Nutrientes doadores de metil, obesidade parental e incidência de obesidade – Estudo CUME
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2023-03-01
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Universidade Federal de Viçosa
Resumo
A obesidade é uma doença crônica, prevalente e multifatorial. A nutriepigenética mostra que a predisposição genética à doença interage com fatores ambientais, como a alimentação, sendo capaz de promover fenótipos distintos. Alguns nutrientes, conhecidos como doadores de metil (MetD), participam do processo de metilação do DNA e são capazes de modular a expressão de genes envolvidos no aumento do peso corporal. Assim, dietas que contemplem esses nutrientes podem contribuir como medida preventiva e terapêutica para o risco de desenvolvimento da obesidade. Diante do exposto, o presente estudo teve como objetivo avaliar a associação entre o consumo de nutrientes MetD e a incidência de obesidade, e a sua relação com a obesidade parental. Neste estudo longitudinal, com 1.205 participantes da Coorte de Universidades de Minas Gerais (Estudo CUME), avaliou-se a incidência da obesidade em um seguimento de 4 anos (2016 – 2020). Os dados foram coletados de forma on-line por meio de questionários autorreferidos. A linha de base foi definida em 2016 e a cada dois anos os participantes foram solicitados a preencher os questionários de seguimento (Q2_2018, Q4_2020) e fornecerem informações do seu peso. O consumo diário dos nutrientes MetD (B2, B6, B9, B12, colina, betaína e metionina) foram obtidos por meio de um questionário de frequência alimentar com 144 itens alimentares, validado para a população em estudo. Um escore do consumo de MetD foi calculado considerando, inicialmente, o valor da mediana da ingestão de cada nutriente, sendo atribuído valor 0 quando a ingestão era baixa (< p50) e valor 1 quando a ingestão era alta (≥ p50). Em seguida os participantes foram categorizados em baixo (0 – 3 pontos), mediano (4 pontos) e alto (5 – 7 pontos) escore conforme o tercil da pontuação total da amostra. A presença de pai e mãe com obesidade foi identificada mediante autorrelato no questionário basal, e a obesidade parental foi determinada pela presença simultânea de pai e mãe com a doença. A regressão de risco proporcionais de Cox foi utilizada para testar as associações, e o modelo foi ajustado por fatores de confusão identificados por meio de um Gráfico Acíclico Direcionado (Directed Acyclic Graph, DAG). Na amostra, 89 (7,4%) casos incidentes de obesidade foram identificados. Estar no terceiro quartil de consumo de B2 e no segundo quartil de consumo de B9 e de colina resultou em 60% (IC 95%:0,20 – 0,79), 52% (IC95%:0,26 – 0,89) e 52% (IC95%:0,24 – 0,93) menor risco de desenvolver obesidade, respectivamente. Obter um escore mediano de MetD também conferiu um menor risco (HR:0,40; IC95%: 0,18 – 0,84). A obesidade parental foi a que conferiu maior risco para os casos incidentes (HR:4,26; IC95%: 1,21 – 10,93). No entanto, ter somente pai com obesidade teve um risco superior ao que ter somente a mãe com a doença (HR:2,32; IC95% 1,21 – 4,46 vs HR:2,09; IC95% 1,15 - 3,78). Porém, ao passo que os participantes com obesidade paterna apresentavam aumento no escore do consumo de doadores de metil, o risco para incidência de obesidade diminuiu (p de interação = 0,022). Não encontramos evidência de associação para os demais nutrientes MetD e o risco de obesidade. Em conclusão, o consumo intermediário de B2, B9 e colina, bem como um escore mediano de consumo dos MetD reduziram o risco de desenvolver obesidade em indivíduos com histórico familiar de obesidade materna, paterna e parental, sugerindo ainda que a alimentação é um fator protetor no histórico familiar da doença. Palavras-chave: Obesidade. Folato. Herança parental. Consumo alimentar. Epigenética.
Obesity is a chronic, prevalent and multifactorial disease. Nutriepigenetics shows that the genetic predisposition to the disease interacts with environmental factors, such as diet, being able to promote different phenotypes. Some nutrients, known as methyl donors (MetD), participate in the DNA methylation process and are capable of modulating the expression of genes involved in increasing body weight. Thus, diets that include these nutrients can contribute as a preventive and therapeutic measure for the risk of developing obesity. Given the above, the present study aimed to evaluate the association between the consumption of MetD nutrients and the incidence of obesity and its relationship with parental obesity. In this longitudinal study, with 1,205 participants from the Cohort of Universities of Minas Gerais (CUME Study), the incidence of obesity was evaluated in a 4-year follow-up (2016 – 2020). Data were collected online through self-reported questionnaires. The baseline was set in 2016 and every two years the participants were asked to complete the follow-up questionnaires (Q2_2018, Q4_2020) and provide their weight information. The daily intake of MetD nutrients (B2, B6, B9, B12, choline, betaine and methionine) was obtained using a food frequency questionnaire with 144 food items, validated for the study population. A MetD consumption score was calculated considering, initially, the median intake value of each nutrient, with a value of 0 when intake was low (< p50) and a value of 1 when intake was high (≥ p50). Participants were then categorized into low (0 – 3 points), median (4 points) and high (5 – 7 points) scores according to the tertile of the sample's total score. The presence of a father and mother with obesity was identified through self-report in the baseline questionnaire, and parental obesity was determined by the simultaneous presence of a father and mother with the disease. Cox proportional hazards regression was used to test associations, and the model was adjusted for confounding factors identified using a Directed Acyclic Graph (DAG). In the sample, 89 (7.4%) incident cases of obesity were identified. Being in the third quartile of B2 consumption and in the second quartile of B9 and choline consumption resulted in 60% (95% CI: 0.20 – 0.79), 52% (95% CI: 0.26 – 0.89 ) and 52% (95%CI:0.24 – 0.93) lower risk of developing obesity, respectively. Obtaining a median MetD score also conferred a lower risk (HR:0.40; 95%CI: 0.18 – 0.84). Parental obesity was the one that conferred the highest risk for incident cases (HR:4.26; 95%CI: 1.66 – 10.93). However, having only one father with obesity had a higher risk than having only one mother with the disease (HR:2.32; 95%CI 1.21 – 4.46 vs HR:2.09; 95%CI 1.15 - 3.78). However, while participants with paternal obesity had an increase in methyl donor consumption score, the risk for incidence of obesity decreased (interaction p = 0.022). We found no evidence of association for the other MetD nutrients and the risk of obesity. In conclusion, intermediate consumption of B2, B9 and choline, as well as a median consumption score of MetD reduced the risk of developing obesity in individuals with a family history of maternal, paternal and parental obesity, further suggesting that diet is a protective factor in the family history of the disease. Keywords: Obesity. Folate. Parental inheritance. Food intake. Epigenetics.
Obesity is a chronic, prevalent and multifactorial disease. Nutriepigenetics shows that the genetic predisposition to the disease interacts with environmental factors, such as diet, being able to promote different phenotypes. Some nutrients, known as methyl donors (MetD), participate in the DNA methylation process and are capable of modulating the expression of genes involved in increasing body weight. Thus, diets that include these nutrients can contribute as a preventive and therapeutic measure for the risk of developing obesity. Given the above, the present study aimed to evaluate the association between the consumption of MetD nutrients and the incidence of obesity and its relationship with parental obesity. In this longitudinal study, with 1,205 participants from the Cohort of Universities of Minas Gerais (CUME Study), the incidence of obesity was evaluated in a 4-year follow-up (2016 – 2020). Data were collected online through self-reported questionnaires. The baseline was set in 2016 and every two years the participants were asked to complete the follow-up questionnaires (Q2_2018, Q4_2020) and provide their weight information. The daily intake of MetD nutrients (B2, B6, B9, B12, choline, betaine and methionine) was obtained using a food frequency questionnaire with 144 food items, validated for the study population. A MetD consumption score was calculated considering, initially, the median intake value of each nutrient, with a value of 0 when intake was low (< p50) and a value of 1 when intake was high (≥ p50). Participants were then categorized into low (0 – 3 points), median (4 points) and high (5 – 7 points) scores according to the tertile of the sample's total score. The presence of a father and mother with obesity was identified through self-report in the baseline questionnaire, and parental obesity was determined by the simultaneous presence of a father and mother with the disease. Cox proportional hazards regression was used to test associations, and the model was adjusted for confounding factors identified using a Directed Acyclic Graph (DAG). In the sample, 89 (7.4%) incident cases of obesity were identified. Being in the third quartile of B2 consumption and in the second quartile of B9 and choline consumption resulted in 60% (95% CI: 0.20 – 0.79), 52% (95% CI: 0.26 – 0.89 ) and 52% (95%CI:0.24 – 0.93) lower risk of developing obesity, respectively. Obtaining a median MetD score also conferred a lower risk (HR:0.40; 95%CI: 0.18 – 0.84). Parental obesity was the one that conferred the highest risk for incident cases (HR:4.26; 95%CI: 1.66 – 10.93). However, having only one father with obesity had a higher risk than having only one mother with the disease (HR:2.32; 95%CI 1.21 – 4.46 vs HR:2.09; 95%CI 1.15 - 3.78). However, while participants with paternal obesity had an increase in methyl donor consumption score, the risk for incidence of obesity decreased (interaction p = 0.022). We found no evidence of association for the other MetD nutrients and the risk of obesity. In conclusion, intermediate consumption of B2, B9 and choline, as well as a median consumption score of MetD reduced the risk of developing obesity in individuals with a family history of maternal, paternal and parental obesity, further suggesting that diet is a protective factor in the family history of the disease. Keywords: Obesity. Folate. Parental inheritance. Food intake. Epigenetics.
Descrição
Palavras-chave
Obesidade, Ácido fólico, Metilação de DNA, Herança materna, Herança paterna, Alimentos - Consumo, Epigenética, Nutrigenômica
Citação
TEIXEIRA, Carolynne Martins. Nutrientes doadores de metil, obesidade parental e incidência de obesidade – Estudo CUME. 2023. 118 f. Dissertação (Mestrado em Ciência da Nutrição) - Universidade Federal de Viçosa, Viçosa. 2023.