总水果”和“总蔬菜”的摄入量较差有关。结果表明，在所研究的人群中饮食质量与碘状态相关。饮食质量较好的孕妇，尤其是总蛋白食物、水果和蔬菜摄入量高且精制谷物摄入量低的孕妇，可能存在碘不足的风险。即使在将碘强化食盐作为公共卫生政策的地区，也应进一步探讨孕妇补充碘的必要性。
