A Supervised Nutritional Program in Pregnancies and NF-κB Expression in Placenta
Condition: Dietary Habits
Study type: Interventional
Phase: Phase 1

Summary: 
      Nuclear factor kappa B (NF-κB) pathway and oxidative stress participate in endothelial
      dysfunction, which is one of the causes of preeclampsia. Among the human antioxidant
      mechanisms there are the enzymes catalase (CAT), glutathione peroxidase (GPx) and superoxide
      dismutase (SOD). Our aim was to measure NF-κB and oxidative stress in pregnant women
      submitted to an individualized diet during pregnancy.
    

Detailed description: 
      Obesity during pregnancy is associated with exaggerated metabolic adaptation, endothelial
      dysfunction and an increased risk of adverse pregnancy outcomes, including preeclampsia, a
      major cause of maternal and fetal morbidity and mortality characterized by increased blood
      pressure, proteinuria and edema, which affects approximately 3% to 7% of all pregnant women.
      Other risk factors, besides obesity, that increase the likelihood of developing preeclampsia
      include chronic hypertension, and diabetes mellitus.

      Reactive oxygen species (ROS) [superoxide anions (•O2-), hydrogen peroxide (H2O2) and
      hydroxyl radicals (•OH)],5 interact with proteins, nucleic acids and lipids and in a process
      called lipid peroxidation (LPO), can cause severe cell and tissue damage. There is current
      evidence that ROS are common activators of nuclear factor-kappa B (NF-κB), a factor that
      initiates a systemic inflammatory process by promoting the synthesis of cytokines,
      interleukin (IL)-6, IL-8, monocyte chemotactic protein-1 (MCP-1) and expression of
      intercellular adhesion molecule (ICAM-1).

      To maintain balance of the oxidative state, the human body possesses intracellular
      antioxidant enzyme systems, including superoxide dismutase (SOD, glutathione peroxidase
      (GPx), and catalase (CAT), which is located mainly in peroxisomes and cytoplasm of the cell.

      The epidemiology of preeclampsia, which is more common among poor women, had previously
      suggested that nutrients may be involved in the disorder, unfortunately, the nutritional data
      obtained from women with the syndrome has been poorly defined.

      The objective of this paper was to provide an overview of the biological plausibility and
      potential mechanisms underlying associations among maternal nutrition, oxidative stress in
      placenta and the risk of preeclampsia.
    

Intervention name(s): Healthy Eating Index (HEI) in supervised pregnancies
Intervention type(s): Behavioral
Intervention description(s): Dietetic treatment was calculated according to height, weeks of gestation and weight, considering an energy intake of 30 kcal/kg of expected weight, distributing the resulting energy according to the percentage of macronutrients' adequation (55-65% carbohydrates, 10-20% fat and the remainder as proteins).16 On each nutritional visit, 24 hour dietary recall was done and analyzed using NutriKcal®VO software in order to evaluate the Healthy Eating Index (HEI), which is commonly employed to assess pregnant women's dietary adequacy (on a scale from 0-100), through the consumption of 12 components of food groups described previously. An improvement in diet was considered when the initial HEI score improved more than one point during the next nutritional assessment.
Other intervention name(s): NutriKcal®VO software
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: adequacy; diet; pregnancy