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Guo S, Rezaei MJ. The benefits of ashwagandha ( Withania somnifera) supplements on brain function and sports performance. Front Nutr 2024; 11:1439294. [PMID: 39155932 PMCID: PMC11327513 DOI: 10.3389/fnut.2024.1439294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/15/2024] [Indexed: 08/20/2024] Open
Abstract
Ashwagandha or Withania somnifera is an herbal plant belonging to the Solanaceae family. Because of its wide range of phytochemicals, ashwagandha root extract has been used in numerous research studies, either alone or in conjunction with other natural plants, for various biomedical applications, which include its anti-microbial, anti-inflammatory, anti-stress, anti-tumor, cardioprotective, and neuroprotective properties. Additionally, it improves endothelial function, lowers reactive oxygen species, controls apoptosis, and improves mitochondrial function. These properties make it a useful treatment for a variety of conditions, including age-related symptoms, anxiety, neurodegenerative diseases, diabetes, stress, arthritis, fatigue, and cognitive/memory impairment. Despite the numerous benefits of ashwagandha supplementation, there have been just four meta-analyses on the herb's effectiveness in treating anxiety, neurobehavioral disorders, impotence, and infertility. Moreover, no reviews exist that examine how ashwagandha affects antioxidant response and physical sports performance. Consequently, the goal of this study was to analyze the scientific literature regarding the effects of ashwagandha consumption on antioxidant response and athletic performance.
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Affiliation(s)
- Shiyi Guo
- College of Physical Education, LiaoNing Petrochemical University, Fushun, Liaoning, China
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Söderström E, Sandborg J, Nilsson E, Henström M, Lemming EW, Lindroos AK, Rood J, Sipinen JP, Löf M. Validation of an web-based dietary assessment tool (RiksmatenFlex) against doubly labelled water and 24 h dietary recalls in pregnant women. Nutr J 2024; 23:85. [PMID: 39080751 PMCID: PMC11287942 DOI: 10.1186/s12937-024-00987-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/17/2024] [Indexed: 08/03/2024] Open
Abstract
INTRODUCTION Digital technologies have enabled new possibilities to assess dietary intake and have shown promise in terms of decreased participant burden, improved accuracy and lower costs. However, their potential and validity in pregnant populations are scarcely explored. OBJECTIVES This study aimed to (a) validate energy intakes obtained from a web-based dietary recall method developed for national surveys (RiksmatenFlex) against total energy expenditure (TEE) by means of the doubly labelled water (DLW) method, and (b) to compare intakes of macronutrients, key unhealthy and healthy foods as well as adherence to food-based dietary guidelines between RiksmatenFlex and repeated 24 h telephone dietary recalls in healthy Swedish pregnant women. METHODS This study was conducted as a nested validation within the HealthyMoms trial. Intakes of foods, macronutrients and energy were assessed during three days through RiksmatenFlex and 24 h telephone dietary recalls, and Swedish Healthy Eating Index (SHEI) scores were also calculated for both methods (n = 52). For 24 women, TEE was also assessed through the DLW method. Paired Samples T-tests and Wilcoxon Signed Ranks Tests were used to identify differences between means for foods, macronutrients, energy and SHEI scores. Pearson correlation coefficient or Spearman's rho were performed to identify relationships between variables. To compare energy intake (RiksmatenFlex) with TEE (DLW method) and 24 h telephone dietary recalls, Bland and Altman plots were constructed. RESULTS Average energy intake from RiksmatenFlex (10,015 [SD 2004] kJ) was not statistically different from TEE (10,252 [SD 1197] kJ) (p = 0.596) (mean difference: -237 kJ/24 h). Correspondingly, there were small mean differences between average intakes of key unhealthy and healthy foods and average SHEI scores between RiksmatenFlex and 24 h telephone dietary recalls. However, the Bland and Altman plots showed wide limits of agreement for all dietary variables (e.g., for energy intake using RiksmatenFlex versus TEE: ±4239 kJ/24 h). High correlations between the investigated dietary variables for the two dietary methods were observed (r = 0.751 to 0.931; all p < 0.001). CONCLUSION RiksmatenFlex captured average intakes of energy, unhealthy and healthy food groups and adherence to food-based dietary guidelines in a comparable way to 24 h telephone dietary recalls and the DLW method. Our results support the validity of RiksmatenFlex as a web-based dietary assessment method for future use in pregnancy for intervention studies and national dietary surveys.
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Affiliation(s)
- Emmie Söderström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
- Department of Medicine, Karolinska Institutet, Huddinge, Sweden.
| | | | - Ellinor Nilsson
- Department of Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Maria Henström
- Department of Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Eva Warensjö Lemming
- Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Department of Food science, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Anna Karin Lindroos
- Swedish Food Agency, Uppsala, Sweden
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jennifer Rood
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Marie Löf
- Department of Medicine, Karolinska Institutet, Huddinge, Sweden
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Flor-Alemany M, Acosta-Manzano P, Migueles JH, Henriksson P, Löf M, Aparicio VA. Impact of Exercise Intervention Combined with Optimal Mediterranean Diet Adherence during Pregnancy on Postpartum Body Composition: A Quasi-Experimental Study-The GESTAFIT Project. Nutrients 2023; 15:4413. [PMID: 37892487 PMCID: PMC10609918 DOI: 10.3390/nu15204413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to investigate whether the effects of an exercise program during pregnancy on postpartum body composition are moderated by following a healthy dietary pattern (i.e., Mediterranean diet (MD)). Eighty-three pregnant women (control n = 40, exercise n = 43) were included in the present quasi-experimental study. The exercise intervention consisted of a 60 min, 3 day/week throughout pregnancy from gestational week 17, supervised concurrent (aerobic + resistance) exercise program. A food frequency questionnaire and the MD Score (min-max: 0-50) were employed to assess dietary habits and the MD adherence during pregnancy, respectively. Postpartum body composition was measured with dual-energy X-ray absorptiometry, 6 weeks postpartum. The body mass index and the gynecoid fat mass at postpartum were lower in the exercise compared to the control group (p = 0.018 and p = 0.047, respectively). There was an interaction showing that the MD adherence during pregnancy positively moderated the effects of the exercise intervention on postpartum lean mass (p = 0.024), fat mass percentage (p = 0.092), android fat mass (p = 0.076), and android-to-gynecoid fat mass (p = 0.019). The Johnson-Neyman technique revealed that the effects of exercise were enhanced at a MD score of ~31 for lean mass, ~25 for fat mass, ~23 for android fat mass and ~29 for android-to-gynecoid fat mass. Our results suggest that a concurrent-exercise training plus an optimal MD adherence during pregnancy might be a useful strategy to promote a healthier body composition at the postpartum period.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain;
| | - Pedro Acosta-Manzano
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain;
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Jairo H. Migueles
- PROFITH “Promoting FITness and Health through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, 58183 Linköping, Sweden;
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Huddinge, Sweden;
| | - Virginia A. Aparicio
- Department of Physiology, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain;
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Castro-Barquero S, Larroya M, Crispi F, Estruch R, Nakaki A, Paules C, Ruiz-León AM, Sacanella E, Freitas T, Youssef L, Benitez L, Casas I, Genero M, Gomez S, Casanovas-Garriga F, Gratacós E, Casas R, Crovetto F. Diet quality and nutrient density in pregnant women according to adherence to Mediterranean diet. Front Public Health 2023; 11:1144942. [PMID: 37645706 PMCID: PMC10461001 DOI: 10.3389/fpubh.2023.1144942] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 07/19/2023] [Indexed: 08/31/2023] Open
Abstract
Background and aims The dietary pattern followed during pregnancy, specifically healthy dietary patterns such as the Mediterranean diet, is a key factor in the mother's and the offspring's health. Pregnant women dietary intake is not enough to cover the micronutrient requirements of pregnancy, and higher adherence to the Mediterranean diet may improve dietary quality and nutritional density. The aim of the present study was to describe the dietary nutrient intake and diet quality during pregnancy and to evaluate whether a high adherence to Mediterranean diet was associated with a more adequate intake of micronutrients. Methods This was a cross-sectional study with 1,356 pregnant women selected during the routine second trimester ultrasound scan (19-23 weeks' gestation). Energy and nutrient intake were calculated using a validated 151-item semi-quantitative food frequency questionnaire and nutrient density was estimated dividing the absolute nutrient intake by total energy intake. Adherence to the Mediterranean diet was evaluated with a 17-item Mediterranean diet adherence score. The criterion used for risk of inadequate nutrient intake has been set below two thirds (2/3) of the dietary reference intakes. The differences were assessed by multivariate linear regression models adjusted for confounders. Results A significant proportion of pregnant women had an inadequate intake of macro and micronutrient that was lower in those with high adherence to the Mediterranean diet (≥12 points, n = 122, 19%), including calcium (the Mediterranean diet high adherence 2.5% vs. low adherence 26.7%, p < 0.001), magnesium (0% vs. 7.6%, p = 0.001), iron (24.5% vs. 74.1%, p < 0.001), and vitamin B9 (0% vs. 29.8%, p < 0.001), vitamin C (0% vs. 1.9%, p = 0.033), and vitamin D (61.5% vs. 92.8%, p < 0.001) intake. High adherence to Mediterranean diet was associated with higher intake of protein, monounsaturated fatty acids, fiber, vitamins (B1, B9, C, D), calcium, magnesium, iron, zinc, phosphor, potassium, essential fatty acids, and α-linolenic acid, and with a lower intake of α-linoleic acid and trans fatty acids as compared to low adherence to Mediterranean diet. Conclusion High adherence to Mediterranean diet was associated with higher diet quality and lower proportion of inadequate micro and macronutrient intake. The Mediterranean diet promotion, particularly among pregnant women, may be a useful and public health strategy to avoid overweight and nutrient deficiencies.
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Affiliation(s)
- Sara Castro-Barquero
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), Universitat de Barcelona, Barcelona, Spain
| | - Marta Larroya
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
| | - Fátima Crispi
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), Universitat de Barcelona, Barcelona, Spain
| | - Ayako Nakaki
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Cristina Paules
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Instituto de Investigación Sanitaria Aragón (IISAragon), Red de Salud Materno Infantil y del Desarrollo (SAMID), RETICS, Instituto de Salud Carlos III (ISCIII), Subdirección General de Evaluación y Fomento de la Investigación y Fondo Europeo de Desarrollo Regional (FEDER), Zaragoza, Spain
| | - Ana María Ruiz-León
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), Universitat de Barcelona, Barcelona, Spain
- Mediterranean Diet Foundation, Barcelona, Spain
| | - Emilio Sacanella
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Tania Freitas
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
| | - Lina Youssef
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Josep Carreras Leukaemia Research Institute, Hospital Clinic/University of Barcelona Campus, Barcelona, Spain
| | - Leticia Benitez
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Irene Casas
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Deu (IRSJD), Barcelona, Spain
| | - Mariona Genero
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Deu (IRSJD), Barcelona, Spain
| | - Silvia Gomez
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
| | - Francesc Casanovas-Garriga
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), Universitat de Barcelona, Barcelona, Spain
| | - Eduard Gratacós
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
- Institut de Recerca Sant Joan de Deu (IRSJD), Barcelona, Spain
| | - Rosa Casas
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), Universitat de Barcelona, Barcelona, Spain
| | - Francesca Crovetto
- Fetal Medicine Research Center, BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Deu (IRSJD), Barcelona, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin RD21/0012/0003, Instituto de Salud Carlos III, Madrid, Spain
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Flor‐Alemany M, Acosta‐Manzano P, Migueles JH, Baena‐García L, Aranda P, Aparicio VA. Association of Mediterranean diet adherence during pregnancy with maternal and neonatal lipid, glycemic and inflammatory markers: The GESTAFIT project. MATERNAL & CHILD NUTRITION 2023; 19:e13454. [PMID: 36437523 PMCID: PMC10019045 DOI: 10.1111/mcn.13454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022]
Abstract
To examine the association of Mediterranean diet (MD) adherence during pregnancy with maternal and neonatal lipid, glycemic, and inflammatory markers. This study included 152 women from the GESTAFIT trial and a subsample of 35 newborns. The Mediterranean Diet Score, derived from food frequency questionnaires, was employed to assess MD adherence. Total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides, and glucose were assessed in the mother (at the 16th and 34th gestational weeks [g.w.]) and in cord arterial and venous serum with standard procedures using an autoanalyzer. Pro-inflammatory and anti-inflammatory cytokines (interleukin [IL]-6, IL-8, IL-10, IL-1beta, interferon gamma, and tumour necrosis factor alpha [TNF-α]) were measured with Luminex xMAP technology. A greater MD adherence was associated with higher HDL-C and lower LDL-C, LDL-C/HDL-C ratio, triglycerides, triglycerides/HDL-C ratio, and TNF-α in the mother at the 16th and the 34th g.w. (|β|: 0.191-0.388, p < 0.05). A higher intake of whole grain cereals, fruits, vegetables and fish and a lower intake of sweets were associated with higher HDL-C and lower LDL-C, LDL-C/HDL-C ratio, triglycerides, triglycerides/HDL-C ratio, and TNF-α at the 16th and 34th g.w. (|β|: 0.188-0.334, p < 0.05). No associations were found with the cord arterial and venous serum markers (p > 0.05). A greater MD adherence during pregnancy, driven by a higher intake of whole grain cereals, fruits, vegetables and fish, and a lower intake of sweets, was positively associated with the maternal lipid and inflammatory serum markers throughout gestation. MD adherence during pregnancy was not associated with cord serum markers.
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Affiliation(s)
- Marta Flor‐Alemany
- Department of PhysiologyUniversity of GranadaGranadaSpain
- Institute of Nutrition and Food TechnologyUniversity of GranadaGranadaSpain
- Sport and Health University Research Institute (iMUDS)GranadaSpain
| | - Pedro Acosta‐Manzano
- Sport and Health University Research Institute (iMUDS)GranadaSpain
- Department of Physical Education and Sports, Phsical Activity for Health Promotion, CTS‐1018 Research Group, Faculty of Sport SciencesUniversity of GranadaGranadaSpain
- Institute of Human Movement Science, Sport and HealthUniversity of GrazGrazAustria
| | - Jairo H. Migueles
- Department of Biosciences and NutritionKarolinska InstitutetHuddingeSweden
- Department of Physical Education and Sports, PROFITH “Promoting FITness and Health through Physical Activity” Research Group, Faculty of Sport SciencesUniversity of GranadaGranadaSpain
| | - Laura Baena‐García
- Department of Nursing, Faculty of Health SciencesUniversity of GranadaCeutaSpain
- Instituto de investigación biosanitaria, ibs GranadaGranadaSpain
| | - Pilar Aranda
- Department of PhysiologyUniversity of GranadaGranadaSpain
| | - Virginia A. Aparicio
- Department of PhysiologyUniversity of GranadaGranadaSpain
- Institute of Nutrition and Food TechnologyUniversity of GranadaGranadaSpain
- Sport and Health University Research Institute (iMUDS)GranadaSpain
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Assessing the Mediterranean diet adherence during pregnancy: Practical considerations based on the associations with cardiometabolic risk. Pregnancy Hypertens 2023; 31:17-24. [PMID: 36446188 DOI: 10.1016/j.preghy.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/05/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of the present study was to provide practical considerations for assessing MD adherence during pregnancy based on the association with cardiometabolic risk. STUDY DESIGN Longitudinal study. MAIN OUTCOME MEASURES A food frequency questionnaire was fulfilled by 152 pregnant women at the 16th gestational week (g.w.). We calculated the Mediterranean Food Pattern (MFP), the MD Scale (MDScale), the Short MD questionnaire (SMDQ), the MD Score (MedDietScore), and the MD scale for pregnant women (MDS-P). The cardiometabolic risk score consisted of pre-pregnancy body mass index, blood pressure, glucose, triglycerides, and high-density lipoprotein-cholesterol (at 16th and 34th g.w.). RESULTS Multiple linear regression models showed that the MFP, the MedDietScore, and the SMDQ were associated with lower cardiometabolic risk at the 16th and 34th g.w. (β's: -0.193 to -0.415, all p < 0.05); and the MDS-P at the 34th g.w. (β = -0.349, p < 0.01). A comparison of these models with the J test showed that the MFP and the MedDietScore outperformed the SMDQ at the 16th g.w. (p's < 0.05); while the MedDietScore outperformed the SMDQ, MFP, and MDS-P (p's < 0.05) at the 34th g.w. Receiver-Operating-Characteristic-derived thresholds for the MFP, MedDietScore and MDS-P indices were 21, 30, and 6 points, respectively, to identify women with high cardiometabolic risk. CONCLUSION The MFP and MedDietScore are recommended to assess MD adherence during pregnancy, as these showed the strongest associations with cardiometabolic risk. Our validated thresholds might assist in the detection of poor dietary patterns during pregnancy.
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Prenatal Factors Associated with Maternal Cardiometabolic Risk Markers during Pregnancy: The ECLIPSES Study. Nutrients 2023; 15:nu15051135. [PMID: 36904135 PMCID: PMC10005748 DOI: 10.3390/nu15051135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
To examine the associations of sociodemographic, lifestyle, and clinical factors with cardiometabolic risk and each of its components during pregnancy in a pregnant population from Catalonia (Spain). A prospective cohort study of 265 healthy pregnant women (39 ± 5 years) in the first and third-trimesters. Sociodemographic, obstetric, anthropometric, lifestyle and dietary variables were collected, and blood samples were taken. The following cardiometabolic risk markers were evaluated: BMI, blood pressure, glucose, insulin, HOMA-IR, triglycerides, LDL, and HDL-cholesterol. From these, a cluster cardiometabolic risk (CCR)-z score was created by summating all z-scores (except insulin and DBP) computed for each risk factor. Data were analyzed using bivariate analysis and multivariable linear regression. In the multivariable models, the first-trimester CCRs was positively associated with overweight/obesity status (β: 3.54, 95%CI: 2.73, 4.36) but inversely related to the level of education (β: -1.04, 95%CI: -1.94, 0.14) and physical activity (PA) (β: -1.21, 95%CI: -2.24, -0.17). The association between overweight/obesity and CCR (β:1.91, 95%CI: 1.01, 2.82) persisted into the third-trimester, whereas insufficient GWG (β: -1.14, 95%CI: -1.98, -0.30) and higher social class (β: -2.28, 95%CI: -3.42, -1.13) were significantly associated with a lower CCRs. Starting pregnancy with normal weight, higher socioeconomic and educational levels, being a non-smoker, non-consumer of alcohol, and PA were protective factors against cardiovascular risk during pregnancy.
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Cortez-Ribeiro AC, Meireles M, Ferro-Lebres V, Almeida-de-Souza J. Olive oil consumption confers protective effects on maternal-fetal outcomes: A systematic review of the evidence. Nutr Res 2023; 110:87-95. [PMID: 36696715 DOI: 10.1016/j.nutres.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023]
Abstract
Because of the maternal diet's importance, numerous studies have examined the effects of olive oil on pregnancy outcomes. This study provides a systematic review that evaluates the evidence between olive oil consumption and maternal-fetal outcomes. We hypothesized that olive oil reduced the risk of adverse pregnancy complications. We searched Web of Science, Scopus, PubMed, and Biblioteca Virtual em Saúde electronic databases (October and November 2021). The keywords used were pregnancy, olive oil, and pregnancy outcomes. This review included all the available studies in English and Portuguese. The exclusion criteria were (1) unrelated to olive oil consumption, (2) other outcomes, and (3) animal studies. The review included 9 articles (6 experimental and 3 observational). In the maternal outcome studies (n = 6), a higher olive oil consumption was associated with a lower prevalence of gestational diabetes mellitus, preeclampsia, and cardiovascular risk. In the fetal outcome studies (n = 8), olive oil consumption was associated with a lower risk for small- or large-for-gestational-age infants. Olive oil consumption confers protective effects on pregnancy outcomes; however, further studies are needed that are specifically designed for the impact of olive oil consumption on maternal-fetal outcomes.
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Affiliation(s)
| | - Manuela Meireles
- Centro de Investigação da Montanha, Instituto Politécnico de Bragança, Campus Santa Apolónia, 5300-253, Bragança, Portugal; Laboratório para Sustentabilidade e Tecnologia em Regiões de Montanha, Instituto Politécnico de Bragança, Campus Santa Apolónia, 5300-253, Bragança, Portugal.
| | - Vera Ferro-Lebres
- Centro de Investigação da Montanha, Instituto Politécnico de Bragança, Campus Santa Apolónia, 5300-253, Bragança, Portugal; Laboratório para Sustentabilidade e Tecnologia em Regiões de Montanha, Instituto Politécnico de Bragança, Campus Santa Apolónia, 5300-253, Bragança, Portugal
| | - Juliana Almeida-de-Souza
- Centro de Investigação da Montanha, Instituto Politécnico de Bragança, Campus Santa Apolónia, 5300-253, Bragança, Portugal; Laboratório para Sustentabilidade e Tecnologia em Regiões de Montanha, Instituto Politécnico de Bragança, Campus Santa Apolónia, 5300-253, Bragança, Portugal
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The Influence of Exercise, Lifestyle Behavior Components, and Physical Fitness on Maternal Weight Gain, Postpartum Weight Retention, and Excessive Gestational Weight Gain. Int J Sport Nutr Exerc Metab 2022; 32:425-438. [PMID: 35894919 DOI: 10.1123/ijsnem.2021-0201] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 04/04/2022] [Accepted: 05/16/2022] [Indexed: 12/28/2022]
Abstract
This study examines (a) the influence of exercise, lifestyle behavior components (sedentary time, physical activity, and sleep and dietary patterns), and physical fitness on maternal weight gain, postpartum weight retention, and excessive gestational weight gain and (b) whether exercise protects against the adverse effects of impaired metabolism and nonoptimal body composition related to excessive gestational weight gain. Subjects were assigned to either a supervised concurrent (aerobic + resistance) exercise program followed 3 days/week (n = 47) or a control group (n = 54). Sedentary time, physical activity, sleep and dietary patterns (assessed by accelerometry and questionnaires), muscle strength (handgrip test), and cardiorespiratory fitness (Bruce test) were determined at gestational Weeks 16 and 33 (early-middle and late pregnancy, respectively), and at 6 weeks postpartum. Weight gain and weight retention were calculated using recorded weights at prepregnancy, early-middle, and late pregnancy, and at 6 weeks postpartum. Birth complications, maternal postpartum body composition, cardiometabolic, and inflammatory markers in maternal and umbilical cord arterial and venous blood, and in colostrum, and mature milk were also recorded. The exercise intervention reduced late weight gain (B = -2.7, SE = 0.83, p = .003) and weight retention (B = -2.85, SE = 1.3, p = .03), independent of any lifestyle behavior component or physical fitness, but did not prevent excessive weight gain. Increasing cardiorespiratory fitness, muscle strength, and sleep duration were associated with a smaller mean weight gain and lower excessive weight gain values (p < .05). Among the participants who experienced excessive weight gain, those who were exercisers had a lower body mass index and systemic tumor necrosis factor-alpha concentration, lower umbilical cord venous tumor necrosis factor-alpha and arterial interferon gamma levels, higher cord arterial interleukin-10 levels, and improved placental function compared with controls (p < .05). In summary, exercise may help optimize gestational weight gain and weight retention, and may attenuate the impaired phenotype related to excessive weight gain. Increasing cardiorespiratory fitness, muscle strength, and sleep duration might help to prevent excessive weight gain during pregnancy.
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Casas R, Castro-Barquero S, Crovetto F, Larroya M, Ruiz-León AM, Segalés L, Nakaki A, Youssef L, Benitez L, Casanovas-Garriga F, Vieta E, Crispi F, Gratacós E, Estruch R. Maternal Dietary Inflammatory Index during Pregnancy Is Associated with Perinatal Outcomes: Results from the IMPACT BCN Trial. Nutrients 2022; 14:nu14112284. [PMID: 35684084 PMCID: PMC9182900 DOI: 10.3390/nu14112284] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023] Open
Abstract
The information available on the effects of maternal dietary habits on systemic inflammation and adverse maternal outcomes is limited. We aimed to evaluate whether Dietary Inflammatory Index (DII) score during pregnancy is associated with maternal body mass index (BMI), Mediterranean diet (MD) adherence, and perinatal outcomes. At 19−23 weeks’ gestation, 1028 pregnant women were recruited. Dietary information was assessed using a 17-item dietary score to evaluate MD adherence and a validated 151-item food frequency questionnaire. DII score was established according to 33 food and nutritional proinflammatory and anti-inflammatory items. Participants were distributed into tertiles according to the DII score, where a lower DII score (first tertile) represented an anti-inflammatory diet and the third tertile represented the more proinflammatory diet. Maternal characteristics and perinatal outcomes were collected, and newborns’ birthweight percentiles were calculated. Adjusted logistic regression models were used to assess the association of the DII score with maternal and perinatal characteristics, setting the third tertile as the reference group. Women in the third tertile showed lower adherence to MD score compared to the first tertile: median (25th to 75th percentile) 9 (7 to 11) vs. 6 (4.25 to 8), p < 0.001. The proinflammatory diet was significantly associated with a higher maternal pre-pregnancy BMI (adjusted β = 0.88; 95% CI: 0.31 to 1.45) and lower newborn’s birthweight percentile (adjusted β = −9.84th; 95% CI: −19.6 to −0.12). These data show that a proinflammatory diet profile may be associated with maternal overweight and fetal undergrowth.
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Affiliation(s)
- Rosa Casas
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto de Salud Carlos III, 28007 Madrid, Spain; (R.C.); (S.C.-B.); (A.M.R.-L.); (R.E.)
- Department of Internal Medicine Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08028 Barcelona, Spain;
| | - Sara Castro-Barquero
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto de Salud Carlos III, 28007 Madrid, Spain; (R.C.); (S.C.-B.); (A.M.R.-L.); (R.E.)
- Department of Internal Medicine Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08028 Barcelona, Spain;
| | - Francesca Crovetto
- BCNatal|Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Deéu, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08028 Barcelona, Spain; (M.L.); (L.S.); (A.N.); (L.Y.); (L.B.); (F.C.); (E.G.)
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), 28029 Madrid, Spain
- Correspondence:
| | - Marta Larroya
- BCNatal|Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Deéu, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08028 Barcelona, Spain; (M.L.); (L.S.); (A.N.); (L.Y.); (L.B.); (F.C.); (E.G.)
| | - Ana Maria Ruiz-León
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto de Salud Carlos III, 28007 Madrid, Spain; (R.C.); (S.C.-B.); (A.M.R.-L.); (R.E.)
- Department of Internal Medicine Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08028 Barcelona, Spain;
| | - Laura Segalés
- BCNatal|Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Deéu, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08028 Barcelona, Spain; (M.L.); (L.S.); (A.N.); (L.Y.); (L.B.); (F.C.); (E.G.)
| | - Ayako Nakaki
- BCNatal|Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Deéu, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08028 Barcelona, Spain; (M.L.); (L.S.); (A.N.); (L.Y.); (L.B.); (F.C.); (E.G.)
| | - Lina Youssef
- BCNatal|Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Deéu, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08028 Barcelona, Spain; (M.L.); (L.S.); (A.N.); (L.Y.); (L.B.); (F.C.); (E.G.)
| | - Leticia Benitez
- BCNatal|Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Deéu, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08028 Barcelona, Spain; (M.L.); (L.S.); (A.N.); (L.Y.); (L.B.); (F.C.); (E.G.)
| | - Francesc Casanovas-Garriga
- Department of Internal Medicine Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08028 Barcelona, Spain;
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Hospital Clinic, Neuroscience Institute, Institut d’Investigacions Biomèdiques August Pi i Sunyer, CIBERSAM, University of Barcelona, 08028 Barcelona, Spain;
| | - Fàtima Crispi
- BCNatal|Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Deéu, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08028 Barcelona, Spain; (M.L.); (L.S.); (A.N.); (L.Y.); (L.B.); (F.C.); (E.G.)
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), 28029 Madrid, Spain
| | - Eduard Gratacós
- BCNatal|Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Deéu, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08028 Barcelona, Spain; (M.L.); (L.S.); (A.N.); (L.Y.); (L.B.); (F.C.); (E.G.)
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), 28029 Madrid, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto de Salud Carlos III, 28007 Madrid, Spain; (R.C.); (S.C.-B.); (A.M.R.-L.); (R.E.)
- Department of Internal Medicine Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08028 Barcelona, Spain;
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Baena-García L, Flor-Alemany M, Marín-Jiménez N, Aranda P, Aparicio VA. A 16-week multicomponent exercise training program improves menopause-related symptoms in middle-aged women. The FLAMENCO project randomized control trial. Menopause 2022; 29:537-544. [PMID: 35102099 DOI: 10.1097/gme.0000000000001947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the influence of a supervised multicomponent exercise training program on menopause-related symptoms, particularly vasomotor symptoms (VMS), in middle-aged women. METHODS A total of 112 middle-aged women (mean age 52 ± 4 y old, age range 45-60 y) from the FLAMENCO project (exercise [n = 59] and counseling [n = 53] groups) participated in this randomized controlled trial (perprotocol basis). The exercise group followed a multicomponent exercise program composed of 60-minute sessions 3 days per week for 16 weeks. The 15-item Cervantes Menopause and Health Subscale was used to assess the frequency of menopause-related symptoms. RESULTS After adjusting for body mass index and Mediterranean diet adherence, the subscales measuring menopause-related symptoms and VMSs decreased 4.6 more in the exercise group compared to the counseling group (between-group differences [B]: 95% CI: -8.8 to -0.2; P = 0.040). The exercise group also showed significant improvements in the subscales of couple relationships (between-group differences [B]: -1.87: 95% CI: -3.29 to - 0.45; P = 0.010), psychological state (between-group differences [B]: -2.3: 95% CI: -5 to -0.2; P = 0.035), and VMSs (between-group differences [B]: -4.5: 95% CI: -8.8 to -0.2; p = 0.040) in the Cervantes Menopause and Health Subscale compared with the counseling group. CONCLUSIONS A 16-week multicomponent physical exercise program showed a positive effect on menopause- related symptoms especially in couple relationships, psychological state, and VMS, among 45 to 60 year old women.
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Affiliation(s)
- Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Ceuta Campus, Spain
- Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Marta Flor-Alemany
- Sport and Health University Research Institute (iMUDS), Granada, Spain
- Department of Physiology, University of Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Nuria Marín-Jiménez
- Sport and Health University Research Institute (iMUDS), Granada, Spain
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
- Instituto de Investigación e Innovación Biomedica de Cadiz (INiBICA), Cadiz, Spain
| | - Pilar Aranda
- Department of Physiology, University of Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Virginia A Aparicio
- Sport and Health University Research Institute (iMUDS), Granada, Spain
- Department of Physiology, University of Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
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Bakaloudi DR, Chrysoula L, Leonida I, Kotzakioulafi E, Theodoridis X, Chourdakis M. Impact of the level of adherence to the Mediterranean Diet on blood pressure: A systematic review and meta-analysis of observational studies. Clin Nutr 2021; 40:5771-5780. [PMID: 34773865 DOI: 10.1016/j.clnu.2021.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/28/2021] [Accepted: 10/02/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND High blood pressure (BP) constitutes a common and serious medical condition which is rising globally, and is among preventable factors for cardiovascular, renal, brain and other diseases. Modifiable risk factors of high BP include unhealthy dietary patterns, presence of obesity, excess alcohol consumption and lack of physical activity. Data in regard to the different types of diets show that Mediterranean diet (MD) is associated with healthy levels of BP. In this study we aimed to investigate the impact of the level of adherence to MD in BP. AIMS-METHODS A systematic literature search (up to 08.2021) in PubMed, Scopus, Embase, Web of Science, Cochrane and Google Scholar databases was conducted, and 54 observational studies were included. RESULTS Systolic blood pressure (SBP) was found to be lower in the high adherence to MD group SMD: -0.08, (95%CI: -0.15, -0.02) whereas no differences regarding diastolic blood pressure (DBP) were observed between the high and low adherence to MD groups [SMD: -0.07, (95%CI: -0.13, 0.00)]. Mean DBP of all included studies for both high and low adherence groups were in healthy levels (<90 mmHg). CONCLUSIONS Higher adherence to MD could positively influence SBP, but further research is needed in this field due to the heterogeneous definitions of low/high adherence and the type of studies used (observational).
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Affiliation(s)
- Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Lydia Chrysoula
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Ioannis Leonida
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Evangelia Kotzakioulafi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Xenophon Theodoridis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
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