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Zheng W, Zhang Y, Zhang P, Chen T, Yan X, Li L, Shao L, Song Z, Han W, Wang J, Huang J, Ma K, Yang R, Ma Y, Xu L, Zhang K, Yuan X, Li G. Gestational diabetes mellitus is associated with distinct folate-related metabolites in early and mid-pregnancy: A prospective cohort study. Diabetes Metab Res Rev 2024; 40:e3814. [PMID: 38769695 DOI: 10.1002/dmrr.3814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 02/02/2024] [Accepted: 03/28/2024] [Indexed: 05/22/2024]
Abstract
AIMS This study aimed to evaluate the association between gestational diabetes mellitus (GDM) and circulating folate metabolites, folic acid (FA) intake, and the methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR) genotype. MATERIALS AND METHODS A prospective pregnancy cohort study was conducted in Beijing, China, from 2022 to 2023. Circulating folate metabolites, including red blood cell (RBC) 5-methyltetrahydrofolate (5-MTHF), 5, 10-methylene-tetrahydrofolate (5,10-CH2-THF), 5- formyltetrahydrofolate (5-CHO-THF), and unmetabolised folic acid (UMFA), and plasma homocysteine (HCY), 5-MTHF, and methylmalonic acid (MMA), were determined at 6-17 weeks and 20-26 weeks of gestation. FA intake and the MTHFR and MTRR genotype were also examined. GDM was diagnosed between 24 and 28 weeks of pregnancy by a 75-g oral glucose tolerance test (OGTT). The association between the folate status and GDM was ascertained using multivariate generalised linear models, logistic regression models, and restricted cubic spline regression, adjusting for potential confounders. RESULTS The study included 2032 pregnant women, of whom 392 (19.29%) developed GDM. UMFA above the 75th percentile (≥P75) [adjusted OR (aOR) (95% confidence interval [CI]) = 1.36 (1.01-1.84)], UMFA ≥ P90 [aOR (95% CI) = 1.82 (1.23-2.69)], and HCY ≥ P75 [aOR (95% CI) = 1.40 (1.04-1.88)] in early pregnancy, and RBC 5-MTHF [aOR (95% CI) = 1.48 (1.10-2.00)], RBC 5,10-CH2-THF [aOR (95% CI) = 1.55 (1.15-2.10)], and plasma 5-MTHF [aOR (95% CI) = 1.36 (1.00-1.86)] in mid-pregnancy ≥ P75 are associated with GDM. Higher UMFA levels in early pregnancy show positive associations with the 1-h and 2-h glucose levels during the OGTT, and higher HCY levels are associated with increased fasting glucose levels during the OGTT. In comparison, RBC 5- MTHF and 5,10-CH2-THF, and plasma 5- MTHF in mid-pregnancy are positively associated with the 1-h glucose level (p < 0.05). The MTHFR and MTRR genotype and FA intake are not associated with GDM. CONCLUSIONS Elevated levels of UMFA and HCY during early pregnancy, along with elevated RBC 5-MTHF and 5,10-CH2-THF and plasma 5-MTHF during mid-pregnancy, are associated with GDM. These findings indicate distinct connections between different folate metabolites and the occurrence of GDM.
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Affiliation(s)
- Wei Zheng
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yujie Zhang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Puyang Zhang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Tengda Chen
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xin Yan
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Lin Li
- Health Biotech Co., Ltd, Beijing, China
| | | | | | - Weiling Han
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jia Wang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Junhua Huang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Kaiwen Ma
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Ruihua Yang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yuru Ma
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Lili Xu
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Kexin Zhang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xianxian Yuan
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Guanghui Li
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
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Tranidou A, Magriplis E, Apostolopoulou A, Tsakiridis I, Chroni V, Tsekitsidi E, Kalaitzopoulou I, Pazaras N, Chourdakis M, Dagklis T. Impact of Maternal Micronutrient Intake on Gestational Diabetes Risk: Results from Greece's BORN2020 Prospective Cohort Study. Nutrients 2024; 16:1375. [PMID: 38732620 PMCID: PMC11085310 DOI: 10.3390/nu16091375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/28/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
Understanding how maternal micronutrient intake and dietary habits impact gestational diabetes mellitus (GDM) is crucial. Data from 797 pregnant women were prospectively analyzed to assess GDM status with the oral glucose tolerance test (OGTT). Nutritional intake was evaluated using a validated food frequency questionnaire (FFQ) across two periods: Period A, covering 6 months before pregnancy, and Period B, from pregnancy onset to mid-gestation (24 weeks). Micronutrient intakes were compared against the European Food Safety Authority (EFSA) dietary reference values (DRVs) and were used to estimate the mean adequacy ratio (MAR) to assess dietary adequacy. GDM was diagnosed in 14.7% (n = 117) of women with the characteristics of a higher mean maternal age (MA) and pre-pregnancy body mass index (BMI). Out of the 13 vitamins assessed, biotin, folate, niacin, and pantothenic acid were found significantly higher in the GDM group, as did iron, magnesium, manganese, phosphorus, and zinc from the 10 minerals. The results were influenced by the timing of the assessment. Importantly, MAR was higher during pregnancy and was found to increase the risk of GDM by 1% (95%CI: 1, 1.02). A sensitivity analysis revealed that reducing MAR significantly raised the GDM risk by 68% (95%CI: 1.02, 2.79). No association was revealed between adherence to the Mediterranean diet (MD) and GDM risk. These findings highlight areas for further investigation into whether dietary modifications involving these specific micronutrients could effectively influence GDM outcomes.
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Affiliation(s)
- Antigoni Tranidou
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.T.); (I.T.)
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece;
| | - Aikaterini Apostolopoulou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.T.); (I.T.)
| | - Violeta Chroni
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Eirini Tsekitsidi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Ioustini Kalaitzopoulou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Nikolaos Pazaras
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.T.); (I.T.)
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Zhang J, Wang X, Zhu P, Huang X, Cao X, Li J. Exploring the relationships between pre-pregnancy BMI, gestational weight gain, and nutritional intake: a real-world investigation in Shandong, China. PeerJ 2024; 12:e17099. [PMID: 38529313 PMCID: PMC10962341 DOI: 10.7717/peerj.17099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/21/2024] [Indexed: 03/27/2024] Open
Abstract
This study investigated the associations between gestational weight gain (GWG), pre-pregnancy body mass index (BMI), and prenatal diet quality in pregnant women from Shandong, China. We analyzed a sample of 532 early-stage pregnant women registered at an outpatient clinic. Diet quality was evaluated using the Chinese Healthy Dietary Index for Pregnancy (CHDI-P), encompassing three dimensions: diversity, adequacy, and limitation, with an overall score out of 100. Dietary intake was documented via 24-h dietary recalls spanning three consecutive days and subsequently translated to a CHDI-P score. At the time of enrollment, BMI was measured on-site and classified as underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Pregnant women were also categorized into inadequate, adequate, and excessive weight gain groups based on their GWG. We employed a Tukey-adjusted generalized linear model to compare the CHDI-P scores between the pre-pregnancy BMI groups and GWG groups. The results revealed that the underweight group had significantly higher total scores and limitation total scores on the CHDI-P (p < 0.001). Conversely, the overweight and obese groups were more susceptible to suboptimal dietary quality. Notably, the inadequate weight gain group displayed significantly elevated food adequacy scores compared to the other two groups (p < 0.05). This indicates that greater GWGs do not necessarily align with principles of adequate nutrition.
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Affiliation(s)
- Juan Zhang
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Xue Wang
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Ping Zhu
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Xiaoge Huang
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Xingru Cao
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Junmin Li
- Jinan Maternity and Child Care Hospital, Jinan, China
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Ren Q, Wang H, Zeng Y, Tan X, Cheng X, Zhou T, Huang W, Xu Y. The Association Between Serum Magnesium Levels and Gestational Diabetes Mellitus: a Systematic Review and Meta-Analysis. Biol Trace Elem Res 2023; 201:5115-5125. [PMID: 36790586 DOI: 10.1007/s12011-023-03591-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023]
Abstract
Observational studies suggest that the potential role of magnesium remains controversial in gestational diabetes mellitus (GDM). This meta-analysis aims to consolidate the available information from observational studies that have focused on the relationship between magnesium levels and GDM. A systematic and comprehensive literature search was conducted in PubMed, Embase, Web of Science, CNKI, and Wanfang databases. Data were extracted independently by two investigators. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were used to summarize the circulating magnesium levels (CI). This meta-analysis included a total of 17 studies involving 2858 participants including 1404 GDM cases and 1454 healthy controls, which showed that magnesium levels were significantly lower in GDM compared to healthy controls (SMD: - 0.35; 95% CI: - 0.62, - 0.07, P = 0.013). Likewise, the same phenomenon was observed in the third trimester (SMD = - 1.07; 95% CI: - 1.84 to - 0.29, P = 0.007). Other subgroup analyses revealed that this trend of decreasing magnesium concentration was only observed in Europeans (SMD = - 0.64; 95% CI: - 0.90, - 0.38, P < 0.0001). This meta-analysis revealed that serum magnesium levels were lower in patients with GDM than in healthy pregnant women, and this discrepancy was most pronounced in European populations and during the third trimester. Nevertheless, current evidence suggests that circulating magnesium deficiency is associated with gestational diabetes; the challenge for the future is to further elucidate the possible benefits of preventing gestational diabetes through magnesium supplementation.
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Affiliation(s)
- Qian Ren
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Cardiovascular and Metabolic Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Hongya Wang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Cardiovascular and Metabolic Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Yan Zeng
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Cardiovascular and Metabolic Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
- Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, China
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, China
| | - Xiaozhen Tan
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Cardiovascular and Metabolic Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
- Experimental Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xi Cheng
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Cardiovascular and Metabolic Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Tingting Zhou
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Cardiovascular and Metabolic Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Wei Huang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, Sichuan, China.
- Luzhou Key Laboratory of Cardiovascular and Metabolic Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China.
| | - Yong Xu
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, Sichuan, China.
- Luzhou Key Laboratory of Cardiovascular and Metabolic Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China.
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Zhou L, Liu J, Zhou M. A comprehensive meta-analysis on the association between vitamin C intake and gestational diabetes mellitus: Insights and novel perspectives. Medicine (Baltimore) 2023; 102:e34740. [PMID: 37565861 PMCID: PMC10419659 DOI: 10.1097/md.0000000000034740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Gestational Diabetes Mellitus (GDM) is a significant health concern in pregnant women and their offspring. Although Vitamin C is known to play a role in maintaining normal physiological processes, its relationship with GDM has not been fully elucidated. METHODS We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, analyzing data from 15 studies selected from PubMed, Embase, Web of Science, and the Cochrane Library up to May 16, 2023. These studies were selected based on inclusion criteria such as study design, outcome of interest, exposure factor, and data extractability. Quality assessment was performed using the Newcastle-Ottawa Scale. We assessed the heterogeneity between studies and conducted a sensitivity analysis. RESULTS Data from 10,131 subjects, including 1304 diagnosed GDM cases, were analyzed. The meta-analysis showed that women in the low Vitamin C exposure group had higher odds of developing GDM (odds ratio 2.72, 95% CI:1.24-4.19). There was a greater likelihood of increased GDM risk with lower Vitamin C exposure (standardized mean difference: -0.71, 95% CI [-1.07 -0.36]). Subgroup analysis revealed that both internal and external Vitamin C exposure, along with exposure during the second or third trimester of pregnancy, was associated with higher GDM incidence rates under low Vitamin C exposure. Sensitivity analysis confirmed the robustness of the results, and no significant publication bias was detected. CONCLUSION Low Vitamin C exposure during pregnancy may increase the risk of GDM. Given these findings, it could be beneficial for pregnant women to increase their intake of Vitamin C-rich foods and to ensure adequate blood Vitamin C levels as a preventive measure against GDM.
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Affiliation(s)
- Lili Zhou
- Department of Gynecology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Junbo Liu
- Department of Gynecology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Min Zhou
- Department of Gynecology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
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Lambert V, Muñoz SE, Gil C, Román MD. Maternal dietary components in the development of gestational diabetes mellitus: a systematic review of observational studies to timely promotion of health. Nutr J 2023; 22:15. [PMID: 36879315 PMCID: PMC9990275 DOI: 10.1186/s12937-023-00846-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND There is ample evidence that considers diet as an important factor in the prevention of gestational diabetes mellitus (GDM). The aim of this review is to synthesise the existing evidence on the relationship between GDM and maternal dietary components. METHODS We performed a systematic bibliographic search in Medline, Latin American and Caribbean Health Sciences Literature (Lilacs) and the Latin American Nutrition Archive (ALAN) of regional and local literature, limiting the searches to observational studies published between 2016 and 2022. Search terms related to nutrients, foods, dietary patterns and the relationship to GDM risk were used. The review included 44 articles, 12 of which were from America. The articles considered different topics about maternal dietary components as follows: 14 are about nutrient intake, 8 about food intake, 4 combined nutrient and food analysis and 18 about dietary patterns. RESULTS Iron, processed meat and a low carbohydrate diet were positively associated with GDM. Antioxidant nutrients, folic acid, fruits, vegetables, legumes and eggs were negatively associated with GDM. Generally, western dietary patterns increase GDM risk, and prudent dietary patterns or plant-based diets decrease the risk. CONCLUSIONS Diet is considered one of the causes of GDM. However, there is no homogeneity in how people eat nor in how researchers assess diet in different contextual conditions of the world.
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Affiliation(s)
- Victoria Lambert
- Instituto de Investigaciones en Ciencias de la Salud, Consejo Nacional de Investigaciones Científicas y Técnicas. Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Sonia Edith Muñoz
- Instituto de Investigaciones en Ciencias de la Salud, Consejo Nacional de Investigaciones Científicas y Técnicas. Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Carla Gil
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María Dolores Román
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
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Bee Pollen as Functional Food: Insights into Its Composition and Therapeutic Properties. Antioxidants (Basel) 2023; 12:antiox12030557. [PMID: 36978805 PMCID: PMC10045447 DOI: 10.3390/antiox12030557] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Bee pollen is a hive product made up of flower pollen grains, nectar, and bee salivary secretions that beekeepers can collect without damaging the hive. Bee pollen, also called bee-collected pollen, contains a wide range of nutritious elements, including proteins, carbs, lipids, and dietary fibers, as well as bioactive micronutrients including vitamins, minerals, phenolic, and volatile compounds. Because of this composition of high quality, this product has been gaining prominence as a functional food, and studies have been conducted to show and establish its therapeutic potential for medical and food applications. In this context, this work aimed to provide a meticulous summary of the most relevant data about bee pollen, its composition—especially the phenolic compounds—and its biological and/or therapeutic properties as well as the involved molecular pathways.
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Qu Q, Rong R, Yu J. Effect of magnesium supplementation on pregnancy outcome in gestational diabetes mellitus patients: A meta-analysis of randomized controlled trials. Food Sci Nutr 2022; 10:3193-3202. [PMID: 36249983 PMCID: PMC9548361 DOI: 10.1002/fsn3.2561] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/14/2021] [Accepted: 08/22/2021] [Indexed: 11/14/2022] Open
Abstract
Conflicting evidence exists regarding the effectiveness of magnesium supplementation during pregnancy in gestational diabetes mellitus (GDM) patients. This meta-analysis examines the effect of magnesium on glycemic indices and metabolic status in GDM. We searched databases for randomized controlled trials (RCTs) conducted, and after applying inclusion and exclusion criteria, a total of four RCTs were considered eligible for the analysis. Outcome parameters included markers for glycemic control and metabolic status. A total of four RCTs with 198 participants (control = 99; magnesium supplemented = 99) were selected for the analysis. Magnesium supplementation resulted in a significant reduction in markers of glycemic control-fasting plasma glucose (standard mean difference ( μ ^ ) = -0.83; 95% CI: [-1.13, -0.54]; p-value <.0001), and insulin levels ( μ ^ = -0.95; 95% CI: [-1.38, -0.52]; p-value <.0001). Also, Mg intake resulted in altered oxidative stress markers TAC ( μ ^ = 1.09; 95% CI: [0.10, 2.07]; p-value = .03) of the pregnant women. No significant effect on GSH and CRP levels was observed. This study provides evidence of the positive effects of magnesium intervention on insulin sensitivity and oxidative stress in GDM patients.
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Affiliation(s)
- Qiuchan Qu
- Department of Reproductive Health, Maternal and Child Health HospitalAffiliated to Nantong UniversityNantongChina
| | - Rong Rong
- Department of Reproductive Health, Maternal and Child Health HospitalAffiliated to Nantong UniversityNantongChina
| | - Jinhua Yu
- Department of Reproductive Health, Maternal and Child Health HospitalAffiliated to Nantong UniversityNantongChina
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ZAÇE DRIEDA, ORFINO ALESSIA, MARIAVITERITTI ANNA, VERSACE VALERIA, RICCIARDI WALTER, DI PIETRO MARIALUISA. A comprehensive assessment of preconception health needs and interventions regarding women of childbearing age: a systematic review. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E174-E199. [PMID: 35647378 PMCID: PMC9121675 DOI: 10.15167/2421-4248/jpmh2022.63.1.2391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/15/2022] [Indexed: 11/24/2022]
Abstract
Background This systematic review summarizes the preconception health needs of women in childbearing age, necessary to be addressed to have an eventual safe and healthy pregnancy. Methods Web of Science, PubMed and Scopus were searched. We excluded studies involving women with reproductive system pathologies and referring to interconceptive or pregnancy period and non-empirical or only abstract studies. Two researchers independently performed the blind screening based on titles/abstracts and full-text and the quality assessment. Results Four major domains resulted from the thematic analysis: knowledge, behaviors and attitudes, health status and access to healthcare services. The most examined topics were knowledge and awareness on preconception health, folic acid assumption, tobacco and alcohol consumption, physical activity and healthy diet. Conclusions This review could assist healthcare professionals (physicians, nurses, midwives) in guiding tailored counselling to women to provide the adequate level of preconception care and act as a reference to policymakers.
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Affiliation(s)
- DRIEDA ZAÇE
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - ALESSIA ORFINO
- ASL Roma 2, Rome, Italy
- Correspondence: Alessia Orfino, ASL Roma 2, Rome, Italy - E-mail:
| | | | - VALERIA VERSACE
- Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica - Area Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - WALTER RICCIARDI
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica - Area Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - MARIA LUISA DI PIETRO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Karimi T, Eini-Zinab H, Rezazadeh A, Moslemi Z. Maternal dietary diversity and nutritional adequacy in relation with anthropometric measurements of newborns at birth: a cohort study in Tehran city. BMC Pediatr 2022; 22:129. [PMID: 35279127 PMCID: PMC8917625 DOI: 10.1186/s12887-021-03102-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/28/2021] [Indexed: 11/30/2022] Open
Abstract
Background Maternal dietary intake during pregnancy plays an important role in fetal development and birth outcomes. The aim of the present study was to determine maternal dietary diversity and Nutritional adequacy in relation with anthropometric measurements of newborn at birth as a cohort study in Tehran city. Methods This prospective cohort study, was conducted by participation of 585 pregnant women referred to public health centers and hospitals covered by Shahid Beheshti, Tehran and Iran Universities in Tehran City. Using face-to-face interviews, general characteristics were obtained by questionnaire. Pre-pregnancy dietary intake was measured by a 168-item semi-quantitative food frequency questionnaire at the first visit, and dietary intake during pregnancy was measured by 2 non-consecutive 24-h food recall (one holiday and one regular day) at 31–34 weeks. Maternal height and weight were measured using standard tools and protocol at the first visit, and maternal weight at the end of pregnancy and data related to neonatal anthropometric indices were collected from mothers and neonates health records in the Sib electrical system. By applying SPSS software (version 23) the association was analyzed by linear regression with adjusting for confounding factors. P-value< 0.05 was considered as significant. Results Mean ± standard deviation of body mass index (BMI) of pre-pregnancy, pregnancy weight gain, BMI for age z-score (BAZ) at birth of infants were 24.52 ± 4.12, 12.16 ± 6.85 kg and − 0.61 ± 1.48, respectively. Mean ± SD of the Dietary Diversity Score (DDS) and Mean Adequacy Ratio (MAR) before and during pregnancy were 5.31 ± 1.11, vs.5.23 ± 1.42 and 289.85 ± 113.12 vs. 371.07 ± 197.28, respectively. After adjusting for confounding factors DDS in the third trimester of pregnancy was inversely correlated with WAZ (B = -0.16, 95% CI = - 0.23_0.30) and BAZ (B = − 0.24, 95% CI = - 0.06_0. 42) at birth, MAR of pre-pregnancy (B = − 0.001, 95% CI = - 0.002_0.00) and in the third trimester of pregnancy (B = − 0.18, 95% CI = - 0.35_0.004) were negatively associated with WAZ at birth. Conclusion The findings showed that maternal nutritional status (dietary diversity and nutritional adequacy) before and during pregnancy were correlated with neonatal anthropometric indices at birth.
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Cui Y, Liao M, Xu A, Chen G, Liu J, Yu X, Li S, Ke X, Tan S, Luo Z, Wang Q, Liu Y, Wang D, Zeng F. Association of maternal pre-pregnancy dietary intake with adverse maternal and neonatal outcomes: A systematic review and meta-analysis of prospective studies. Crit Rev Food Sci Nutr 2021:1-22. [PMID: 34666569 DOI: 10.1080/10408398.2021.1989658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study aimed to summarize the evidence regarding the effects of dietary intake before conception on pregnancy outcomes by performing a systematic review and meta-analysis of prospective studies. Electronic databases were searched from inception up to August 2021. Overall, 65 studies involving 831 798 participants were included and 38 studies were quantitatively pooled. With regard to maternal outcomes, pre-pregnancy intake of fried food, fast food, red and processed meat, heme iron and a low-carbohydrate dietary pattern was positively associated with the risk of gestational diabetes mellitus (GDM) (all P < 0.05). However, a high dietary fiber intake and folic acid supplementation were negatively associated with GDM risk (both P < 0.05). With regard to neonatal outcomes, maternal caffeine intake before pregnancy significantly increased the risk of spontaneous abortion, while folic acid supplementation had protective effects on total adverse neonatal outcomes, preterm birth, and small-for-gestational age (SGA, all P < 0.05). However, no significant associations were found between adverse pregnancy outcomes (i.e., GDM and SGA) and the pre-pregnancy dietary intake of sugar-sweetened beverages, potato, fish, and carbohydrates and the Healthy Eating Index. Our study suggests that maintaining a healthy diet before conception has significant beneficial effects on pregnancy outcomes.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1989658.
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Affiliation(s)
- Yunfeng Cui
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Minqi Liao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Aihua Xu
- Department of Gynaecology and Obstetrics, Ganzhou Maternal and Child Health Hospital, Ganzhou, China
| | - Gengdong Chen
- Department of Obstetrics, Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China
| | - Jun Liu
- Department of Preventive Medicine Laboratory, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Xiaoxuan Yu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Shuna Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xingyao Ke
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Sixian Tan
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Zeyan Luo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Qian Wang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Yanhua Liu
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Donghong Wang
- Department of Gynaecology and Obstetrics, Affiliated Hospital of Zunyi Medical University, Guizhou, China
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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Machairiotis N, Vasilakaki S, Minns L, Malakasis A. Nutrients that modulate gestational diabetes mellitus: A systematic review of cohort studies Jan 2019-Jan 2020. Int J Clin Pract 2021; 75:e14033. [PMID: 33480127 DOI: 10.1111/ijcp.14033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 01/17/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The role of eating habits of pregnant women in the development and treatment of gestational diabetes mellitus (GDM) is well established. OBJECTIVES To estimate the contribution of specific nutrients and dietary patterns in the development or privation of GDM in pregnant women. DATA SOURCES A systematic review of cohort studies, published between January 2019 and January 2020, of English articles using PubMed, Scopus and Europe PMC databases. Search terms included diabetes, pregnancy, dietary, food, and nutrients. STUDY SELECTION Only cohort studies about the association between eating habits before and during pregnancy and the risk of GDM in English were included. The studies used dietary patterns, specific nutrients or records of food intake of the participants using a questionnaire. DATA EXTRACTION Two authors independently extracted data from articles-including dietary patterns, food intake, nutrients, number and demographic data of participants, data about pregnancies-using predefined criteria. RESULTS In total, 28 cohort studies were organised to examine the correlation between dietary patterns and the prevention of GDM. Studies were conducted in 13 countries and included 3 058 242 participants. Of those, 13 (46%) studies focused on the consumption of vitamins, probiotics, micronutrients, folate, vegetables and fruits. Moreover, seven (25%) studies focused on what is considered to be "unhealthy" eating habits, including prudent and Western dietary patterns. The mediterranean pattern was used in three (11%) studies. CONCLUSIONS Ongoing studies support advice to adhere to a healthy balanced diet, with the addition of folic acid and a multi-vitamin suitable for pregnancy. There is new evidence suggesting probiotics and cod-liver oil supplementation may improve glycaemic control and also the important consideration of the psychological influences of eating.
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Affiliation(s)
- Nikolaos Machairiotis
- Department of Obstetrics and Gynaecology, Accredited Endometriosis Centre, Northwick Park Hospital, London North West Healthcare NHS Trust, Harrow, London, UK
| | - Sofia Vasilakaki
- Pharmacy Department, University of Athens, Panepistimiopolis of Zographou, Athens, Greece
| | - Laura Minns
- Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - Anastasios Malakasis
- Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
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Liu Q, Wei S, Lei J, Luo L, Wang F. Periconceptional folate and gestational diabetes mellitus: a systematic review and meta-analysis of cohort studies. J Matern Fetal Neonatal Med 2021; 35:6884-6893. [PMID: 34034602 DOI: 10.1080/14767058.2021.1929158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the relationship between periconceptional folate exposure and risk of gestational diabetes mellitus (GDM). METHODS Several electronic databases, including PubMed, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), and Cochrane Library, were searched for all relevant cohort studies by January 2021. Studies on relationship between folate exposure (intake or status) and GDM risk were included. Quality of included studies was assessed using Newcastle-Ottawa Scale. Random effects meta-analysis was performed to estimate overall odds ratio (OR) and 95% confidence intervals (CIs) by Stata software (Stata Corp., College Station, TX). RESULTS Ten cohort studies with 40,244 pregnancies were eligible for quantitative meta-analysis. Significant association was observed between folate exposure and risk of GDM (OR = 1.24, p=.036, 95% CI: 1.01-1.52). Subgroup analysis revealed that periconceptional folate exposure of population in China (OR = 1.35, 95% CI: 1.09-1.67) but not in western countries, folate exposure during pregnancy (OR = 1.49, 95% CI: 1.22-1.81) but not before pregnancy, and internal folate exposure (OR = 1.36, 95% CI: 1.10-1.67), were significantly associated with increased GDM risk. CONCLUSIONS Overall, periconceptional folate exposure is positively associated with GDM risk, especially the exposure during pregnancy and exposure in Chinese populations.
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Affiliation(s)
- Qingyun Liu
- Department of Clinical Laboratory, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Shanshan Wei
- Gastrointestinal Endoscopy Center, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jiafan Lei
- Central Laboratory, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Liangping Luo
- Medical Imaging Center,The First Affiliated Hospital of Jinan University, Guangzhou, China.,Engineering Research Center of Medical Imaging Artificial Intelligence for Precision Diagnosis and Treatment, Guangzhou, China
| | - Feng Wang
- Department of Clinical Laboratory, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
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Schoenaker DAJM, de Jersey S, Willcox J, Francois ME, Wilkinson S. Prevention of Gestational Diabetes: The Role of Dietary Intake, Physical Activity, and Weight before, during, and between Pregnancies. Semin Reprod Med 2021; 38:352-365. [PMID: 33530118 DOI: 10.1055/s-0041-1723779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Gestational diabetes mellitus (GDM) is the most common complication of pregnancy and a significant clinical and public health problem with lifelong and intergenerational adverse health consequences for mothers and their offspring. The preconception, early pregnancy, and interconception periods represent opportune windows to engage women in preventive and health promotion interventions. This review provides an overview of findings from observational and intervention studies on the role of diet, physical activity, and weight (change) during these periods in the primary prevention of GDM. Current evidence suggests that supporting women to increase physical activity and achieve appropriate weight gain during early pregnancy and enabling women to optimize their weight and health behaviors prior to and between pregnancies have the potential to reduce rates of GDM. Translation of current evidence into practice requires further development and evaluation of co-designed interventions across community, health service, and policy levels to determine how women can be reached and supported to optimize their health behaviors before, during, and between pregnancies to reduce GDM risk.
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Affiliation(s)
- Danielle A J M Schoenaker
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Susan de Jersey
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia.,Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jane Willcox
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Monique E Francois
- School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Shelley Wilkinson
- School of Human Movements and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Mothers, Babies and Women's Theme, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
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Abstract
PURPOSE OF REVIEW Women should enter pregnancy in the best possible health. There is increasing recognition of the importance of nutrition for reproductive health; however, key dietary factors in relation to optimizing fertility are nonexistent. The purpose of this review is to investigate dietary factors, preconception, and the association with fertility and later health in pregnancy. RECENT FINDINGS This article summarizes recent literature assessing preconception dietary intake and the association with fertility, time to pregnancy, and also the relationship with polycystic ovary syndrome and gestational diabetes; these conditions associate with each other, and also with infertility. The impact of paternal diet is also reported. SUMMARY There is recent interest investigating diet and time to pregnancy, suggesting higher intakes of fruit, minimal intake of fast food and sugar sweetened beverages, and a diet lower in glycemic load, may improve time to pregnancy. There is minimal recent literature on paternal diet and impact on fertility. Present advice to women with polycystic ovary syndrome is in line with international recommendations for lifestyle management to improve reproductive outcomes; and for gestational diabetes, prepregnancy may be an optimal time to improve dietary intakes, particularly through consumption of an overall healthy dietary pattern or a Mediterranean-style dietary pattern.
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Cardoso RV, Fernandes Â, Gonzaléz-Paramás AM, Barros L, Ferreira IC. Flour fortification for nutritional and health improvement: A review. Food Res Int 2019; 125:108576. [DOI: 10.1016/j.foodres.2019.108576] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/17/2019] [Accepted: 07/21/2019] [Indexed: 12/19/2022]
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Plows JF, Reynolds CM, Vickers MH, Baker PN, Stanley JL. Nutritional Supplementation for the Prevention and/or Treatment of Gestational Diabetes Mellitus. Curr Diab Rep 2019; 19:73. [PMID: 31368026 DOI: 10.1007/s11892-019-1199-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Gestational diabetes mellitus (GDM) is a common pregnancy complication that has short- and long-term health implications for both the mother and child. While lifestyle modifications, insulin therapy, and oral agents such as metformin are effective, they can be difficult to adhere to, and there remain concerns over long-term effects of oral agents on the infant. Further, GDM has no proven preventive strategies, which could be more effective than treatment postdiagnosis. Nutritional supplements are an appealing, potentially safer, and better tolerated alternative to pharmaceuticals to treat and/or prevent GDM. Here, we review the existing evidence for nutritional supplementation for treatment and prevention of GDM. RECENT FINDINGS There is limited evidence that myo-inositol, vitamins D and B6, magnesium, selenium, zinc, fatty acids, and probiotics might be beneficial for the prevention or treatment of GDM. There are very few studies for each nutrient, and the existing studies tend to have few participants. Where multiple studies of a nutrient exist, often those studies were conducted within the same country, limiting the generalizability of the findings, or alternatively there was no consensus across findings. There is limited evidence that nutritional supplementation of myo-inositol, vitamins D and B6, magnesium, selenium, zinc, fatty acids, and probiotics could improve glycemic control or prevent GDM. Our understanding is constrained by the small number of studies, small sample sizes in most studies, and by lack of consistency across findings. Further large, high-quality, randomized controlled trials are required to determine the efficacy of nutritional supplements to treat or prevent GDM.
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Affiliation(s)
- Jasmine F Plows
- Children's Hospital Los Angeles, 4641 Sunset Blvd, Los Angeles, CA, 90027, USA.
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, 1021, Auckland, New Zealand.
| | - Clare M Reynolds
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, 1021, Auckland, New Zealand
| | - Mark H Vickers
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, 1021, Auckland, New Zealand
| | - Philip N Baker
- University of Leicester, Maurice Shock Building, Leicester, LE1 7RH, United Kingdom
| | - Joanna L Stanley
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, 1021, Auckland, New Zealand
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