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Gao F, Cui CY. Dietary Cholesterol Intake and Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies. J Am Coll Nutr 2021; 41:107-115. [PMID: 33416437 DOI: 10.1080/07315724.2020.1844605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This meta-analysis aimed to understand the association between dietary cholesterol intake and the risk of gestational diabetes mellitus (GDM). We systematically searched the PubMed, Web of Science, and EMBASE databases to identify observational studies, published before September 2020, investigating the relationship between dietary cholesterol intake and risk of GDM. After evaluating the heterogeneity among studies, we used fixed- or random-effects models to calculate pooled values of relative risk (RR) and 95% confidence intervals (CIs) in order to estimate the effect of dietary cholesterol on the risk of GDM. We included a total of 9 studies (3 cohort, 4 cross-sectional, and 2 case-control) involving 30123 participants and 3237 cases. The pooled RR of GDM comparing highest versus lowest category of dietary cholesterol intake was 1.49 (95% CI, 1.18-1.88). The dose-response relationship showed that the risk of GDM increased by 32% (RR = 1.32; 95% CI, 1.20-1.45) for every increase of 100 mg per day in dietary cholesterol intake. This meta-analysis indicates that an increase in dietary cholesterol intake is associated with increased risk of GDM. Detailed cohort studies are essential to gain a better understanding of this association. Key teaching pointsStudies on animal models have suggested that a cholesterol-rich diet can promote systemic inflammation and insulin resistance, both of which can contribute to T2DM and GDM.Several epidemiological studies have investigated a potential relationship between dietary cholesterol intake and GDM risk, and the results are controversial.Our meta-analysis indicates that increased dietary cholesterol intake is associated with increased GDM risk.Dose-response analysis showed a linear relationship between dietary cholesterol intake and risk of GDM.
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Affiliation(s)
- Fan Gao
- Xi'an Centre for Disease Control and Prevention, Xi'an, China
| | - Cai-Yan Cui
- Xi'an Centre for Disease Control and Prevention, Xi'an, China
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Menon S, Benova L, Mabeya H. Epilepsy management in pregnant HIV+ women in sub-Saharan Africa, clinical aspects to consider: a scoping review. BMC Med 2020; 18:341. [PMID: 33198766 PMCID: PMC7670685 DOI: 10.1186/s12916-020-01799-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/25/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Since the introduction of highly active antiretroviral therapy (HAART), acquired immune deficiency syndrome (AIDS) related mortality has markedly declined. As HAART is becoming increasingly available, the infection with human immunodeficiency virus (HIV+) in sub-Saharan Africa (SSA) is becoming a chronic condition. While pregnancy in HIV+ women in SSA has always been considered a challenging event for the mother and the fetus, for pregnant HIV+ women also diagnosed with epilepsy (WWE), there are additional risks as HIV increases the odds of developing seizures due to the vulnerability of the central nervous system to other infections, immune dysfunction, and overall metabolic disturbances. In light of a growing proportion of HIV+ WWE on HAART and an increasing number of pregnant women accessing mother-to-child transmission of HIV programs through provision of HAART in SSA, there is a need to develop contextualized and evidenced-based clinical strategies for the management of epilepsy in this population. In this study, we conduct a literature scoping review to identify issues that warrant consideration for clinical management. RESULT Twenty-three articles were retained after screening, which covered six overarching clinical aspects: status epilepticus (SE), Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), dyslipidemia, congenital malformation (CM), chronic kidney disease (CKD), and neurological development. No studies for our population of interest were identified, highlighting the need for a cautionary approach to be employed when extrapolating findings. CONCLUSION High risks of CM and drug interactions with first-line antiepileptic drugs (AEDs) warrant measures to increase the accessibility and choices of safer second-line AEDs. To ensure evidence-based management of epilepsy within this population, the potential high prevalence of SE, CKD, dyslipidemia, and SJS/TEN and the cumulative effect of drug-drug interactions should be considered. Further understanding of the intersections between pregnancy and drug-drug interactions in SSA is needed to ensure evidenced-based management of epilepsy in pregnant HIV+ WWE. To prevent SE, the barriers for AED treatment adherence in pregnant HIV+ women should be explored. Our review underscores the need to conduct cohort studies of HIV+ WWE in reproductive age over time and across pregnancies to capture the cumulative effect of HAART and AED to inform clinical management.
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Affiliation(s)
- Sonia Menon
- Instiute of Tropical Medicine Antwerp, Antwerp, Belgium.
| | - Lenka Benova
- Instiute of Tropical Medicine Antwerp, Antwerp, Belgium
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AL-TAIE A, Mohammed N, Albasry Z. Potential confounders and a modified Framingham risk score for the prediction of pregnancy-related medical conditions occurrence among pregnant women: A retrospective study from Baghdad, Iraq. J Pharm Bioallied Sci 2020; 12:391-399. [PMID: 33679084 PMCID: PMC7909052 DOI: 10.4103/jpbs.jpbs_109_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/20/2020] [Accepted: 07/06/2020] [Indexed: 11/09/2022] Open
Abstract
Background: The incidence of pregnancy-related medical conditions relied on a set of potential factors that could be available even before the term of pregnancy and may be associated with poor outcomes later in life. This study aimed to investigate the association between some potential predictive factors related to maternal, gestational, and clinical parameters and the incidence of pregnancy-related medical conditions in a sample of Iraqi pregnant women. Materials and Methods: A retrospective, observational, single-center study was carried out on 92 pregnant women during their routine visit to the obstetric clinic in a certain distinct of Baghdad province, Iraq. Demographic, gestational, and clinical records of the participants were collected and analyzed to detect the predictive factors for pregnancy-related medical conditions. Results: 56.5% of the participants were at a gestational age of 25–37 weeks. 32.6% complained of pregnancy-related medical conditions, mainly gestational hypertension and diabetes mellitus. Pregnant women with pregnancy-related medical conditions were significantly correlated with a family history (P < 0.0001), previous gestational medical conditions (P < 0.001), diastolic blood pressure (P = 0.0011), different lipid panels (P = 0.0001), and maternal blood phenotype O (P = 0.0001). Conclusion: Some predictive factors related to maternal, gestational, and health characteristics are correlated with the incidence of pregnancy-related medical conditions. Interventions to adjust and recognize these confounders are essentials even before pregnancy which could improve maternal health and reduce the overall risk of pregnancy-related medical conditions.
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Wu Y, Sun G, Zhou X, Zhong C, Chen R, Xiong T, Li Q, Yi N, Xiong G, Hao L, Yang N, Yang X. Pregnancy dietary cholesterol intake, major dietary cholesterol sources, and the risk of gestational diabetes mellitus: A prospective cohort study. Clin Nutr 2019; 39:1525-1534. [PMID: 31296343 DOI: 10.1016/j.clnu.2019.06.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 05/06/2019] [Accepted: 06/18/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND & AIMS The Scientific Report of 2015 Dietary Guidelines Advisory Committee recommended the elimination of dietary cholesterol limits. However, cholesterol intake increases during pregnancy and studies regarding the association between dietary cholesterol and gestational diabetes mellitus (GDM) are limited. We evaluate the association of total dietary cholesterol and different sources of cholesterol intake during pregnancy, with GDM risk and blood glucose levels in a Chinese prospective cohort study. METHODS A total of 2124 pregnant women from the Tongji Maternal and Child Health Cohort was included. A validated semi-quantitative food frequency questionnaire was used to assess dietary cholesterol intake prior to GDM diagnosis. GDM was diagnosed by the 75-g 2-h oral glucose tolerance test. Cubic-restricted spline function and logistic regression analyses were used to evaluate the association between dietary cholesterol intake during pregnancy and GDM. Generalized linear models were conducted to examine the associations of cholesterol intake with fasting blood glucose (FBG), 1-h post-load blood glucose (PBG) and 2-h PBG. RESULTS The average dietary cholesterol intake was 379.1 mg/d, and cholesterol from eggs explained 64.2% of the variability. Total dietary cholesterol intake and cholesterol from eggs rather than other foods, were linearly associated with GDM risk, with adjusted OR for GDM of 2.10 (95%CI: 1.24, 3.58) for total cholesterol intake and 1.83 (95%CI: 1.08, 3.07) for cholesterol from eggs comparing the highest versus lowest quintile. A 100-mg/d increase in total cholesterol and cholesterol from eggs intake were associated with an increased GDM risk by 18% and 16%, respectively. Moreover, higher maternal dietary total cholesterol could increase FBG and 1-h PBG, while cholesterol from eggs increased FBG only. CONCLUSION Higher dietary cholesterol from eggs intake during pregnancy was associated with greater risk of GDM.
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Affiliation(s)
- Yuanjue Wu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guoqiang Sun
- Hubei Maternal and Child Health Hospital, Wuhan, Hubei, China
| | - Xuezhen Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chunrong Zhong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Renjuan Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ting Xiong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qian Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Nianhua Yi
- Hubei Maternal and Child Health Hospital, Wuhan, Hubei, China
| | | | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Mizgier M, Jarzabek-Bielecka G, Mruczyk K. Maternal diet and gestational diabetes mellitus development. J Matern Fetal Neonatal Med 2019; 34:77-86. [PMID: 30922196 DOI: 10.1080/14767058.2019.1598364] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Purpose: All possible measures should be taken to prevent glucose tolerance disorders and limit their consequences. The aim of this study was to show the relationship between maternal eating habits and the risk of developing gestational diabetes mellitus (GDM).Materials and methods: The nutrition of 55 pregnant women was evaluated using a three-day food record and food frequency questionnaire (FFQ) and nutrition of 12 months before pregnancy was assessed only by means of the FFQ. The patients were divided into groups: H - with uncomplicated pregnancy (n = 42) and GDM - with gestational diabetes mellitus (n = 13), based on oral glucose tolerance test (OGTT) results performed between 24 and 28 weeks.Results: Significant differences were found between groups H and GDM in terms of daily fat intake (32.1 versus 36.2%) and dietary reference values (standards) for total fat, monosaturated fatty acids (MUFA), and polysaturated fatty acids (PUFA). In the GDM group, the coverage of standards for total fat, staturated fatty acids (SFA) and MUFA exceeded the recommended values. Moreover, patients from this group consumed products typical for the "Western model of nutrition" more often, which may contribute to GDM.Conclusions: A "Western diet" and higher intake of energy from total fat and saturated fatty acid in the first half of pregnancy and before pregnancy may contribute to an increased risk of developing GDM.
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Affiliation(s)
- Malgorzata Mizgier
- Department of Morphological and Health Sciences, Dietetic Division, Faculty of Physical Culture in Gorzów Wielkopolski, Poznan University of Physical Education, Poznan, Poland
| | - Grazyna Jarzabek-Bielecka
- Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznan, Poland
| | - Kinga Mruczyk
- Department of Morphological and Health Sciences, Dietetic Division, Faculty of Physical Culture in Gorzów Wielkopolski, Poznan University of Physical Education, Poznan, Poland
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Nasioudis D, Doulaveris G, Kanninen TT. Dyslipidemia in pregnancy and maternal-fetal outcome. ACTA ACUST UNITED AC 2018; 71:155-162. [PMID: 30318877 DOI: 10.23736/s0026-4784.18.04330-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hyperlipidemia is a known cause of atherosclerosis and directly contributes to the current epidemic in cardio-vascular disease. Pregnancy is typified by an increase in serum levels of total cholesterol and triglycerides pushed by the rise in estrogen, progesterone and lactogen. Mobilization of stored fat depots in late pregnancy may provide a reservoir of fatty acids for fetal growth and placental tissue steroid synthesis. This physiologic increase in lipids performs an essential role during pregnancy; however, elevated levels of lipids in predisposed women or with familiar forms of hyperlipidemia can carry increased risk for maternal-fetal complications. The present treatment of pregnant women with hyperlipidemia is the suspension of medications. However, hyperlipidemia during pregnancy is associated with preeclampsia, preterm birth and gestational diabetes and offspring of these mothers show a propensity to enhanced fatty streak formation and an increased risk of progressive atherosclerosis. This current evidence may motivate the further study on the potential benefits of treatment of hyperlipidemia in pregnancy and its effects on maternal-fetal outcomes.
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Affiliation(s)
- Dimitrios Nasioudis
- Department of Obstetrics and Gynecology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Georgios Doulaveris
- Department of Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, New York, NY, USA
| | - Tomi T Kanninen
- Department of Obstetrics and Gynecology, Richmond University Medical Center, New York, NY, USA -
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Milajerdi A, Tehrani H, Haghighatdoost F, Larijani B, Surkan PJ, Azadbakht L. Associations between higher egg consumption during pregnancy with lowered risks of high blood pressure and gestational diabetes mellitus. INT J VITAM NUTR RES 2018; 88:166-175. [DOI: 10.1024/0300-9831/a000505] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Abstract. Introduction: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. High cholesterol intake may increase the risk of hyperglycemia, yet little research has evaluated the relation between cholesterol or egg as a main source of dietary cholesterol and GDM. We aimed to study this association among pregnant Iranian women. Methods and Participants: Four hundred sixty-two pregnant women participated in this case-control study. Participants’ dietary intake, weight, height, and blood pressure were obtained and BMI was calculated. Fasting plasma glucose and liver enzymes were also measured. Logistic regression was used to obtain odds ratios and 95% confidence intervals for GDM across tertiles of cholesterol and egg consumption. Results: Among study participants, 115 consumed less than one, 194 consumed one and the remaining participants consumed more than one egg per week (mean cholesterol intake 121.31±61.69 mg/d). Participants within the highest tertile of egg consumption had 41% lower risk of GDM (OR: 0.59; 95% CI: 0.35-0.99) compared with those in the lowest tertile (P=0.01). Higher egg consumption was associated with lower risk of having high blood pressure (P=0.01). The difference in odds of GDM and high blood pressure between the highest and the lowest tertile of cholesterol consumption was not significant, even after controlling for age, energy intake, number of children and socio-economic status. Conclusion: Higher dietary intake of egg during pregnancy was associated with lower odds of GDM. We found no significant association between cholesterol intake and odds of GDM. Further research are needed to confirm these results and determine causality.
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Affiliation(s)
- Alireza Milajerdi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hatav Tehrani
- Department of Obstetrics and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pamela J. Surkan
- Department of international health, John Hopkins School of Public Health, Baltimore, USA
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Department of Obstetrics and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Farhangi MA, Najafi M, Jafarabadi MA, Jahangiry L. Mediterranean dietary quality index and dietary phytochemical index among patients candidate for coronary artery bypass grafting (CABG) surgery. BMC Cardiovasc Disord 2017; 17:114. [PMID: 28482801 PMCID: PMC5422981 DOI: 10.1186/s12872-017-0544-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 04/28/2017] [Indexed: 12/12/2022] Open
Abstract
Background The aim of the present research was to evaluate the relationship between Mediterranean dietary quality index (Med-DQI) and dietary phytochemical index (DPI) with metabolic risk factors of cardiovascular disease in candidates for coronary artery bypass graft (CABG) surgery. Methods This was a cross-sectional study on 454 patients aged 35–80 years as candidates of CABG and hospitalized in Tehran Heart Center. Anthropometric and demographic characteristics were obtained from all participants and a 138-item semi-quantitative food frequency questionnaire (FFQ) was used to evaluate Med-DQI and DPI. Biochemical parameters including HbA1C, serum lipids, albumin, creatinine and C-reactive protein (CRP) were assessed by commercial laboratory methods. Results Patients with higher scores of “saturated fatty acids” had lower serum albumin concentrations (P < 0.05). High scores of “cholesterol” subgroup was also accompanied with higher serum Hb A1C percent (P = 0.04). Significantly higher concentrations of serum creatinine were also observed in categorizes with lower “fish” scores. Patients with lower phytochemical intakes had significantly higher Med-DQI scores. Conclusion According to our findings, high dietary intakes of saturated fatty acids and cholesterol were associated with low serum albumin and Hb A1C concentration. Further studies are needed to better clarify these associations and possible underlying mechanisms.
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Affiliation(s)
- Mahdieh Abbasalizad Farhangi
- Drug Applied Research Center, Nutrition Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Najafi
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, North Karegar Street, Tehran, 1411713138, Iran.
| | | | - Leila Jahangiry
- Tabriz Health Services Managment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Ferriols E, Rueda C, Gamero R, Vidal M, Payá A, Carreras R, Flores-le Roux JA, Pedro-Botet J. [Relationship between lipid alterations during pregnancy and adverse pregnancy outcomes]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2016; 28:232-244. [PMID: 26088001 DOI: 10.1016/j.arteri.2015.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/13/2015] [Accepted: 04/14/2015] [Indexed: 06/04/2023]
Abstract
Lipids play an important role during pregnancy, and in this period major changes occur in lipoprotein metabolism. During the third trimester plasma cholesterol and triglyceride levels are substantially increased, returning to normal after delivery. Described associations between increased morbidity during pregnancy and excessive increases in plasma cholesterol and triglycerides. For this reason we have reviewed the relationship between lipid alterations, preeclampsia, gestational diabetes and preterm birth. The overall metabolic control can improve pregnancy outcomes, and the assessment of supraphysiological changes in lipid profile will classify pregnancy risk at a higher level, which would entail a stricter control.
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Affiliation(s)
- Elena Ferriols
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España.
| | - Carolina Rueda
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España
| | - Rocío Gamero
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España
| | - Mar Vidal
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España
| | - Antonio Payá
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España; Departament de Pediatria, d'Obstetrícia i Ginecologia, i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
| | - Ramón Carreras
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España; Departament de Pediatria, d'Obstetrícia i Ginecologia, i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
| | - Juana A Flores-le Roux
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Juan Pedro-Botet
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
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Schoenaker DAJM, Mishra GD, Callaway LK, Soedamah-Muthu SS. The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies. Diabetes Care 2016; 39:16-23. [PMID: 26696657 DOI: 10.2337/dc15-0540] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diet may influence the risk of gestational diabetes mellitus (GDM), but inconsistent findings have been reported. The purpose of this study was to synthesize evidence from observational studies on the associations between dietary factors and GDM. RESEARCH DESIGN AND METHODS Medline and Embase were searched for articles published until January 2015. We included observational studies of reproductive-aged women that reported on associations of maternal dietary intake before or during pregnancy, including energy, nutrients, foods, and dietary patterns, with GDM. All relevant results were extracted from each article. The number of comparable studies that adjusted for confounders was insufficient to perform a meta-analysis. RESULTS The systematic review included 34 articles comprising 21 individual studies (10 prospective cohort, 6 cross-sectional, and 5 case-control). A limited number of prospective cohort studies adjusting for confounders indicated associations with a higher risk of GDM for replacing 1-5% of energy from carbohydrates with fat and for high consumption of cholesterol (≥300 mg/day), heme iron (≥1.1 mg/day), red and processed meat (increment of 1 serving/day), and eggs (≥7 per week). A dietary pattern rich in fruit, vegetables, whole grains, and fish and low in red and processed meat, refined grains, and high-fat dairy was found to be beneficial. The current evidence is based on a limited number of studies that are heterogeneous in design, exposure, and outcome measures. CONCLUSIONS The findings support current dietary guidelines to limit consumption of foods containing saturated fat and cholesterol, such as processed meat and eggs, as part of an overall balanced diet. Further large prospective studies are warranted.
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Affiliation(s)
| | - Gita D Mishra
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Leonie K Callaway
- School of Medicine, University of Queensland, Brisbane, Australia Departments of Obstetric and Internal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Barbieiri P, Nunes JC, Torres AG, Nishimura RY, Zuccolotto DCC, Crivellenti LC, Franco LJ, Sartorelli DS. Indices of dietary fat quality during midpregnancy is associated with gestational diabetes. Nutrition 2015; 32:656-61. [PMID: 26876000 DOI: 10.1016/j.nut.2015.12.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/11/2015] [Accepted: 12/11/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate the relationship between gestational diabetes mellitus (GDM) and the usual intake of fatty acids and indices of dietary fat quality [the atherogenicity (AI) and thrombogenicity indices (TI), and the ratios of hypo-and hypercholesterolemic (hH), ∑n-3/∑n-6, and polyunsaturated/saturated fatty acids (P:S)], during mid-pregnancy. METHODS 799 adult pregnant women living in Ribeirão Preto, SP, Brazil were screened and accepted for this cross-sectional GDM study. The Multiple Source Method was used to estimate participants' usual diet, using two 24-hour dietary recalls during mid-pregnancy. Diagnosis of GDM was defined by the American Diabetes Association criteria of 2015. Logistic regression analysis were used to assess the association between GDM and dietary fat, adjusted for age, education, parity, gestational age at the time of the interview, pre-pregnancy and current BMI, prior GDM, family history of diabetes, smoking, physical activity, energy, fiber, and fatty acids. RESULTS The mean (standard deviation) age of the women was 28 (5) years, and 19% had GDM. After multiple adjustments, inverse associations between the highest tertile of ∑n-3 fatty acids intake [0.21 (0.08-0.56)], α-linolenic intake [0.15 (0.05-0.42)], and GDM were found. A positive association between GDM and the highest tertile of TI [2.66 (1.34-5.29)], and a negative association with the highest tertile of hH ratio [0.41 (0.22-0.77)], were observed. No association between GDM and other indices of dietary fat quality were found. CONCLUSION The quality of dietary fat during pregnancy is strongly associated with GDM. Randomized clinical trial are needed to confirm these findings.
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Affiliation(s)
- Patrícia Barbieiri
- Graduate Program in Community Health, Ribeirão Preto Medical School (FMRP), University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Juliana C Nunes
- Department of Food Technology, School of Nutrition, Federal University of Rio de Janeiro State (UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Alexandre G Torres
- Laboratory of Food Science and Nutritional Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Renata Y Nishimura
- Graduate Program in Community Health, Ribeirão Preto Medical School (FMRP), University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Daniela C C Zuccolotto
- Graduate Program in Community Health, Ribeirão Preto Medical School (FMRP), University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Lívia C Crivellenti
- Graduate Program in Community Health, Ribeirão Preto Medical School (FMRP), University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Laércio J Franco
- Graduate Program in Community Health, Ribeirão Preto Medical School (FMRP), University of São Paulo (USP), Ribeirão Preto, SP, Brazil; Department of Social Medicine, FMRP, USP, Ribeirão Preto, SP, Brazil
| | - Daniela S Sartorelli
- Graduate Program in Community Health, Ribeirão Preto Medical School (FMRP), University of São Paulo (USP), Ribeirão Preto, SP, Brazil; Department of Social Medicine, FMRP, USP, Ribeirão Preto, SP, Brazil.
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Shin MK, Kim YS, Kim JH, Kim SH, Kim Y. Dietary Patterns and Their Associations with the Diet Quality Index-International (DQI-I) in Korean Women with Gestational Diabetes Mellitus. Clin Nutr Res 2015; 4:216-24. [PMID: 26566516 PMCID: PMC4641983 DOI: 10.7762/cnr.2015.4.4.216] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/06/2015] [Accepted: 09/25/2015] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to examine dietary pattern, nutritional intake, and diet quality of Korean pregnant women with gestational diabetes mellitus (GDM). Between October 2008 and May 2012, 166 pregnant women diagnosed with GDM completed a questionnaire and dietary intake was assessed using a 3-day food record. Blood pressure, fasting plasma glucose, and glycated hemoglobin (HbA1c) concentrations were measured and oral glucose tolerance test (OGTT) was performed. Two major dietary patterns ("carbohydrate and vegetable" and "western" patterns) were identified through factor analysis. Dietary pattern scores for each dietary pattern were categorized into tertiles. The dietary quality index-international (DQI-I) was used to measure overall diet quality. Subjects with higher carbohydrate and vegetable pattern scores reported less physical activity (p < 0.05) and have higher diastolic blood pressure levels (p = 0.05). After adjusting for age and energy intake, higher carbohydrate and vegetable pattern scores were associated with higher sodium intakes (p = 0.02), but lower intakes of fat (p = 0.002) and other micronutrients. On the other hand, higher western pattern scores were associated with higher fat intake (p = 0.0001), but lower intakes of sodium (p = 0.01) and other micronutrients. Higher scores for both dietary patterns were associated with lower scores in the moderation category of the DQI-I (p < 0.0001). HbA1c and fasting plasma glucose levels were significantly lower among participants with high DQI-I than those with low DQI-I (p < 0.05). The study findings suggest that many Korean women with GDM do not consume nutritionally adequate or balanced diets, regardless of dietary pattern.
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Affiliation(s)
- Moon-Kyung Shin
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Yoo-Sun Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Jung-Hyun Kim
- Department of Physical Education, Chung-Ang University, Seoul 06974, Korea
| | - Sung-Hoon Kim
- Department of Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul 04619, Korea
| | - Yuri Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
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13
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Goletzke J, Buyken AE, Louie JCY, Moses RG, Brand-Miller JC. Dietary micronutrient intake during pregnancy is a function of carbohydrate quality. Am J Clin Nutr 2015; 102:626-32. [PMID: 26178724 DOI: 10.3945/ajcn.114.104836] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 06/15/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Despite normal gestational weight gain, dietary studies in pregnant women show intakes below the recommendations for energy and micronutrients. OBJECTIVE This study compared changes in dietary intake from the second to third trimester with emphasis on energy intake and carbohydrate quality. DESIGN These post hoc analyses were based on 566 women participating in the Pregnancy and Glycemic Index Outcomes study, a randomized controlled trial comparing the effect of low-glycemic index (GI) dietary advice with healthy eating advice on selected pregnancy outcomes. With the use of multilevel mixed-regression analysis, changes in total energy intake, starch, sugar, fiber intake, GI, and glycemic load (GL) were correlated with intake of different micronutrients. RESULTS Energy intake decreased in the third trimester, and most women did not meet the national recommended amounts for iron, folate, and dietary fiber from food sources alone. After adjustment for age, ethnicity, prepregnancy body mass index, and intervention group, change in energy intake was positively related to change in intake of all micronutrients (P < 0.001). GI, GL, and starch intake were inversely related to micronutrient intake (P < 0.001), whereas higher total sugars predicted higher intake (P < 0.001). Associations with dietary fiber were inconsistent. CONCLUSIONS Normal pregnancy can be associated with a decline in energy and micronutrient intake from diet. Low dietary GI and GL were the best predictors of a favorable micronutrient profile. This trial was registered at www.anzctr.org.au as ACTRN12610000174088.
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Affiliation(s)
- Janina Goletzke
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany; School of Molecular Bioscience and
| | - Anette E Buyken
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
| | | | - Robert G Moses
- Illawarra Shoalhaven Local Health District Wollongong, Wollongong, Australia
| | - Jennie C Brand-Miller
- School of Molecular Bioscience and Charles Perkins Centre, University of Sydney, Sydney, Australia; and
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Maternal dietary patterns and gestational diabetes mellitus: a large prospective cohort study in China. Br J Nutr 2015; 113:1292-300. [PMID: 25821944 DOI: 10.1017/s0007114515000707] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Few studies have explored the relationship between dietary patterns and the risk of gestational diabetes mellitus (GDM). Evidence from non-Western areas is particularly lacking. In the present study, we aimed to examine the associations between dietary patterns and the risk of GDM in a Chinese population. A total of 3063 pregnant Chinese women from an ongoing prospective cohort study were included. Data on dietary intake were collected using a FFQ at 24-27 weeks of gestation. GDM was diagnosed using a 75 g, 2 h oral glucose tolerance test. Dietary patterns were determined by principal components factor analysis. A log-binomial regression model was used to examine the associations between dietary pattern and the risk of GDM. The analysis identified four dietary patterns: vegetable pattern; protein-rich pattern; prudent pattern; sweets and seafood pattern. Multivariate analysis showed that the highest tertile of the vegetable pattern was associated with a decreased risk of GDM (relative risk (RR) 0·79, 95% CI 0·64, 0·97), compared with the lowest tertile, whereas the highest tertile of the sweets and seafood pattern was associated with an increased risk of GDM (RR 1·23, 95% CI 1·02, 1·49). No significant association was found for either the protein-rich or the prudent pattern. The protective effect of a high vegetable pattern score was more evident among women who had a family history of diabetes (P for interaction=0·022). These findings suggest that the vegetable pattern was associated with a decreased risk of GDM, while the sweets and seafood pattern was associated with an increased risk of GDM. These findings may be useful in dietary counselling during pregnancy.
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15
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Relation of the Mediterranean diet with the incidence of gestational diabetes. Eur J Clin Nutr 2013; 68:8-13. [PMID: 24084515 DOI: 10.1038/ejcn.2013.177] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 08/20/2013] [Accepted: 08/21/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND/OBJECTIVES Some studies document relationships of the incidence of gestational diabetes mellitus (GDM) with individual components of the diet, but studies exploring relationships with patterns of eating are lacking. This observational study aimed to explore a possible relationship between the incidence of GDM and the Mediterranean diet (MedDiet) pattern of eating. SUBJECTS/METHODS In 10 Mediterranean countries, 1076 consecutive pregnant women underwent a 75-g OGTT at the 24th-32nd week of gestation, interpreted both by the ADA_2010 and the International Association of the Diabetes and Pregnancy Study Groups (IADPSG)_2012 criteria. The dietary habits were assessed by a previously validated questionnaire and a Mediterranean Diet Index (MDI) was computed, reflecting the degree of adherence to the MedDiet pattern of eating: a higher MDI denoting better adherence. RESULTS After adjustment for age, BMI, diabetes in the family, weight gain and energy intake, subjects with GDM, by either criterion, had lower MDI (ADA_2010, 5.8 vs 6.3, P=0.028; IADPSG_2012, 5.9 vs 6.4, P<0.001). Moreover, the incidence of GDM was lower in subjects with better adherence to the MedDiet (higher tertile of MDI distribution), 8.0% vs 12.3%, OR=0.618, P=0.030 by ADA_2010 and 24.3% vs 32.8%, OR=0.655, P=0.004 by IADPSG_2012 criteria. In subjects without GDM, MDI was negatively correlated with both fasting plasma glucose and AUC glucose, P<0.001 for both. CONCLUSIONS Adherence to a MedDiet pattern of eating is associated with lower incidence of GDM and better degree of glucose tolerance, even in women without GDM. The possibility to use MedDiet for the prevention of GDM deserves further testing with intervention studies.
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Bartels Ä, Egan N, Broadhurst DI, Khashan AS, Joyce C, Stapleton M, O'Mullane J, O'Donoghue K. Maternal serum cholesterol levels are elevated from the 1st trimester of pregnancy: a cross-sectional study. J OBSTET GYNAECOL 2013; 32:747-52. [PMID: 23075347 DOI: 10.3109/01443615.2012.714017] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Cholesterol is monitored in the non-pregnant adult population, where normal values are established. Although reported to be elevated in pregnancy, cholesterol is neither routinely measured nor treated. We aimed to investigate cholesterol levels throughout pregnancy and to establish reference values for cholesterol in healthy pregnant women. This was a cross-sectional analysis of serum cholesterol in healthy women with an uncomplicated singleton pregnancy. Pregnant women attending for antenatal care were recruited and cholesterol levels assayed at 12, 20, 28 and 36 weeks' gestation and on day 1-3 postpartum. A total of 222 women were recruited. The majority (95%) were white Irish, with a median age of 31 years (range 16-46). Median BMI was 25.9 kg/m2 (range 18-40) and 16% were smokers. Cholesterol levels were elevated in all trimesters of pregnancy, with median values from 1st trimester raised outside the non-pregnant adult range. High-density lipoprotein (HDL) levels ranged from 0.9 to 3.7 mmol/l and low-density lipoprotein (LDL) levels ranged from 1.3 to 6.1 mmol/l. Fasting, smoking and obesity did not have any significant effects on results. Total and LDL-cholesterol levels were raised throughout pregnancy. Levels were above non-pregnant adult ranges as early as the 1st trimester. The implications of this on fetus and mother are undetermined and deserve further investigation.
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Affiliation(s)
- Ä Bartels
- Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Cork, Ireland
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Louie JCY, Markovic TP, Ross GP, Foote D, Brand-Miller JC. Higher glycemic load diet is associated with poorer nutrient intake in women with gestational diabetes mellitus. Nutr Res 2013; 33:259-65. [DOI: 10.1016/j.nutres.2013.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 02/11/2013] [Accepted: 02/19/2013] [Indexed: 01/17/2023]
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Bowers K, Tobias DK, Yeung E, Hu FB, Zhang C. A prospective study of prepregnancy dietary fat intake and risk of gestational diabetes. Am J Clin Nutr 2012; 95:446-53. [PMID: 22218158 PMCID: PMC3260071 DOI: 10.3945/ajcn.111.026294] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Fatty acids play a vital role in glucose homeostasis; however, studies on habitual dietary fat intakes and gestational diabetes mellitus (GDM) risk are limited and provide conflicting findings. OBJECTIVE We determined whether the total amount and the type and source of prepregnancy dietary fats are related to risk of GDM. DESIGN A prospective study was conducted in 13,475 women who reported a singleton pregnancy between 1991 and 2001 in the Nurses' Health Study II. In these women, 860 incident GDM cases were reported. The adjusted RR of GDM was estimated for quintiles of total fat, specific fat, and the source of fat intakes by pooled logistic regression. RESULTS Higher animal fat and cholesterol intakes were significantly associated with increased GDM risk. Across increasing quintiles of animal fat, RRs (95% CIs) for GDM were 1.00 (reference), 1.55 (1.20, 1.98), 1.43 (1.09, 1.88), 1.40 (1.04, 1.89), and 1.88 (1.36, 2.60) (P-trend = 0.05). Corresponding RRs (95% CIs) for dietary cholesterol were 1.00 (reference), 1.08 (0.84, 1.32), 1.02 (0.78, 1.29), 1.20 (0.93, 1.55), and 1.45 (1.11, 1.89) (P-trend = 0.04). The substitution of 5% of energy from animal fat for an equal percentage of energy from carbohydrates was associated with significantly increased risk of GDM [RR (95% CI): 1.13 (1.08, 1.18); P < 0.0001]. No significant associations were observed between dietary polyunsaturated fat, monounsaturated fat, or trans fat intakes and GDM risk. CONCLUSION Higher prepregnancy intakes of animal fat and cholesterol were associated with elevated GDM risk.
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Affiliation(s)
- Katherine Bowers
- Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
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Zhang C, Ning Y. Effect of dietary and lifestyle factors on the risk of gestational diabetes: review of epidemiologic evidence. Am J Clin Nutr 2011; 94:1975S-1979S. [PMID: 21613563 PMCID: PMC3364079 DOI: 10.3945/ajcn.110.001032] [Citation(s) in RCA: 176] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition in pregnancy, is a common pregnancy complication and a growing health concern. GDM has been related to significant short-term and long-term adverse health outcomes for both mothers and offspring. Importantly, this number is increasing with the increasing burden of obesity among women of reproductive age. Collectively, these data highlight the significance of understanding risk factors, in particular modifiable factors, for GDM and of preventing GDM among high-risk populations. Research in the past decade has identified a few diet and lifestyle factors that are associated with GDM risk. This review provides an overview of emerging diet and lifestyle factors that may contribute to the prevention of GDM. It also discusses major methodologic concerns about the available epidemiologic studies of GDM risk factors.
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Affiliation(s)
- Cuilin Zhang
- Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 21205, USA.
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20
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Hwang YJ, Park BK, Park S, Kim SH. A Comparative Study of Eating Habits and Food Intake in Women with Gestational Diabetes according to Early Postpartum Glucose Tolerance Status. Diabetes Metab J 2011; 35:354-63. [PMID: 21977455 PMCID: PMC3178696 DOI: 10.4093/dmj.2011.35.4.354] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 12/27/2010] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Women with gestational diabetes mellitus (GDM) are at high risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD); continuous life-style intervention, especially diet, is central to managing T2DM and CVD. However, little is known about the dietary patterns of women with GDM after delivery. The goal of this study was to compare the eating habits and food intakes of women diagnosed with GDM during the early postpartum period. METHODS We performed a 75 g oral glucose tolerance test (OGTT) in 184 women with GDM between 6 and 12 weeks after delivery. Based on the results of the OGTT, the subjects were divided into three groups according to the American Diabetes Association criteria; normal glucose tolerance (NGT) (n=100), pre-diabetes (n=73), and diabetes mellitus (DM) (n=11). Eating habits and usual food intake after delivery were investigated using a questionnaire, based on 24 hour-recall, which was administered by a trained dietitian. The daily intake data were analyzed using CAN Pro 3.0. Blood tests were performed pre- and post-delivery. RESULTS Eating habits were not significantly different among the three groups. However, animal fat consumption was significantly different among the three groups. The intake ratio of fat calories to total calories was also significantly higher in the pre-diabetes and DM groups. CONCLUSION Although diet in the period 6 to 12 weeks postpartum did not influence glucose level, it may be important to educate women with GDM about the risks of excessive animal fat intake during pregnancy and the postpartum period in order to prevent later onset of T2DM.
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Affiliation(s)
- You Jeong Hwang
- Department of Nutrition, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
| | - Bo Kyung Park
- Department of Nutrition, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
| | - Sunmin Park
- Department of Food and Nutrition, Hoseo University, Asan, Korea
| | - Sung-Hoon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
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Bartels Ä, O'Donoghue K. Cholesterol in pregnancy: a review of knowns and unknowns. Obstet Med 2011; 4:147-51. [PMID: 27579113 DOI: 10.1258/om.2011.110003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2011] [Indexed: 02/02/2023] Open
Abstract
Cholesterol forms part of every cell in the human body, and also helps make and metabolize hormones, bile acids and vitamin D. Human plasma cholesterol levels are determined by production in the liver and by dietary intake. Lipoproteins carry cholesterol around the body, and facilitate it crossing the placenta. Cholesterol is carefully monitored in the non-pregnant adult population, where its association with atherosclerosis and cardiovascular disease is well understood. Although it is known that cholesterol rises in pregnancy, at present it is not routinely measured or treated. The effects of maternal high cholesterol on pregnancy and on fetal development are not yet fully understood. However, a growing body of evidence from animal and human studies suggests adverse consequences of high cholesterol levels in pregnancy.
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Affiliation(s)
- Änne Bartels
- Department of Obstetrics and Gynaecology, Anu Research Centre, Cork University Maternity Hospital, University College Cork , Wilton, Cork, Republic of Ireland
| | - Keelin O'Donoghue
- Department of Obstetrics and Gynaecology, Anu Research Centre, Cork University Maternity Hospital, University College Cork , Wilton, Cork, Republic of Ireland
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Qiu C, Frederick IO, Zhang C, Sorensen TK, Enquobahrie DA, Williams MA. Risk of gestational diabetes mellitus in relation to maternal egg and cholesterol intake. Am J Epidemiol 2011; 173:649-58. [PMID: 21324948 DOI: 10.1093/aje/kwq425] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Higher egg and cholesterol intakes are associated with increased risk of type 2 diabetes mellitus. However, their association with gestational diabetes mellitus (GDM) has not been evaluated. The authors assessed such associations in both a prospective cohort study (1996-2008; 3,158 participants) and a case-control study (1998-2002; 185 cases, 411 controls). A food frequency questionnaire was used to assess maternal diet. Multivariable models were used to derive relative risks and 95% confidence intervals. Compared with no egg consumption, adjusted relative risks for GDM were 0.94, 1.01, 1.12, 1.54, and 2.52 for consumption of ≤1, 2-3, 4-6, 7-9, and ≥10 eggs/week, respectively (P for trend=0.008). Women with high egg consumption (≥7/week) had a 1.77-fold increased risk compared with women with lower consumption (95% confidence interval (CI): 1.19, 2.63). The relative risk for the highest quartile of cholesterol intake (≥294 mg/day) versus the lowest (<151 mg/day) was 2.35 (95% CI: 1.35, 4.09). In the case-control study, the adjusted odds ratio for consuming ≥7 eggs/week versus <7 eggs/week was 2.65 (95% CI: 1.48, 4.72), and the odds of GDM increased with increasing cholesterol intake (P for trend=0.021). In conclusion, high egg and cholesterol intakes before and during pregnancy are associated with increased risk of GDM.
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Affiliation(s)
- Chunfang Qiu
- Center for Perinatal Studies, Swedish Medical Center, 1124 Columbia Street, Suite 750, Seattle, WA 98104, USA.
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Abstract
Coronary heart disease (CHD) remains one of the leading causes of death in the United States and other industrialized nations. A better understanding of modifiable risk factors for CHD is critical in order to effectively prevent this disease. Dietary factors known to influence the risk of CHD include saturated fats, trans-fats, and polyunsaturated fatty acids. Although higher plasma levels of low-density lipoprotein cholesterol are associated with an increased risk of coronary disease and lipid-lowering therapy has been shown to reduce the risk of cardiovascular disease, the relation between dietary cholesterol and the risk of CHD is not clearly understood. This article reviews the current evidence on the association between dietary cholesterol and the risk of CHD.
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Morisset AS, St-Yves A, Veillette J, Weisnagel SJ, Tchernof A, Robitaille J. Prevention of gestational diabetes mellitus: a review of studies on weight management. Diabetes Metab Res Rev 2010; 26:17-25. [PMID: 19943327 DOI: 10.1002/dmrr.1053] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Entering pregnancy with overweight, obesity or gaining excessive gestational weight could increase the risk of gestational diabetes mellitus (GDM), which is associated with negative consequences for both the mother and the offspring. The objective of this article was to review scientific evidence regarding the association between obesity and GDM, and how weight management through nutritional prevention strategies could prove successful in reducing the risk for GDM. Studies published between January 1975 and January 2009 on the relationship between GDM, pre-pregnancy body mass index (BMI), gestational weight gain and nutritional prevention strategies were included in this review. Results from these reports suggest that maternal obesity assessed by pre-pregnancy BMI is associated with an increased risk of GDM. They also show an association between gestational weight gain and increased risk for GDM. Higher dietary fat and lower carbohydrate intakes during pregnancy appear to be associated with a higher risk for GDM, independent of pre-pregnancy BMI. Some studies showed that restricting energy and carbohydrates could minimize gestational weight gain. However, a firm conclusion on the most effective nutritional intervention for the control of gestational weight gain and glycaemic responses could not be reached based on available studies. In light of the studies reviewed, we conclude that weight management through nutritional prevention strategies could be successful in reducing the risk of GDM. Further studies are required to identify the most effective diet composition to prevent GDM and excessive gestational weight gain.
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Affiliation(s)
- Anne-Sophie Morisset
- Endocrinology and Genomics, Laval University Medical Research Center, Québec City, Québec, Canada
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