Percorrer por autor "Bracchi, Isabella"
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- Association of 3-Phenoxybenzoic Acid Exposure during Pregnancy with Maternal Outcomes and Newborn Anthropometric Measures: Results from the IoMum Cohort StudyPublication . Guimarães, Juliana; Bracchi, Isabella; Pinheiro, Cátia; Moreira, Nara Xavier; Coelho, Cláudia Matta; Pestana, Diogo; Prucha, Maria do Carmo; Martins, Cristina; Domingues, Valentina F.; Delerue-Matos, Cristina; Dias, Cláudia C.; Azevedo, Luís Filipe R.; Calhau, Conceição; Leite, João Costa; Ramalho, Carla; Keating, Elisa; Fernandes, Virgínia CruzThe aims of this study were to characterize the exposure of pregnant women living in Portugal to 3-phenoxybenzoic acid (3-PBA) and to evaluate the association of this exposure with maternal outcomes and newborn anthropometric measures. We also aimed to compare exposure in summer with exposure in winter. Pregnant women attending ultrasound scans from April 2018 to April 2019 at a central hospital in Porto, Portugal, were invited to participate. Inclusion criteria were: gestational week between 10 and 13, confirmed fetal vitality, and a signature of informed consent. 3-PBA was measured in spot urine samples by gas chromatography with mass spectrometry (GC-MS). The median 3-PBA concentration was 0.263 (0.167; 0.458) μg/g creatinine (n = 145). 3-PBA excretion was negatively associated with maternal pre-pregnancy body mass index (BMI) (p = 0.049), and it was higher during the summer when compared to winter (p < 0.001). The frequency of fish or yogurt consumption was associated positively with 3-PBA excretion, particularly during the winter (p = 0.002 and p = 0.015, respectively), when environmental exposure is low. Moreover, 3-PBA was associated with levothyroxine use (p = 0.01), a proxy for hypothyroidism, which could be due to a putative 3-PBA—thyroid hormone antagonistic effect. 3-PBA levels were not associated with the anthropometric measures of the newborn. In conclusion, pregnant women living in Portugal are exposed to 3-PBA, particularly during summer, and this exposure may be associated with maternal clinical features.
- Determinants of maternal exposure to heavy metals and semi-metals: Focus on diet and lifestylePublication . Guimarães, J.; Bracchi, Isabella; Pinheiro, C.; Vieira, M.I.; Barbosa, M. Oliveira; Almeida, A.; Azevedo, R.; Pinto, Edgar; Pestana, D.; Calhau, C.; Prucha, M. do Carmo; Martins, C.; Dias, C.C.; Azevedo, L.F.R.; Ramalho, C.; Fernandes, Virginia Cruz; Keating, E.; Fernandes, Virgínia; Pinto, EdgarKnowledge on determinants and health risks of toxic metal exposure in pregnancy is scarce in Portugal. This study aims to characterize food and lifestyle determinants of maternal exposure to Lead (Pb), Cadmium (Cd) and Arsenic (As). We included 1111 pregnant women undergoing routine 1sttrimester fetal ultrasound scan between 2018 and 2021 at CHUSJoão (Porto) and Hospital CUF Descobertas (Lisbon), who had single pregnancy and gave informed consent. At this stage, we collected diet and lifestyle information and a random urine sample for Pb, Cd and As quantification by ICP-MS. The majority of the sample had detectable urinary levels of toxic elements (n (%) and median (P25; P75) for Pb, Cd (in ng/g), and As (in μg/ g): 980 (88) and 547.2 (289.1; 975.9), 628 (57) and 142.5 (81.5; 234.9), 1080 (97) and 27.4 (14.9; 51.3), respectively). Cd and As urinary concentrations were positively correlated (r s =0.250, p<0.001). Smoking habits were associated with higher Pb (p=0.034) and Cd (p=0.008) levels and Pb levels had a negative weak correlation with birth head circumference (r s =-0.102; p=0.009). Regarding diet, the frequencies of fish and eggs intake were positively associated with Cd and As levels (p=0.005 and p< 0.001, respectively for fish intake; p=0.030 and p<0.001, respectively, for eggs intake). Women who reported consuming fish or eggs at least four times a week presented median (P25; P75) As levels of 35.2 (21.3; 71.9) or 35.9 (16.8; 57.2) μg/g, respectively. These concentrations exceed the commonly accepted reference range (≥24.0 μg/g), observed in healthy populations. Our results evidence that, in pregnant women, smoking might be a determinant of Pb and Cd exposure and fish and eggs might be relevant determinants of Cd and As exposure. These data stress the need to study the consequences of Pb or As and Cd cumulative exposure on the health of the mother and the offspring.
- Does iron and B12 Supplementation play a role in diet-induced changes in muscle mass? – Findings from the veggienutri cross-sectional studyPublication . Pinheiro, Cátia; Silva, Flávia; Rocha, Inês; Martins, Carina; Giesteira, Liliana; Dias, Bruna; Lucas, Ana; Alexandre, Ana Margarida; Ferreira, Catarina; Viegas, Bruna; Bracchi, Isabella; Guimarães, Juliana; Amaro, Joana; Amaral, Teresa F.; Dia, Cláudia Camila; Oliveira, Andreia; Ndrio, Altin; Guimarães, João Tiago; Leite, João Costa; Negrão, Rita; Keating, ElisaIn Portugal, lack of information regarding vegetarian populations and difficult access to nutritional counselling may exacerbate the risks of poorly planned plant-based diets. To study body composition differences between vegetarian and omnivorous adults, and to identify putative underlying nutritional and health parameters. 425 omnivorous (OMNI), lacto-ovo-vegetarian (LOV) or vegan (VEG) adults living in Portugal free of any chronic disease were included. Participants answered a food frequency and a sociodemographic and lifestyle questionnaire. Bioelectric impedance analysis was performed, and fasting blood samples were collected for health biomarkers analysis. Total protein intake was significantly lower for stricter vegetarian habits (median (P25; P75) in g/day: 98.6 (79.5; 123.1), 90.4 (65.9; 121.0), and 87.6 (59.8; 118.5) for OMNI, LOV and VEG, respectively; p = 0.020). Compared to being OMNI, being LOV, but not VEG, was independently associated with having +4.8 % (p = 0.002) fat mass and −2.2 % (p = 0.043) muscle mass (model adjusted for sex, age, marital status, physical exercise, multivitamin supplement intake and nutritional counselling). On the other hand, isolated B12 supplements were most used by VEG (93% in VEG vs. 17% in OMNI and 59% in LOV, p = 0.001), while isolated iron supplements were most used by LOV (29% in LOV vs. 14% in OMNI and 13% in VEG, p = 0.042). Among VEG, B12 blood levels correlated negatively with blood homocysteine (rs = −0.386, p < 0.001) and positively with % muscle mass (rs = 0.136, p = 0.005) and iron supplement users presented higher C-reactive protein (p = 0.014) and lower % muscle mass (p = 0.003), when compared to non-users. Our data suggest that among VEG, B12 supplementation may rescue from low-protein-induced muscle mass loss, while among LOV, ironrelated inflammation may exacerbate it.
- Early-life exposure to non-nutritive sweeteners: effects on hepatic FGF21 pathways and mitochondrial functionPublication . Brandão, Sofia; Bracchi, Isabella; Felipe, Stela Mirla; Magalhães, José; Keating, Elisa; Negrão, RitaTo combat obesity, diets and food products containing non-nutritive sweeteners (NNS), which provide sweetness without caloric intake, have gained popularity, even among pregnant women who reported intentional NNS consumption during gestation. In 2023, the World Health Organization warned about NNS consumption, as their long-term effects may be associated with an increased risk of type 2 diabetes, cardiovascular diseases, and mortality. Importantly, the environment during early life can induce permanent changes in metabolic health in adult life, suggesting that fetal exposure to NNS may induce long-term metabolic dysfunction in offspring. Fibroblast growth factor 21 (FGF21) is a key regulator of metabolic homeostasis. So, this branch of the MHSWEET project aims to study the effects of Rebaudioside A (RebA, the major sweetener component of stevia) exposure during the perigestational period on hepatic lipid metabolism of adult offspring and the involvement of FGF21. Female Sprague-Dawley rats were administered RebA in the drinking water or water as control from 4 weeks before mating until weaning. Food and beverage consumption, morphometric parameters, fasting glucose, oral glucose tolerance, and insulin sensitivity were measured before sacrifice at 10 months of age. Functionality of G1 hepatic mitochondria (OROBOROS® Oxygraph-2k system), hepatic triglyceride levels (Oil-Red-O staining), genes involved in hepatic lipid metabolic pathways and inflammation (RT-PCR) will be evaluated. The results obtained so far, showed that RebA exposure increased body weight in adult female offspring and induced dysglycemia in adult male offspring. The remaining studies are still being conducted. Results seem to support the hypothesis that intrauterine exposure to RebA may program offspring to a dysmetabolic state. These results will be useful to improve knowledge, and support public health policies regarding NNS use throughout life.
- Early-life exposure to non-nutritive sweeteners: Impact on adipose tissue morphology and metabolic functionPublication . Oliveira-Barbosa, Margarida; Bracchi, Isabella; Keating, Elisa; Negrão, RitaNon-sugar sweeteners (NSS) are sugar alternatives widely incorporated into food and beverages (1), providing sweetness with negligible caloric contribution (2). Over the past two decades, their consumption has increased among pregnant women (3,4). In 2023, WHO discouraged NSS intake highlighting the need for studies regarding exposure during critical windows of development (5), such as pregnancy and childhood (6). The MHSWEET project explores the role of NSS consumption on fetal programming of metabolic dysfunction. This branch of the MHSWEET aims to evaluate metabolic function of adipose tissue of adult mice exposed in utero to Rebaudioside A (RebA), the main sweetener component of the NSS Stevia. It also seeks to determine if this early-life exposure affects offspring’s susceptibility to metabolic dysfunction induced by a high-fat diet (HFD). Female Sprague-Dawley rats (G0) ingested RebA in drinking water (4mg steviol eq/kg body weight/day – EFSA’s ADI, n=8), or regular water (C, n=8), before mating until weaning (13 weeks). After weaning, offspring (G1) were fed a standard diet (STD) until 8 months of age, when they were administered STD or HFD until 10 months of age, creating 4 groups of study: C/STD, C/HFD, RebA/STD and RebA/HFD. Mesenteric adipose tissue morphology (H&E staining), as well as lipid and mitochondrial metabolic pathways (RT-PCR) will be assessed. The results so far showed that RebA exposure increased body weight in female offspring from 30 weeks of age onwards compared to controls (p=0.0165). Blind histological and RT-PCR analyses are ongoing to search for: a) adipocyte hypertrophy potentially induced by RebA exposure or HFD, mainly in RebA exposed offspring and b) alterations in lipid and mitochondrial metabolic pathways that may explain the observed changes in body weight and any changes in adipocyte morphology. This study will be crucial to assess health implications of NSS consumption during vulnerable stages of life.
- Essential trace elements status in portuguese pregnant women and their association with maternal and neonatal outcomes: A prospective study from the IoMum CohortPublication . Bracchi, Isabella; Guimarães, Juliana; Rodrigues, Catarina; Azevedo, Rui; Coelho, Cláudia Matta; Pinheiro, Cátia; Morais, Juliana; Barreiros-Mota, Inês; Fernandes, Virgínia Cruz; Delerue-Matos, Cristina; Pinto, Edgar; Moreira-Rosário, André; Azevedo, Luís Filipe Ribeiro de; Dias, Cláudia Camila; Lima, Jorge; Sapinho, Inês; Ramalho, Carla; Calhau, Conceição; Leite, João Costa; Almeida, Agostinho; Pestana, Diogo; Keating, ElisaCobalt (Co), copper (Cu), manganese (Mn), molybdenum (Mo), and zinc (Zn) are essential trace elements (ETEs) important in cellular chemical reactions and antioxidant defense. Ingestion of ETEs during pregnancy is crucial but their role in specific pregnancy outcomes is largely unknown. This study aimed to quantify urinary levels of these ETEs in pregnancy and to evaluate their role in pregnancy health. First trimester pregnant women of Porto and Lisbon regions provided a urine sample, and sociodemographic and lifestyle data. Clinical data were obtained from clinical records. Urinary ETEs were quantified by inductively coupled plasma mass spectrometry (ICP-MS). Our results show that having urinary Zn levels above the 50th percentile (P50) increases the risk of pre-eclampsia (PE). On the other hand, urinary Zn levels above the P50 decreased the risk of being born with head circumference small for gestational age but it increased the risk having length small for gestational age at birth. This study may provide valuable information for public health policies related to prenatal nutrition, while informing future efforts to de-fine urinary reference intervals for ETEs in pregnant women
- Food and lifestyle determinants of maternal exposure to semi-metal and heavy metal pollutantsPublication . Guimarães, Juliana; Bracchi, Isabella; Pinheiro, Cátia; Vieira, Maria Inês; Barbosa, Margarida Oliveira; Almeida, Agostinho; Azevedo, Rui; Pinto, Edgar; Pestana, Diogo; Calhau, Conceição; Prucha, Maria do Carmo; Martins, Cristina; Dias, Cláudia C.; Azevedo, Luís Filipe R.; Ramalho, Carla; Fernandes, Virgínia Cruz; Keating, Elisa; Fernandes, Virgínia; Pinto, EdgarExposure to toxics elements such as Lead (Pb), Cadmium (Cd), Lithium (Li) and Arsenic (As) pose health risks particularly for vulnerable groups like pregnant women and children. Knowledge about toxic metal exposure in these groups is scarce in Portugal. This study aims to identify food and lifestyle determinants of maternal exposure to toxic elements. Pregnant women from the IoMum cohort, undergoing firsttrimester fetal ultrasound between April 2018 and December 2021 at CHUSJoão (Porto) and Hospital CUF Descobertas (Lisbon), were invited to participate. At this stage, dietary and lifestyle information was collected through a structured questionnaire. A random urine sample was collected for Pb, Cd, Li and total (inorganic + organic) As quantification by ICP-MS and the values were adjusted for urinary creatinine concentration. A total of 305 mother: child pairs were included. RESULTS: The majority of the sample had detectable urinary levels of toxic elements (n (%): 269 (88), 157 (52), 305 (100) and 293 (96) for Pb, Cd, Li and total As, respectively). Pb urinary concentration was inversely associated with education level (p=0.008) while Cd and As levels were positively associated with education level (p=<0.001 and 0.002, respectively). Smoking was associated with higher Pb levels (p<0.001). Fish intake frequency was positively associated with Cd and As levels (p=0.005 and p<0.001, respectively) with women with fish intake higher than 4 times a week presenting median (P25;P75) in μg/g total As 33.8 (20.9 ; 67.7) concentration above the reference range typically (≥ 24.0 μg/g), seen in a group of healthy individuals. On the other hand, milk intake frequency was inversely associated Pb levels (p=0.025). Our results suggest that fish consumption may be a significant source of Cd and As exposure and that a higher milk intake may have a protective effect against Pb exposure.
- Impact of maternal stevia consumption on offspring`s metabolic health: A role in fetal programmingPublication . Bracchi, Isabella; Barbosa, Margarida; Vieira, Maria Inês; Brandão, Sofia; Esteves, Ana Carolina; Martins, Carina; Rocha, Inês; Pestana, Diogo; Negrão, Rita; Keating, ElisaThe consumption of non-sugar sweeteners (NSS) by pregnant women has increased in recent decades. Stevia, a natural NSS, is generally considered safe, but the World Health Organization recently recommended restricting the use of NSS, including stevia, highlighting the need to assess their safety during early stages of development. To investigate the role of RebaudiosideA (RebA) consumption, the main sweetener component of Stevia, as a fetal programmer of metabolic dysfunction. Female Sprague Dawley rats were administered RebA in the drinking water (4mg steviolequivalents/kg bodyweight/day, corresponding to the EFSA’s ADI) from 4 weeks before mating until weaning (total 13 weeks) (RebA, n=8), or water as control (C, n=8). Offspring (G1, both sexes) were weaned at 3 weeks of age into a standard diet until 10 months of age. G1 morphometry, food and water consumption were assessed. G1 glucose homeostasis was assessed by oral glucose tolerance (OGTT) and insulin sensitivity tests (IST) at 2, 6 and 10 months of age. Two-wayANOVA, with Sidak correction, was performed to test the effect of time, RebA, and the interaction between them. Female offspring early exposed to RebA (RebA-G1) presented greater weight gain from 30 weeks of age and onwards when compared to matched controls (p=0.0165). Food and water consumption were similar between groups. Early exposure to RebA changed the glycemic response of female G1 over time during the IST (p=0.0200) at 10 but not at 2 or 6 months of age. Male RebA-G1 presented higher glycemia 2h-post OGTT at 10 months of age, when compared to matched controls (p=0.0197). Maternal RebA consumption during the perigestional period led to increased weight gain and signs of insulin resistance in female offspring, and a degree of dysglycemia in male offspring. These findings strongly suggest a role of RebA in fetal programming of metabolic dysfunction.
- Iodine knowledge is associated with iodine status in Portuguese pregnant women: results from the IoMum cohort studyPublication . Pinheiro, Cátia; Moreira, Nara Xavier; Ferreira, Pedro; Coelho, Cláudia Matta; Guimarães, Juliana; Pereira, Gonçalo; Cortez, Alice; Bracchi, Isabella; Pestana, Diogo; Mota, Inês Barreiros; Prucha, Carmo; Martins, Cristina; Ribeiro, Célia Alves; Pinto, Edgar; Almeida, Agostinho; Delerue-Matos, Cristina; Montenegro, Nuno; Dias, Cláudia Camila; Moreira-Rosário, André; Azevedo, Luís Filipe; Brantsæter, Anne-Lise; Ramalho, Carla; Fernandes, Virgínia Cruz; Leite, João Costa; Calhau, Conceição; Keating, ElisaLack of knowledge about iodine has been suggested as a risk factor for iodine deficiency in pregnant women, but no studies have addressed this issue in Portugal. So, the aim of this study was to investigate iodine knowledge among Portuguese pregnant women and its association with iodine status. IoMum, a prospective observational study, included 485 pregnant women recruited at Centro Hospitalar e Universitário de S. João, Porto, between the 10th and 13th gestational weeks. Partial scores for knowledge on iodine importance, on iodine food sources or on iodised salt were obtained through the application of a structured questionnaire. Then, a total iodine knowledge score was calculated and grouped into low, medium and high knowledge categories. Urinary iodine concentration (UIC) was measured in spot urine samples by inductively coupled plasma MS. Of the pregnant women, 54 % correctly recognised iodine as important to neurocognitive development, 32 % were unable to identify any iodine-rich food and 71 % presented lack of knowledge regarding iodised salt. Of the women, 61 % had a medium total score of iodine knowledge. Knowledge on iodine importance during pregnancy was positively associated with iodine supplementation and also with UIC. Nevertheless, median UIC in women who correctly recognised the importance of iodine was below the cut-off for adequacy in pregnancy (150 µg/l). In conclusion, knowledge on iodine importance is positively associated with iodine status. Despite this, recognising iodine importance during pregnancy may not be sufficient to ensure iodine adequacy. Literacy-promoting actions are urgently needed to improve iodine status in pregnancy.
- The association of milk and dairy consumption with iodine status in pregnant women in Oporto regionPublication . Ferreira, Pedro; Pinheiro, Cátia; Coelho, Cláudia Matta; Guimarães, Juliana; Pereira, Gonçalo; Moreira, Nara Xavier; Cortez, Alice; Bracchi, Isabella; Pestana, Diogo; Mota, Inês Barreiros; Prucha, Carmo; Martins, Cristina; Ribeiro, Célia Alves; Pinto, Edgar; Almeida, Agostinho; Delerue-Matos, Cristina; Montenegro, Nuno; Dias, Cláudia Camila; Moreira-Rosário, André; Azevedo, Luís Filipe; Brantsæter, Anne-Lise; Ramalho, Carla; Fernandes, Virgínia Cruz; Calhau, Conceição; Leite, João Costa; Keating, ElisaThe role of milk and dairy products in supplying iodine to pregnant women is unknown in Portugal. The aim of this study was to evaluate the association between milk and dairy product consumption and the iodine status of pregnant women in the IoMum cohort of the Oporto region. Pregnant women were recruited between 10 and 13 weeks of gestation, when they provided a spot urine sample and information on lifestyle and intake of iodine-rich foods. Urinary iodine concentration (UIC) was determined by inductively coupled plasma MS. A total of 468 pregnant women (269 iodine supplement users and 199 non-supplement users) were considered eligible for analysis. Milk (but not yogurt or cheese) intake was positively associated with UIC, in the whole population (P = 0·02) and in the non-supplement users (P = 0·002), but not in the supplement users (P = 0·29). In non-supplement users, adjusted multinomial logistic regression analysis showed that milk consumption <3 times/month was associated with a five times increased risk of having UIC < 50 µg/l when compared with milk consumption ≥2 times/d (OR 5·4; 95 % CI 1·55, 18·78; P = 0·008). The highest UIC was observed in supplement users who reported consuming milk once per d (160 µg/l). Milk, but not yogurt or cheese, was positively associated with iodine status of pregnant women. Despite the observed positive association, daily milk consumption may not be sufficient to ensure adequate iodine intake in this population.