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Taniguchi T, Williams-Nguyen J, Muller CS, Fyfe-Johnson A, Henderson A, Umans JG, Standridge J, Shackleford T, Rosenman R, Buchwald D, Jernigan VB. Pilot study of a heart-healthy food box intervention for Native Americans with uncontrolled hypertension: methods and results from the Chickasaw Healthy Eating Environments Research Study. HEALTH EDUCATION RESEARCH 2024; 39:454-465. [PMID: 38965030 PMCID: PMC11398897 DOI: 10.1093/her/cyae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/30/2024] [Accepted: 06/21/2024] [Indexed: 07/06/2024]
Abstract
We sought to evaluate the acceptability and feasibility of a culturally tailored food box intervention for improving blood pressure (BP), food security and Body Mass Index (BMI) among Chickasaw Nation adults with uncontrolled hypertension. As part of the Chickasaw Healthy Eating Environments Research Study (CHEERS), we administered a group randomized pilot study in four tribal communities (two intervention, two control). Participants in the intervention communities received six heart-healthy food boxes, culturally tailored to traditional Chickasaw diet and current food context. Outcomes were measured over 6 months. We enrolled 262 participants, and 204 with complete data on key variables were included in the analysis. The food boxes were very popular, and we achieved high retention for follow-up data collection. Intervention community participants had 2.6 mmHg lower mean systolic BP and improved diet quality and BMI compared with control participants, although, as expected for a pilot study, the differences were not statistically significant. The culturally tailored diet intervention and randomized trial study design were acceptable and feasible for Chickasaw Nation adults with uncontrolled hypertension. Our findings support the value of tribal-food bank partnerships as a potential approach for reducing food insecurity and hypertension-related disparities in Native American communities.
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Affiliation(s)
- Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Jessica Williams-Nguyen
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Clemma S Muller
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Amber Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Austin Henderson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | | | | | - Robert Rosenman
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | | | - Valarie Bluebird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Valenzuela-Fuenzalida JJ, Bravo VS, Valarezo LM, Delgado Retamal MF, Leiva JM, Bruna-Mejías A, Nova-Baeza P, Orellana-Donoso M, Suazo-Santibañez A, Oyanedel-Amaro G, Gutierrez-Espinoza H. Effectiveness of DASH Diet versus Other Diet Modalities in Patients with Metabolic Syndrome: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:3054. [PMID: 39339654 PMCID: PMC11434995 DOI: 10.3390/nu16183054] [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: 08/03/2024] [Revised: 09/03/2024] [Accepted: 09/05/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Metabolic syndrome refers to the coexistence of several known cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia, and hypertension. These conditions are interrelated and share underlying mediators, mechanisms, and pathways. Improvement in dietary habits has been shown to improve metabolic parameters in patients undergoing treatment with different diets. METHODS A systematic search in different databases was realized using the keywords "Metabolic syndrome", "X syndrome", "Dash dietary" and "Dash diet". Finally, six studies were included in this meta-analysis. RESULTS All articles comparing the DASH diet vs. other diet modalities reported significant differences in favor of the DASH diet on Systolic blood pressure (SBP) (standardized mean difference [SMD] = -8.06, confidence interval [CI] = -9.89 to -7.32, and p < 0.00001), Diastolic blood pressure (SMD = -6.38, CI = -7.62 to -5.14, and p < 0.00001), Cholesterol HDL (SMD = 0.70, CI = 0.53 to 0.88, and p < 0.00001) and Cholesterol LDL (SMD = -1.29, CI = -1.73 to -0.85, and p < 0.00001) scales. CONCLUSIONS The DASH diet has been shown to be beneficial in altered parameters in patients with MS, and the resulting improvements can significantly affect the daily health of these patients. We therefore recommend that professionals who manage these pathologies promote the use of the DASH diet for the management of specific symptoms.
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Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 7591538, Chile; (J.J.V.-F.); (V.S.B.); (L.M.V.); (M.F.D.R.); (J.M.L.); (A.B.-M.); (P.N.-B.); (M.O.-D.)
- Departamento de Ciencias Química y Biológicas, Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago 8370993, Chile
| | - Vicente Silva Bravo
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 7591538, Chile; (J.J.V.-F.); (V.S.B.); (L.M.V.); (M.F.D.R.); (J.M.L.); (A.B.-M.); (P.N.-B.); (M.O.-D.)
| | - Laura Moyano Valarezo
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 7591538, Chile; (J.J.V.-F.); (V.S.B.); (L.M.V.); (M.F.D.R.); (J.M.L.); (A.B.-M.); (P.N.-B.); (M.O.-D.)
| | - María Fernanda Delgado Retamal
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 7591538, Chile; (J.J.V.-F.); (V.S.B.); (L.M.V.); (M.F.D.R.); (J.M.L.); (A.B.-M.); (P.N.-B.); (M.O.-D.)
| | - Josefa Matta Leiva
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 7591538, Chile; (J.J.V.-F.); (V.S.B.); (L.M.V.); (M.F.D.R.); (J.M.L.); (A.B.-M.); (P.N.-B.); (M.O.-D.)
| | - Alejandro Bruna-Mejías
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 7591538, Chile; (J.J.V.-F.); (V.S.B.); (L.M.V.); (M.F.D.R.); (J.M.L.); (A.B.-M.); (P.N.-B.); (M.O.-D.)
| | - Pablo Nova-Baeza
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 7591538, Chile; (J.J.V.-F.); (V.S.B.); (L.M.V.); (M.F.D.R.); (J.M.L.); (A.B.-M.); (P.N.-B.); (M.O.-D.)
| | - Mathias Orellana-Donoso
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 7591538, Chile; (J.J.V.-F.); (V.S.B.); (L.M.V.); (M.F.D.R.); (J.M.L.); (A.B.-M.); (P.N.-B.); (M.O.-D.)
- Escuela de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile
| | - Alejandra Suazo-Santibañez
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de Las Americas, Santiago 8370040, Chile;
| | - Gustavo Oyanedel-Amaro
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 8910060, Chile;
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Soliman AR, Hegazy M, Ahmed RM, Abdelghaffar S, Gomaa M, Alwakil S, Soliman D, Sedky L, Shaltout I. Dietary recommendations for people with diabetes in special situations: a position statement report by Arabic Association for the Study of Diabetes and metabolism (AASD). JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:139. [PMID: 39227957 PMCID: PMC11373442 DOI: 10.1186/s41043-024-00619-y] [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: 07/09/2024] [Accepted: 08/11/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Diabetes is a significant global health concern. Regional factors play a crucial role in determining the appropriate diet for patients. MAIN BODY The Arabic Association for the Study of Diabetes and Metabolism has developed a position statement that addresses the dietary needs of patients in the context of low income and cultural dietary habits. This statement aims to explore the most suitable diet for Middle East and North Africa (MENA) region and provide guidance for physicians to overcome barriers in optimal care. While most dietary guidelines focus on uncomplicated diabetes, it's essential to recognize that diabetes often coexists with other common diseases in our region. CONCLUSION International guidelines cannot be directly applied to the Egypt and Arab countries due to cultural and dietary differences. Our position statement shares valuable insights into managing diabetes in special situations and diverse clinical settings within this region. These recommendations are flexible, considering personal, cultural, and traditional differences.
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Affiliation(s)
- Amin Roshdy Soliman
- Internal Medicine and Nephrology, Kasr Alainy Faculty of Medicine- Cairo University, Cairo, Egypt.
| | - Mona Hegazy
- Internal Medicine, Hepatology, and Gastroenterology Division, Kasr Alainy Faculty of Medicine- Cairo University, Cairo, Egypt
| | - Rabab Mahmoud Ahmed
- Internal Medicine and Nephrology, Kasr Alainy Faculty of Medicine- Cairo University, Cairo, Egypt
| | - Shereen Abdelghaffar
- Pediatric Diabetes and Endocrinology, Kasr Alainy Faculty of Medicine- Cairo University, Cairo, Egypt
| | - Mohammed Gomaa
- Internal Medicine, Kasr Alainy Faculty of Medicine- Cairo University, Cairo, Egypt
| | - Sahar Alwakil
- Internal medicine, Diabetes , Endocrinology and Clinical nutrition, Kasr Alainy Faculty of Medicine- Cairo University, Cairo, Egypt
| | - Dina Soliman
- Department of Anesthesiology, Kasr Alainy Faculty of Medicine- Cairo University, Cairo, Egypt
| | - Lobna Sedky
- Clinical Oncology, Kasr Alainy Faculty of medicine, NEMROCK (kasr Al Ainy Center of Clinical Oncology), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
- Woman4Oncology-Egypt organization: W40-E. Co-supervisor of Nemrock Onco-Nutrition MDT, Cairo, Egypt
| | - Inass Shaltout
- Internal Medicine and Diabetes, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
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Henderson A, Rosenman R, Fyfe-Johnson AL, Taniguchi T, Standridge J, Shackleford T, Muller CJ, Umans JG, Jernigan VBB. The cost-efficacy of a healthy food box for managing hypertension within a native American population: a group randomized controlled trial. Arch Public Health 2024; 82:59. [PMID: 38671533 PMCID: PMC11046939 DOI: 10.1186/s13690-024-01274-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Dietary interventions are used for the treatment of hypertension. We evaluated the cost-efficacy of delivering boxes of healthy, culturally tailored foods and checks that can only be spent on produce in a Native American population. METHODS We conducted a group randomized controlled trial from 2018 to 2020 with N = 2 treatment counties and N = 2 control counties and a total of N = 160 Native American adults with baseline stage 1 or stage 2 hypertension. Participants in the intervention group received monthly boxes of food that adheres to the Dietary Approaches to Stop Hypertension diet as well as checks that could only be spent on produce for 6 months. We measured blood pressure and quality of life at baseline and at a 6-month follow-up in both intervention and control groups. We used ordered logistic regression to estimate the effect of treatment on probability of blood pressure improvements. We then conducted a cost-efficacy analysis. RESULTS We found that treatment was effective in reducing blood pressure in women with stage 1 hypertension at baseline. Based on this finding, we also estimate that this intervention satisfies normative cost-effectiveness thresholds, even when lifetime treatment is needed to preserve the impact, so long as treatment is only continued in those who respond to treatment. CONCLUSIONS Direct delivery of healthy foods and checks that can only be spent on produce are a potentially cost-effective intervention for the management of hypertension among Native American women with stage 1 hypertension. Further research is needed to understand why we found an impact only for this group.
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Affiliation(s)
- Austin Henderson
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington, United States of America.
| | - Robert Rosenman
- School of Economic Sciences, Washington State University, Pullman, Washington, United States of America
| | - Amber L Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington, United States of America
| | - Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Stillwater, Oklahoma, United States of America
| | - Joy Standridge
- Nutrition Services Department, Chickasaw Nation, Ada, Oklahoma, United States of America
| | - Tyra Shackleford
- Nutrition Services Department, Chickasaw Nation, Ada, Oklahoma, United States of America
| | - Clemma J Muller
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington, United States of America
| | - Jason G Umans
- Hyattsville MD and Georgetown-Howard Universities Center for Clinical and Translational Science, MedStar Health Research Institute, Washington DC, United States of America
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Stillwater, Oklahoma, United States of America
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Henderson A, Rosenman R, Fyfe-Johnson AL, Taniguchi T, Standridge J, Shackleford T, Muller CJ, Umans JG, Jernigan VBB. The Cost-Efficacy of a Healthy Food Box for Managing Hypertension Within a Native American Population: The Chickasaw Healthy Eating Environment Research Study. RESEARCH SQUARE 2024:rs.3.rs-3901299. [PMID: 38352591 PMCID: PMC10862957 DOI: 10.21203/rs.3.rs-3901299/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Background Dietary interventions are used for the treatment of hypertension. We evaluated the cost-efficacy of delivering boxes of healthy, culturally tailored foods and checks that can only be spent on produce in a Native American population. Methods We conducted a group randomized controlled trial from 2018-2020 with N = 2 treatment counties and N = 2 control counties and a total of N = 160 Native American adults with baseline stage 1 or stage 2 hypertension. Participants in the intervention group received monthly boxes of food that adheres to the Dietary Approaches to Stop Hypertension diet as well as checks that could only be spent on produce for 6 months. We measured blood pressure and quality of life at baseline and at a 6-month follow-up in both intervention and control groups. We used ordered logistic regression to estimate the effect of treatment on probability of blood pressure improvements. We then conducted a cost-efficacy analysis. Results We found that treatment was effective in women with stage 1 hypertension at baseline. Based on this finding, we also estimate that this intervention satisfies normative cost-effectiveness thresholds, even when lifetime treatment is needed to preserve the impact, so long as treatment is only continued in those who respond to treatment. Conclusions Direct delivery of healthy foods and checks that can only be spent on produce are a potentially cost-effective intervention for the management of hypertension among Native American women with stage 1 hypertension. Further research is needed to understand why we found an impact only for this group.
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Belfort GP, Farias DR, Padilha PDC, da Silva LBG, dos Santos K, dos Santos MS, Zajdenverg L, Keating E, Saunders C. Influence of the DASH Diet on Gestational Weight Gain and Perinatal Outcomes in Women with Pre-Existing Diabetes Mellitus: A Randomized, Single-Blind, Controlled Clinical Trial. Life (Basel) 2023; 13:2191. [PMID: 38004331 PMCID: PMC10671988 DOI: 10.3390/life13112191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND This study aimed to investigate the influence of the dietary approaches to stop hypertension (DASH) diet on gestational weight gain and perinatal outcomes in pregnant women with pre-existing diabetes mellitus (PDM). METHODS A randomized, single-blind, controlled clinical trial was conducted with 68 pregnant women with PDM throughout prenatal care until delivery (18 weeks) at a public maternity hospital in Rio de Janeiro, Brazil (2016-2020). The standard diet adopted by the control group (standard diet group-SDG) contained 45-55% carbohydrates, 15-20% protein, and 25-30% lipids of the total energy intake. An adapted DASH diet, with a similar macronutrient composition, but with higher calcium, potassium, magnesium, fiber, and reduced saturated fat, was prescribed for the intervention group (DASH diet group-DDG). Student's t- or Mann-Whitney U tests were used to compare outcomes between groups. To assess the trajectory of gestational weight gain throughout the intervention between the study groups, linear mixed-effects regression models were used. RESULTS The DDG had lower gestational weight gain at the fifth (p = 0.03) and seventh appointment (p = 0.04), with no difference in average total gestational weight gain (SDG: 10 kg [SD = 4]; DDG: 9 kg [SD = 5], p = 0.23). There was a trend for a lower length of stay of the newborns (p = 0.08) in the DDG without differences for other perinatal outcomes. CONCLUSIONS The DASH diet promoted less variation in gestational weight gain without promoting a difference in total gestational weight gain, and there was no difference between the study groups for perinatal outcomes.
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Affiliation(s)
- Gabriella P. Belfort
- Postgraduate Program in Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Carlos Chagas Filho Ave, 373, University City, Rio de Janeiro 21941-590, RJ, Brazil; (D.R.F.); (C.S.)
- School of Nutrition, Federal University of the State of Rio de Janeiro, Pasteur Ave, 296, Urca, Rio de Janeiro 22290-240, RJ, Brazil
| | - Dayana R. Farias
- Postgraduate Program in Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Carlos Chagas Filho Ave, 373, University City, Rio de Janeiro 21941-590, RJ, Brazil; (D.R.F.); (C.S.)
| | - Patricia de C. Padilha
- Postgraduate Program in Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Carlos Chagas Filho Ave, 373, University City, Rio de Janeiro 21941-590, RJ, Brazil; (D.R.F.); (C.S.)
| | - Letícia B. G. da Silva
- Postgraduate Program in Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Carlos Chagas Filho Ave, 373, University City, Rio de Janeiro 21941-590, RJ, Brazil; (D.R.F.); (C.S.)
| | - Karina dos Santos
- Postgraduate Program in Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Carlos Chagas Filho Ave, 373, University City, Rio de Janeiro 21941-590, RJ, Brazil; (D.R.F.); (C.S.)
- School of Nutrition, Federal University of the State of Rio de Janeiro, Pasteur Ave, 296, Urca, Rio de Janeiro 22290-240, RJ, Brazil
| | - Mayara S. dos Santos
- Maternity School of the Federal University of Rio de Janeiro, Laranjeiras Street, 180, Rio de Janeiro 22240-003, RJ, Brazil; (M.S.d.S.); (L.Z.)
| | - Lenita Zajdenverg
- Maternity School of the Federal University of Rio de Janeiro, Laranjeiras Street, 180, Rio de Janeiro 22240-003, RJ, Brazil; (M.S.d.S.); (L.Z.)
| | - Elisa Keating
- Unit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, Prof. Hernâni Monteiro Ave, 4200-319 Porto, Portugal
| | - Claudia Saunders
- Postgraduate Program in Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Carlos Chagas Filho Ave, 373, University City, Rio de Janeiro 21941-590, RJ, Brazil; (D.R.F.); (C.S.)
- Maternity School of the Federal University of Rio de Janeiro, Laranjeiras Street, 180, Rio de Janeiro 22240-003, RJ, Brazil; (M.S.d.S.); (L.Z.)
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Belfort GP, de Padilha PC, Farias DR, da Silva LBG, dos Santos K, Gomes EDS, Lima TSV, Bornia RBRG, Rezende KBC, Saunders C. Effect of the Dietary Approaches to Stop Hypertension (DASH) diet on the development of preeclampsia and metabolic outcomes in pregnant women with pre-existing diabetes mellitus: a randomised, controlled, single-blind trial. J Nutr Sci 2023; 12:e73. [PMID: 37457679 PMCID: PMC10345782 DOI: 10.1017/jns.2023.54] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/07/2023] [Indexed: 07/18/2023] Open
Abstract
Preeclampsia (PE) affects up to five times more women with pre-existing diabetes mellitus (PDM) than women without it. The present study aimed to identify the effect of the DASH diet on PE incidence (primary outcome) and blood pressure, glycated haemoglobin (GH), serum lipids, glutathione peroxidase (GP), C-reactive protein (CRP - secondary outcomes) in pregnant with PDM. This randomised, controlled, single-blind trial studied sixty-eight pregnant women with PDM throughout prenatal care until delivery (18 weeks) at a public maternity hospital, Brazil. The standard diet group (SDG) received a diet containing 45-65 % carbohydrates, 15-20 % protein and 25-30 % lipids. The DASH diet group (DDG) received the adapted DASH diet with a similar macronutrient distribution, but with a higher concentration of fibres, unsaturated fats, calcium, magnesium and potassium as well as lower saturated fat. Student's t, Mann-Whitney U and the Chi-square tests were used to compare outcomes. PE incidence was 22⋅9 % in the SDG and 12⋅1 % in the DDG (P = 0⋅25). GP levels significantly increased in the DDG (intra-group analysis; mean difference = 1588 [CI 181, 2994], P = 0⋅03) and tended to be different from the variation in the SDG (mean difference = -29⋅5 [CI -1305; 1⋅365]; v. DDG: 1588 [CI 181; 2994], P = 0⋅09). GH levels decreased significantly and similarly between groups (SDG: -0⋅61 [CI -0⋅26, -0⋅96], P = 0⋅00) v. DDG: -1⋅1 [CI -0⋅57, -1⋅62], P = 0⋅00). There was no evidence of a difference in PE incidence at the end of the intervention between the two diets. The DASH diet seems to favour PE-related biochemical markers.
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Affiliation(s)
- Gabriella P. Belfort
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, 373, Carlos Chagas Filho Ave, University City, Rio de Janeiro, RJ 21941-590, Brazil
- Applied Nutrition Department, Federal University of the State of Rio de Janeiro, 296, Pasteur Ave, Rio de Janeiro, RJ 22290-240, Brazil
| | - Patricia C. de Padilha
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, 373, Carlos Chagas Filho Ave, University City, Rio de Janeiro, RJ 21941-590, Brazil
| | - Dayana R. Farias
- Social and Applied Nutrition Department, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, 373, Carlos Chagas Filho Ave, University City, Rio de Janeiro, RJ 21941-590, Brazil
| | - Letícia B. G. da Silva
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, 373, Carlos Chagas Filho Ave, University City, Rio de Janeiro, RJ 21941-590, Brazil
| | - Karina dos Santos
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, 373, Carlos Chagas Filho Ave, University City, Rio de Janeiro, RJ 21941-590, Brazil
- Public Health Nutrition Department, Federal University of the State of Rio de Janeiro, 296, Pasteur Ave, Rio de Janeiro, RJ 22290-240, Brazil
| | - Erlaine de S. Gomes
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, 373, Carlos Chagas Filho Ave, University City, Rio de Janeiro, RJ 21941-590, Brazil
| | - Thaissa S. V. Lima
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, 373, Carlos Chagas Filho Ave, University City, Rio de Janeiro, RJ 21941-590, Brazil
| | - Rita Bernardete R. G. Bornia
- Maternity School of the Federal University of Rio de Janeiro, 180 Laranjeiras St, Rio de Janeiro, RJ, 22240-003, Brazil
| | - Karina B. C. Rezende
- Maternity School of the Federal University of Rio de Janeiro, 180 Laranjeiras St, Rio de Janeiro, RJ, 22240-003, Brazil
| | - Claudia Saunders
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, 373, Carlos Chagas Filho Ave, University City, Rio de Janeiro, RJ 21941-590, Brazil
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Richardson LA, Basu A, Chien LC, Alman AC, Snell-Bergeon JK. Longitudinal Associations of Healthy Dietary Pattern Scores with Coronary Artery Calcification and Pericardial Adiposity in United States Adults with and without Type 1 Diabetes. J Nutr 2023; 153:2085-2093. [PMID: 37187353 PMCID: PMC10375506 DOI: 10.1016/j.tjnut.2023.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Pericardial adipose tissue volume (PAT) and coronary artery calcification (CAC) are prognostic indicators for future cardiovascular events; however, no studies have assessed the long-term associations of adherence to dietary patterns (DPs) with PAT and CAC in adults with and without type 1 diabetes (T1D). OBJECTIVES We investigated the longitudinal associations of the Mediterranean Diet (MedDiet) and Dietary Approaches to Stop Hypertension (DASH) diet with PAT and CAC progression in adults with and without T1D. METHODS The Coronary Artery Calcification in Type 1 Diabetes (CACTI) study is a population-based, prospective study of 652 T1D and 764 nondiabetic mellitus (nonDM) (19-56 y) participants that began in 2000-2002 with follow-up visits in 2003-2004 and 2006-2007. At each visit, food frequency questionnaires were collected and used to develop adherence scores for the MedDiet and DASH diets. PAT and CAC were measured at each visit using electron beam computed tomography. CAC progression was defined as a ≥2.5 mm square root-transformed volume. Mixed effect models were used to conduct statistical analyses. RESULTS Combined models found a significant-0.09 cm3 (95% CI: -0.14, -0.03; P = 0.0027) inverse association in PAT for every 1-point increase in the MedDiet score and a significant-0.26 cm3 (95% CI: -0.38, -0.14; P < 0.0001) inverse association in PAT for every 1-point increase in the DASH score. In combined models, the DPs were not significantly associated with lower odds of CAC progression; however, both DPs had significant interactions by diabetes status for CAC. Only the DASH diet was associated with lower odds of CAC progression in the nonDM group (OR: 0.96; 95% CI: 0.93, 0.99; P = 0.0224). CONCLUSIONS These data suggest that the DPs are associated with lower PAT, which may reduce future cardiovascular events. The DASH diet may be beneficial for lower odds of CAC progression in those without T1D.
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Affiliation(s)
- Leigh Ann Richardson
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, Las Vegas, NV, United States
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, United States.
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, Las Vegas, NV, United States
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Janet K Snell-Bergeon
- Barbara Davis Center for Diabetes, Anschutz Medical Campus, University of Colorado, Aurora, CO, United States
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Cruz MC, Azinheiro S, Pereira SG. Modulation of gut microbiota by diet and probiotics: potential approaches to prevent gestational diabetes mellitus. GUT MICROBIOME (CAMBRIDGE, ENGLAND) 2023; 4:e17. [PMID: 39295903 PMCID: PMC11406384 DOI: 10.1017/gmb.2023.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 02/11/2023] [Accepted: 05/18/2023] [Indexed: 09/21/2024]
Abstract
Gestational diabetes mellitus (GDM) is a rising global health problem that affects approximately 6% of pregnant women. Lifestyle interventions, particularly diet, and exercise are the first-line treatment, followed by pharmacotherapy, but with associated side effects to both mother and offspring. Modulation of gut microbiota may help prevent or manage GDM. Some gut bacterial groups associated with GDM are also associated with inflammatory biomarkers and gut dysbiosis. Available literature reports that low-glycaemic index diet reduces maternal fasting and 2-hour postprandial glucose and maintains a beneficial gut bacterial composition. Pre- and probiotics can aid GDM therapy by modulating gut microbiota to eubiotic status and improving glucose metabolism. Probiotics as adjuvant GDM therapy should consider bacterial strains, dosage, and treatment duration. Limitations in their use require further studies to develop specific probiotic-based GDM supplement therapy that impacts glycaemic control and inflammatory status by reducing fasting plasma glucose, insulin resistance, and improving lipid profiles of pregnant women.
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Affiliation(s)
| | - Sarah Azinheiro
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
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Sinclair K, Nguyen CJ, Wetherill MS, Nelson K, Jackson AM, Taniguchi T, Jernigan VBB, Buchwald D. Native opportunities to stop hypertension: study protocol for a randomized controlled trial among urban American Indian and Alaska Native adults with hypertension. Front Public Health 2023; 11:1117824. [PMID: 37333529 PMCID: PMC10272533 DOI: 10.3389/fpubh.2023.1117824] [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: 12/06/2022] [Accepted: 05/11/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction American Indian and Alaska Native (AI/AN) adults experience disproportionate cardiovascular disease (CVD) morbidity and mortality compared to other races, which may be partly attributable to higher burden of hypertension (HTN). Dietary Approaches to Stop Hypertension (DASH) is a high-impact therapeutic dietary intervention for primary and secondary prevention of CVD that can contribute to significant decreases in systolic blood pressure (BP). However, DASH-based interventions have not been tested with AI/AN adults, and unique social determinants of health warrant independent trials. This study will assess the effectiveness of a DASH-based intervention, called Native Opportunities to Stop Hypertension (NOSH), on systolic BP among AI/AN adults in three urban clinics. Methods NOSH is a randomized controlled trial to test the effectiveness of an adapted DASH intervention compared to a control condition. Participants will be aged ≥18 years old, self-identify as AI/AN, have physician-diagnosed HTN, and have elevated systolic BP (≥ 130 mmHg). The intervention includes eight weekly, tailored telenutrition counseling sessions with a registered dietitian on DASH eating goals. Intervention participants will be provided $30 weekly and will be encouraged to purchase DASH-aligned foods. Participants in the control group will receive printed educational materials with general information about a low-sodium diet and eight weekly $30 grocery orders. All participants will complete assessments at baseline, after the 8-week intervention, and again 12 weeks post-baseline. A sub-sample of intervention participants will complete an extended support pilot study with assessments at 6- and 9-months post-baseline. The primary outcome is systolic BP. Secondary outcomes include modifiable CVD risk factors, heart disease and stroke risk scores, and dietary intake. Discussion NOSH is among the first randomized controlled trials to test the impact of a diet-based intervention on HTN among urban AI/AN adults. If effective, NOSH has the potential to inform clinical strategies to reduce BP among AI/AN adults. Clinical trials registration https://clinicaltrials.gov/ct2/show/NCT02796313, Identifier NCT02796313.
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Affiliation(s)
- Ka’imi Sinclair
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, United States
| | - Cassandra J. Nguyen
- Nutrition Department at University of California, Davis, Davis, CA, United States
| | - Marianna S. Wetherill
- Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Tulsa, OK, United States
| | - Katie Nelson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, United States
| | | | - Tori Taniguchi
- Center for Indigenous Health Research and Policy, Center for Health Sciences, Oklahoma State University, Tulsa, OK, United States
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Center for Health Sciences, Oklahoma State University, Tulsa, OK, United States
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, United States
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Lin Q, Zhang Z, Meng Q, Xie Y, Liu Z, Hu C, Wang G, Qin P, Bo Q. Effects of different dietary patterns during pregnancy on birth outcomes and glucose parameters in women with gestational diabetes mellitus: A systematic review and meta-analysis. Prim Care Diabetes 2023:S1751-9918(23)00086-4. [PMID: 37127452 DOI: 10.1016/j.pcd.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/13/2023] [Accepted: 04/21/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE Dietary interventions are the cornerstone of gestational diabetes mellitus (GDM) treatment. This study aimed to evaluate the effects of dietary patterns during pregnancy on birth outcomes and glucose parameters in women with GDM. METHODS PubMed, Embase, and The CoChrane Library were searched from the time of database creation to November 30, 2021, along with manual searches. Data analyses were performed using Stata 15.4 software. RESULTS From 2461 studies, 27 RCTs involving 1923 women were eligible. The pooled results showed that dietary pattern interventions during pregnancy reduced birth weight (WMD: -0.14 kg; 95% CI: -0.24, -0.00), hemoglobin A1 C (HbA1 C) (WMD: -0.19, 95% CI: -0.34, -0.05), and macrosomia incidence (RR 0.65 [95% CI 0.48, 0.88]). Low glycemic index (GI) diet reduced macrosomia incidence (RR 0.31 [95% CI 0.11, 0.93]) and fasting plasma glucose (FPG) levels (WMD: -0.10 mmol/L; 95% CI: -0.14, -0.05); a low carbohydrate (CHO) diet reduced large for gestational age (LGA) incidence (RR 0.33 [95% CI 0.13, 0.82]) and HbA1 C (WMD: -0.32; 95% CI: -0.51, -0.14); dietary approaches to stop hypertension (DASH) diet reduced birth weight (WMD:-0.59 kg; 95% CI: -0.64, -0.55), insulin use (RR 0.31 [95% CI 0.18, 0.56), macrosomia incidence (RR 0.12 [95% CI 0.03, 0.50]), and cesarean sections incidence (RR 0.57 [95% CI 0.40, 0.82]). CONCLUSION Dietary patterns during pregnancy can improve certain birth outcomes and glycemic parameters. Due to limitations in the quality and number of included studies, the above findings still need to be validated by further randomized controlled trials with high quality and large samples.
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Affiliation(s)
- Qiulin Lin
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Zhiqiang Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Qingchong Meng
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Yali Xie
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Zhengxiang Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Chunqiu Hu
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Guoxiu Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Panzhu Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Qingli Bo
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China.
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Dos Santos K, Rosado EL, da Fonseca ACP, Belfort GP, da Silva LBG, Ribeiro-Alves M, Zembrzuski VM, Campos M, Zajdenverg L, Drehmer M, Martínez JA, Saunders C. A Pilot Study of Dietetic, Phenotypic, and Genotypic Features Influencing Hypertensive Disorders of Pregnancy in Women with Pregestational Diabetes Mellitus. Life (Basel) 2023; 13:life13051104. [PMID: 37240750 DOI: 10.3390/life13051104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/19/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and perinatal morbimortality. Dietetic, phenotypic, and genotypic factors influencing HDP were analyzed during a nutrigenetic trial in Rio de Janeiro, Brazil (2016-2020). Pregnant women with pregestational diabetes mellitus (n = 70) were randomly assigned to a traditional or DASH diet group. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured during prenatal visits and HDP were diagnosed using international criteria. Phenotypic data were obtained from medical records and personal interviews. Genotyping for FTO and ADRB2 polymorphisms used RT-PCR. Linear mixed-effect models and time-to-event analyses were performed. The variables with significant effect on the risk for progression to HDP were: black skin color (adjusted hazard ratio [aHR] 8.63, p = 0.01), preeclampsia in previous pregnancy (aHR 11.66, p < 0.01), SBP ≥ 114 mmHg in the third trimester (aHR 5.56, p 0.04), DBP ≥ 70 mmHg in the first trimester (aHR 70.15, p = 0.03), mean blood pressure > 100 mmHg (aHR 18.42, p = 0.03), and HbA1c ≥ 6.41% in the third trimester (aHR 4.76, p = 0.03). Dietetic and genotypic features had no significant effect on the outcome, although there was limited statistical power to test both.
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Affiliation(s)
- Karina Dos Santos
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° Andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
- Escola de Nutrição, Universidade Federal do Estado do Rio de Janeiro, Avenida Pasteur, 296, Prédio 2, 3° Andar, Rio de Janeiro 22290-240, Brazil
| | - Eliane Lopes Rosado
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° Andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Ana Carolina Proença da Fonseca
- Laboratório de Genética Humana, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Pavilhão Leônidas Deane, Avenida Brasil 4365, Rio de Janeiro 21040-360, Brazil
| | - Gabriella Pinto Belfort
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° Andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
- Escola de Nutrição, Universidade Federal do Estado do Rio de Janeiro, Avenida Pasteur, 296, Prédio 2, 3° Andar, Rio de Janeiro 22290-240, Brazil
| | - Letícia Barbosa Gabriel da Silva
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° Andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Marcelo Ribeiro-Alves
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Rio de Janeiro 21040-360, Brazil
| | - Verônica Marques Zembrzuski
- Laboratório de Genética Humana, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Pavilhão Leônidas Deane, Avenida Brasil 4365, Rio de Janeiro 21040-360, Brazil
| | - Mario Campos
- Laboratório de Genética Humana, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Pavilhão Leônidas Deane, Avenida Brasil 4365, Rio de Janeiro 21040-360, Brazil
| | - Lenita Zajdenverg
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco K, 2° Andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Michele Drehmer
- Programa de Pós-Graduação em Epidemiologia e Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2400, Porto Alegre 90035-003, Brazil
| | - J Alfredo Martínez
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food Institute (Instituto Madrileño de Estudos Avanzados en Alimentación), Crta. de Canto Blanco, n 8, E-28049 Madrid, Spain
| | - Cláudia Saunders
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° Andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
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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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14
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Zhu Q, Yu L, Li Y, Man Q, Jia S, Liu B, Zong W, Zhou Y, Zuo H, Zhang J. Association between dietary approaches to stop hypertension (DASH) diet and hyperuricemia among Chinese adults: findings from a nationwide representative study. Nutr J 2023; 22:21. [PMID: 36991418 PMCID: PMC10053091 DOI: 10.1186/s12937-023-00845-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/21/2023] [Indexed: 03/30/2023] Open
Abstract
Background Certain foods and food groups could positively or negatively impact serum uric acid (SUA) levels. However, evidence on the holistic dietary strategy to prevent and control hyperuricemia (HUA) development remains limited. Objective The aim of this research work was to explore the association of dietary approaches to stop hypertension (DASH) diet with SUA levels and odds of HUA among Chinese adults. Methods This research premise included 66,427 Chinese adults aged 18 and above who were part of the China Adult Chronic Disease and Nutrition Surveillance in 2015. Dietary consumptions were assessed via the household condiment weighing approach and a three-day, 24-hour dietary recall. Total fat, saturated fat, calcium, protein, potassium, cholesterol, magnesium, fiber, and sodium were all adopted to calculate the DASH score (score range, 0–9). The associations of DASH score with SUA levels and odds of HUA were evaluated using multiple linear and logistic regression models, respectively. Results We established that a higher DASH score was linked with a lower SUA levels (β = − 0.11; 95% CI: − 0.12, − 0.1; p < 0.001) and odds of HUA (OR = 0.85; 95% CI: 0.83, 0.87; p < 0.001) after adjustment for age, sex, ethnicity, education status, marital status, health behaviours and health factors. The association of the DASH diet with odds of HUA was stronger among men (p-interaction = 0.009), non-Han Chinese (p-interaction< 0.001) as well as rural residents (p-interaction< 0.001). Conclusions Our results illustrate that the DASH diet was remarkably negatively with SUA levels and odds of HUA in the Chinese adult population. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-023-00845-w.
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Affiliation(s)
- Qianrang Zhu
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lianlong Yu
- grid.198530.60000 0000 8803 2373NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
- grid.512751.50000 0004 1791 5397Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yuqian Li
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
- grid.198530.60000 0000 8803 2373NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Qingqing Man
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shanshan Jia
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Beibei Liu
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenqi Zong
- grid.410734.50000 0004 1761 5845Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yonglin Zhou
- grid.410734.50000 0004 1761 5845Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hui Zuo
- grid.263761.70000 0001 0198 0694School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jian Zhang
- grid.198530.60000 0000 8803 2373National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
- grid.198530.60000 0000 8803 2373NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
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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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Jaworsky K, DeVillez P, Basu A. The Role of Phytochemicals and Plant-Based Diets in Gestational Diabetes: Evidence from Clinical Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4188. [PMID: 36901197 PMCID: PMC10001985 DOI: 10.3390/ijerph20054188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Gestational diabetes mellitus (GDM) is defined as glucose intolerance identified during pregnancy. The increased risk of pregnancy complications and the adverse health effects for the mother and baby associated with GDM require urgent and effective ways to control the condition. The primary goal of this semi-quantitative review was to examine the effects of phytochemicals and plant-based diets on GDM in clinical studies involving women undergoing pregnancy and to summarize the findings for application in clinical practice and disease management. The articles included in this review show that intervention strategies, including fruits, vegetables, whole grains, nuts and seeds, and tea, may be beneficial in the management of GDM and lower blood glucose and improve adverse pregnancy outcomes in these women. The randomized controlled trials reviewed collectively show improved glycemic control markers, blood lipid values, and body weight and composition when supplemented with phytochemical-rich supplements and foods compared to those in the control groups. The findings support the clinical observations of lower GDM risks in women consuming plant-derived diets rich in phytochemicals. Nutrition interventions involving plant-based foods and diets are thus a practical way to reduce hyperglycemia both in patients diagnosed with GDM and those at high risk for the development of GDM.
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Affiliation(s)
- Kataryna Jaworsky
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
- Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89154, USA
| | - Pamela DeVillez
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
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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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Dingena CF, Arofikina D, Campbell MD, Holmes MJ, Scott EM, Zulyniak MA. Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Nutrients 2023; 15:323. [PMID: 36678193 PMCID: PMC9864154 DOI: 10.3390/nu15020323] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Diabetes disrupts one in six pregnancies, bestowing immediate and long-term health risks to mother and child. Diet and exercise are commonly prescribed to control dysglycemia, but their effectiveness across sub-populations and types of diabetes (type-1; type-2; or gestational diabetes mellitus, GDM) is uncertain. Therefore, a systematic review and meta-analysis on the effect of diet and/or exercise on glycemia in pregnant women with diabetes was conducted. Random effects models were used to evaluate effect sizes across studies and anticipated confounders (e.g., age, ethnicity, BMI). Of the 4845 records retrieved, 26 studies (8 nutritional supplements, 12 dietary, and 6 exercise interventions) were included. All studies were conducted in patients with GDM. Overall, supplement- and exercise-based interventions reduced fasting glucose (−0.30 mmol/L; 95% CI = −0.55, −0.06; p = 0.02; and 0.10 mmol/L; 95% CI = −0.20, −0.01; p = 0.04); and supplement- and diet-based interventions reduced HOMA-IR (−0.40; 95% CI = −0.58, −0.22; p < 0.001; and −1.15; 95% CI = −2.12, −0.17; p = 0.02). Subgroup analysis by confounders only confirmed marginal changed effect sizes. Our results suggest a favorable role of certain nutritional supplements, diet, and exercise practices on glycemia in women with GDM and underline a lack of evidence in ~20% of other diabetes-related pregnancies (i.e., women with pre-existing diabetes).
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Affiliation(s)
- Cassy F. Dingena
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK
| | - Daria Arofikina
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK
| | - Matthew D. Campbell
- School of Nursing and Health Sciences, Institute of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK
| | - Melvin J. Holmes
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK
| | - Eleanor M. Scott
- Division of Clinical and Population Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UK
| | - Michael A. Zulyniak
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK
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19
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Goodarzi-Khoigani M, Imanpour V, Khoshhali M, Kelishadi R. Systematic review and meta-analysis of nutritional interventions to prevent of gestational hypertension or/and preeclampsia among healthy pregnant women. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2023; 28:25. [DOI: 10.4103/jrms.jrms_89_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 10/12/2022] [Accepted: 10/27/2022] [Indexed: 04/07/2023]
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20
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Rosenhouse-Dantsker A, Gazgalis D, Logothetis DE. PI(4,5)P 2 and Cholesterol: Synthesis, Regulation, and Functions. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1422:3-59. [PMID: 36988876 DOI: 10.1007/978-3-031-21547-6_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2) is the most abundant membrane phosphoinositide and cholesterol is an essential component of the plasma membrane (PM). Both lipids play key roles in a variety of cellular functions including as signaling molecules and major regulators of protein function. This chapter provides an overview of these two important lipids. Starting from a brief description of their structure, synthesis, and regulation, the chapter continues to describe the primary functions and signaling processes in which PI(4,5)P2 and cholesterol are involved. While PI(4,5)P2 and cholesterol can act independently, they often act in concert or affect each other's impact. The chapters in this volume on "Cholesterol and PI(4,5)P2 in Vital Biological Functions: From Coexistence to Crosstalk" focus on the emerging relationship between cholesterol and PI(4,5)P2 in a variety of biological systems and processes. In this chapter, the next section provides examples from the ion channel field demonstrating that PI(4,5)P2 and cholesterol can act via common mechanisms. The chapter ends with a discussion of future directions.
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Affiliation(s)
| | - Dimitris Gazgalis
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Diomedes E Logothetis
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
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21
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Li Z, Li S, Xiao Y, Zhong T, Yu X, Wang L. Nutritional intervention for diabetes mellitus with Alzheimer's disease. Front Nutr 2022; 9:1046726. [DOI: 10.3389/fnut.2022.1046726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
The combined disease burden of diabetes mellitus (DM) and Alzheimer's disease (AD) is increasing, and the two diseases share some common pathological changes. However, the pharmacotherapeutic approach to this clinical complexity is limited to symptomatic rather than disease-arresting, with the possible exception of metformin. Whether nutritional intervention might extend or synergize with these effects of metformin is of interest. In particular, dietary patterns with an emphasis on dietary diversity shown to affect cognitive function are of growing interest in a range of food cultural settings. This paper presents the association between diabetes and AD. In addition, the cross-cultural nutritional intervention programs with the potential to mitigate both insulin resistance (IR) and hyperglycemia, together with cognitive impairment are also reviewed. Both dietary patterns and nutritional supplementation showed the effects of improving glycemic control and reducing cognitive decline in diabetes associated with AD, but the intervention specificity remained controversial. Multi-nutrient supplements combined with diverse diets may have preventive and therapeutic potential for DM combined with AD, at least as related to the B vitamin group and folate-dependent homocysteine (Hcy). The nutritional intervention has promise in the prevention and management of DM and AD comorbidities, and more clinical studies would be of nutritional scientific merit.
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22
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Primordial Prevention of Atherosclerotic Cardiovascular Disease. J Cardiopulm Rehabil Prev 2022; 42:389-396. [DOI: 10.1097/hcr.0000000000000748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Gestational diabetes mellitus (GDM) traditionally refers to abnormal glucose tolerance with onset or first recognition during pregnancy. GDM has long been associated with obstetric and neonatal complications primarily relating to higher infant birthweight and is increasingly recognized as a risk factor for future maternal and offspring cardiometabolic disease. The prevalence of GDM continues to rise internationally due to epidemiological factors including the increase in background rates of obesity in women of reproductive age and rising maternal age and the implementation of the revised International Association of the Diabetes and Pregnancy Study Groups' criteria and diagnostic procedures for GDM. The current lack of international consensus for the diagnosis of GDM reflects its complex historical evolution and pragmatic antenatal resource considerations given GDM is now 1 of the most common complications of pregnancy. Regardless, the contemporary clinical approach to GDM should be informed not only by its short-term complications but also by its longer term prognosis. Recent data demonstrate the effect of early in utero exposure to maternal hyperglycemia, with evidence for fetal overgrowth present prior to the traditional diagnosis of GDM from 24 weeks' gestation, as well as the durable adverse impact of maternal hyperglycemia on child and adolescent metabolism. The major contribution of GDM to the global epidemic of intergenerational cardiometabolic disease highlights the importance of identifying GDM as an early risk factor for type 2 diabetes and cardiovascular disease, broadening the prevailing clinical approach to address longer term maternal and offspring complications following a diagnosis of GDM.
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Affiliation(s)
- Arianne Sweeting
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jencia Wong
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Helen R Murphy
- Diabetes in Pregnancy Team, Cambridge University Hospitals, Cambridge, UK
- Norwich Medical School, Bob Champion Research and Education Building, University of East Anglia, Norwich, UK
- Division of Women’s Health, Kings College London, London, UK
| | - Glynis P Ross
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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24
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Schneider EH, Fitzgerald AC, Ponnapula SS, Dopico AM, Bukiya AN. Differential distribution of cholesterol pools across arteries under high-cholesterol diet. Biochim Biophys Acta Mol Cell Biol Lipids 2022; 1867:159235. [PMID: 36113825 DOI: 10.1016/j.bbalip.2022.159235] [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: 07/14/2021] [Revised: 08/26/2022] [Accepted: 09/05/2022] [Indexed: 11/19/2022]
Abstract
Excessive cholesterol constitutes a major risk factor for vascular disease. Within cells, cholesterol is distributed in detergent-sensitive and detergent-resistant fractions, with the largest amount of cholesterol residing in cellular membranes. We set out to determine whether various arteries differ in their ability to accumulate esterified and non-esterified cholesterol in detergent-sensitive versus detergent-resistant fractions throughout the course of a high-cholesterol diet. Male Sprague-Dawley rats were placed on 2 % cholesterol diet while a control group was receiving iso-caloric standard chow. Liver, aorta, and pulmonary, mesenteric, and cerebral arteries were collected at 2-6, 8-12, 14-18, and 20-24 weeks from the start of high-cholesterol diet. After fraction separation, esterified and free non-esterified cholesterol levels were measured. In all arteries, largest cholesterol amounts were present in detergent-sensitive fractions in the non-esterified form. Overall, cholesterol in aorta and cerebral arteries was elevated during 14-18 weeks of high-cholesterol diet. Cerebral arteries also exhibited increase in esterified cholesterol within detergent-sensitive domains, as well as increase in cholesterol level in the detergent-resistant fraction at earlier time-points of diet. Pulmonary artery and mesenteric artery were largely resistant to cholesterol accumulation. Quantitative polymerase chain reaction (qPCR) analysis revealed up-regulation of low-density lipoprotein receptor (Ldlr) and low-density lipoprotein receptor-related protein 1 (Lrp1) gene expression in cerebral arteries when compared to mesenteric and pulmonary arteries, respectively. In summary, we unveiled the differential ability of arteries to accumulate cholesterol over the course of a high-cholesterol diet. The differential accumulation of cholesterol seems to correlate with the up-regulated gene expression of proteins responsible for cholesterol uptake.
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Affiliation(s)
- Elizabeth H Schneider
- Department of Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Amanda C Fitzgerald
- Department of Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Supriya Suzy Ponnapula
- Department of Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Alex M Dopico
- Department of Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Anna N Bukiya
- Department of Pharmacology, Addiction Science and Toxicology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38163, United States.
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25
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Trout KK, Compher CW, Dolin C, Burns C, Quinn R, Durnwald C. Increased Protein with Decreased Carbohydrate Intake Reduces Postprandial Blood Glucose Levels in Women with Gestational Diabetes: The iPRO Study. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:728-739. [PMID: 36147835 PMCID: PMC9436385 DOI: 10.1089/whr.2022.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 06/16/2023]
Abstract
Introduction There is an urgent need to establish an evidence base for recommendations regarding proportions of macronutrients for optimized nutritional management of gestational diabetes mellitus (GDM). Our study compared isocaloric diets in women with GDM that differed in protein and carbohydrate content with fats held constant. We hypothesized that the glucose area under the curve (AUC) would be lower with the higher protein/lower carbohydrate diet. Research Design and Methods This study used a random order crossover design within a controlled research unit environment. Nineteen women were randomized to treatment, with 12 participants completing both arms of the study. Blood sampling occurred preprandially and at t = 30, 60, 120, and 180" relative to meals. Inclusion criteria were confirmed diet-controlled GDMA1, singleton gestation, and with no pre-existing medical comorbidities. Mean gestational age at entrance to study = 32 (±1.76) weeks. Mean prepregnant body mass index of participants = 28.7 (±5.3) kg/m2 Participants were randomly assigned initially to either an increased protein/low carbohydrate (iPRO30%/CHO35%) diet or a lower protein/higher carbohydrate (LPRO15%/CHO50%) diet for a 36 hour inpatient stay on the research unit. All meals and snacks were prepared in a metabolic kitchen. After a 3-7 day washout period, participants were randomized to the opposite treatment. Results On day 2 (with confirmed overnight fasting), the average 3-hour pre- through postprandial glucose AUC was lower in iPRO30%/CHO35% treatment arm (17395.20 ± 2493.47 vs. 19172.47 ± 3484.31, p = 0.01). Conclusion This study is the first to demonstrate that a higher protein, lower carbohydrate meal, especially at breakfast, can result in lower postprandial blood glucose values in women with gestational diabetes. A lack of statistically significant differences at other collection time points could have been due to several factors, but most likely due to small sample size. Longer term outcomes of a higher protein diet, including maternal glycemic control, nitrogen balance, and impact on fetal growth outcomes, are needed.
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Affiliation(s)
- Kimberly K. Trout
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Charlene W. Compher
- Departments of Biobehavioral Health Sciences, and University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cara Dolin
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Carrie Burns
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ryan Quinn
- Departments of Biobehavioral Health Sciences, and University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Celeste Durnwald
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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26
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Altemani AH, Alzaheb RA. The prevention of gestational diabetes mellitus (The role of lifestyle): a meta-analysis. Diabetol Metab Syndr 2022; 14:83. [PMID: 35706048 PMCID: PMC9199329 DOI: 10.1186/s13098-022-00854-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/05/2022] [Indexed: 11/11/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is the most common complication of pregnancy. The disease is on the rise worldwide with deleterious consequences on the fetus, mother, and children. The study aimed to review the role of lifestyle in the prevention of GDM. We searched PubMed, SCOPUS, Web of Science, Cochrane Library, EBSCO, and Google Scholar from the first published article up to December 2021; articles were eligible if they were controlled trials, prospective cohorts, and case-control. Out of 5559 articles retrieved, 66 full texts were screened, and 19 studies were included in the meta-analysis. (6 studies assessed the effects of diet, and 13 were on exercise). The dietary intervention showed significant positive effect on GDM, odd ratio = 0.69, 95% CI, 0.56-84, P-value for overall effect = 0.002. The DASH diet was better than Mediterranean Diet (odd ratio, 0.71, 95% CI, 68-74, P-value < 0.001). Regarding exercise, no significant prevention was evident on GDM, odd ratio, 0.77, 95% CI, 0.55-1.06, P-value = 0.11. However, a significant prevention of gestational diabetes was found when the exercise was mild-moderate (odd ratio = 0.65, 95% CI, 0.53-80, P < 0.0001) and started in the first trimester (odd ratio, 0.57, 95% CI, 0.43-0.75, P < 0.0001. No significant effect was found when the exercise was vigorous (odd ratio = 1.09, 95% CI, 0.50-2.38, P = 0.83) and started during the second trimester of pregnancy (odd ratio, 1.08, 95% CI, 0.65-1.80, P = 0.77. Diet and early mild-moderate exercise were effective in GDM prevention. Exercise during the second trimester and moderate-vigorous were not. Further studies assessing the type, duration, and frequency of physical activity are needed.
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Affiliation(s)
- Abdullah H Altemani
- Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk, 71491, Saudi Arabia.
| | - Riyadh A Alzaheb
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
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27
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Yamada P, Paetow A, Chan M, Arslan A, Landberg R, Young BK. Pregnancy outcomes with differences in grain consumption: a randomized controlled trial. J Perinat Med 2022; 50:411-418. [PMID: 34981703 DOI: 10.1515/jpm-2021-0479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Contemporary obstetrics has begun to appreciate the importance of diet in pregnancy, but guidelines are not based on robust data. The hypothesis that a whole grains diet improves pregnancy outcomes is tested in this study. We compared maternal and neonatal outcomes for a pregnancy diet containing 75% of total carbohydrates as refined grains with outcomes for a diet with 75% of total carbohydrates as whole grains. METHODS This was a randomized interventional study in a clinic population over the last 4-7 months of normal pregnancy with extensive compliance measures. Besides obstetrical and neonatal outcomes, anthropometric measurements were done. In addition to food frequency questionnaires (FFQs), total plasma alkyl resorcinols, a unique quantitative measure of whole grains, were used as a measure of whole grain consumption. RESULTS The data show effective compliance and no difference in outcomes between the diets with regard to maternal weight gain, birth weights, subcutaneous fat and glucose tolerance. CONCLUSIONS Ensuring compliance to a proper pregnancy diet resulted in satisfactory weight gain and normal outcomes even when the proportion of whole grains consumed is only 25% of total carbohydrates.
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Affiliation(s)
- Pamella Yamada
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Alexandra Paetow
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Michael Chan
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Alan Arslan
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Rikard Landberg
- Division of Food and Nutrition Science, Department of Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Bruce K Young
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
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28
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A randomized controlled trial of the effects of whole grains versus refined grains diets on the microbiome in pregnancy. Sci Rep 2022; 12:7509. [PMID: 35525865 PMCID: PMC9079079 DOI: 10.1038/s41598-022-11571-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 04/18/2022] [Indexed: 01/04/2023] Open
Abstract
Dietary whole grain consumption has been postulated to have metabolic benefits. The purpose of this study was to compare a pregnancy diet containing 75% of total carbohydrates as refined grains with a diet of 75% of total carbohydrates as whole grains for pregnancy outcomes and effects on the microbiome. Gestational weight gain, glucose tolerance and newborn outcomes were measured on 248 enrolled compliant women from whom a subset of 103 women consented to give 108 vaginal and 109 anal swabs. The data presented here are limited to the patients from whom the vaginal and anal swabs were obtained in order to study the microbiome. A microbiome—16SrRNA survey—was characterized in these samples. Samples and measurements were obtained at the first obstetrical visit, before beginning a prescribed diet (T1—baseline) and after 17–32 weeks on the prescribed diet (T3). Food frequency questionnaires and total plasma alkylresorcinols were used as a measure of whole grain consumption. There were no dietary differences in maternal weight gain, birth weight, or glucose tolerance test. Mothers consuming the whole grains diet showed a trend of gestational decrease in vaginal bacterial alpha diversity, with increasing Lactobacillus-dominance. No significant difference was observed for the anal microbiome. The results suggest that diet modulations of the vaginal microbiome during gestation may have important implications for maternal and neonatal health and in the intergenerational transfer of maternal microbiome. Trial registration: ClinicalTrials.gov Identifier: NCT03232762.
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29
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Morales E, García-Serna AM, Larqué E, Sánchez-Campillo M, Serrano-Munera A, Martinez-Graciá C, Santaella-Pascual M, Suárez-Martínez C, Vioque J, Noguera-Velasco JA, Avilés-Plaza FV, Martínez-Villanueva M, Ballesteros-Meseguer C, Galdo-Castiñeira L, García-Marcos L. Dietary Patterns in Pregnancy and Biomarkers of Oxidative Stress in Mothers and Offspring: The NELA Birth Cohort. Front Nutr 2022; 9:869357. [PMID: 35495932 PMCID: PMC9039535 DOI: 10.3389/fnut.2022.869357] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although adherence to the Mediterranean and antioxidant-rich diets during pregnancy is suggested to improve maternal-fetal health by reducing oxidative stress, yet there is no study available. Objective We examined whether maternal dietary patterns in pregnancy impact the biomarkers of oxidative stress in mothers and their offspring. Methods Study population included 642 mothers and 335 newborns of the "Nutrition in Early Life and Asthma" (NELA) birth cohort. Maternal diet during pregnancy was assessed by a validated food frequency questionnaire and a priori-defined dietary indices (relative Mediterranean Diet [rMED], alternative Mediterranean Diet [aMED], Dietary Approach to Stop Hypertension [DASH], Alternate Healthy Index [AHEI], and AHEI-2010) were calculated. Biomarkers measured were: hydroperoxides, carbonyl groups, and 8-hydroxydeoxyguanosine (8OHdG) determined in maternal blood and newborn cord blood, and urinary maternal and offspring 15-F2t-isoprostane. Multivariate linear regression models were performed. Results Maternal rMED score was inversely associated with the maternal levels of 8OHdG at mid-pregnancy (beta per 1-point increase = -1.61; 95% CI -2.82, -0.39) and the newborn levels of hydroperoxides (beta per 1-point increase = -4.54; 95% CI -9.32, 0.25). High vs. low maternal rMED score was marginally associated with the decreased levels of 8OHdG in newborns (beta = -9.17; 95% CI -19.9, 1.63; p for trend 0.079). Maternal DASH score tended to be inversely associated with maternal urinary 15-F2t-isoprostane (beta per 1-point increase = -0.69; 95% CI, -1.44, 0.06). High vs. low maternal AHEI score was associated with reduced offspring urinary levels of 15-F2t-isoprostane (beta = -20.2; 95% CI -38.0, -2.46; p for trend 0.026). Conclusion These results suggest that maternal adherence to healthy dietary patterns during pregnancy may reduce DNA damage and lipid oxidation in mothers and offspring.
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Affiliation(s)
- Eva Morales
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Public Health Sciences, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Azahara M García-Serna
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Elvira Larqué
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Physiology, Faculty of Biology, University of Murcia, Murcia, Spain
| | | | | | - Carmen Martinez-Graciá
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Food Science and Technology, Faculty of Veterinary, University of Murcia, Murcia, Spain
| | - Marina Santaella-Pascual
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Food Science and Technology, Faculty of Veterinary, University of Murcia, Murcia, Spain
| | - Clara Suárez-Martínez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Department of Food Science and Technology, Faculty of Veterinary, University of Murcia, Murcia, Spain
| | - Jesús Vioque
- Health and Biomedical Research Institute of Alicante, University Miguel Hernandez (ISABIAL-UMH), Alicante, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José A Noguera-Velasco
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Molecular Therapy and Biomarkers Research Group, Clinical Analysis Service, Virgen de la Arrixaca University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Francisco V Avilés-Plaza
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Molecular Therapy and Biomarkers Research Group, Clinical Analysis Service, Virgen de la Arrixaca University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Miriam Martínez-Villanueva
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Molecular Therapy and Biomarkers Research Group, Clinical Analysis Service, Virgen de la Arrixaca University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Carmen Ballesteros-Meseguer
- Obstetrics & Gynecology Service, Virgen de la Arrixaca University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Lina Galdo-Castiñeira
- Obstetrics & Gynecology Service, Virgen de la Arrixaca University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Luis García-Marcos
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.,Paediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia, Murcia, Spain.,ARADyAL Allergy Network, Madrid, Spain
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30
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dos Santos K, Rosado EL, da Fonseca ACP, Belfort GP, da Silva LBG, Ribeiro-Alves M, Zembrzuski VM, Martínez JA, Saunders C. FTO and ADRB2 Genetic Polymorphisms Are Risk Factors for Earlier Excessive Gestational Weight Gain in Pregnant Women with Pregestational Diabetes Mellitus: Results of a Randomized Nutrigenetic Trial. Nutrients 2022; 14:1050. [PMID: 35268025 PMCID: PMC8912276 DOI: 10.3390/nu14051050] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/16/2022] Open
Abstract
Excessive gestational weight gain (GWG) is associated with increased risk of maternal and neonatal complications. We investigated obesity-related polymorphisms in the FTO gene (rs9939609, rs17817449) and ADRB2 (rs1042713, rs1042714) as candidate risk factors concerning excessive GWG in pregnant women with pregestational diabetes. This nutrigenetic trial, conducted in Brazil, randomly assigned 70 pregnant women to one of the groups: traditional diet (n = 41) or DASH diet (n = 29). Excessive GWG was the total weight gain above the upper limit of the recommendation, according to the Institute of Medicine guidelines. Genotyping was performed using real-time PCR. Time-to-event analysis was performed to investigate risk factors for progression to excessive GWG. Regardless the type of diet, AT carriers of rs9939609 (FTO) and AA carriers of rs1042713 (ADRB2) had higher risk of earlier exceeding GWG compared to TT (aHR 2.44; CI 95% 1.03-5.78; p = 0.04) and GG (aHR 3.91; CI 95% 1.12-13.70; p = 0.03) genotypes, respectively, as the AG carriers for FTO haplotype rs9939609:rs17817449 compared to TT carriers (aHR 1.79; CI 95% 1.04-3.06; p = 0.02).
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Affiliation(s)
- Karina dos Santos
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil; (K.d.S.); (E.L.R.); (G.P.B.); (L.B.G.d.S.)
| | - Eliane Lopes Rosado
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil; (K.d.S.); (E.L.R.); (G.P.B.); (L.B.G.d.S.)
| | - Ana Carolina Proença da Fonseca
- Laboratório de Genética Humana, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Pavilhão Leônidas Deane, Avenida Brasil 4365, Rio de Janeiro 21040-360, Brazil; (A.C.P.d.F.); (V.M.Z.)
| | - Gabriella Pinto Belfort
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil; (K.d.S.); (E.L.R.); (G.P.B.); (L.B.G.d.S.)
| | - Letícia Barbosa Gabriel da Silva
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil; (K.d.S.); (E.L.R.); (G.P.B.); (L.B.G.d.S.)
| | - Marcelo Ribeiro-Alves
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Rio de Janeiro 21040-360, Brazil;
| | - Verônica Marques Zembrzuski
- Laboratório de Genética Humana, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Pavilhão Leônidas Deane, Avenida Brasil 4365, Rio de Janeiro 21040-360, Brazil; (A.C.P.d.F.); (V.M.Z.)
| | - J. Alfredo Martínez
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food Institute, Crta. de Canto Blanco, n 8, E-28049 Madrid, Spain;
| | - Cláudia Saunders
- Programa de Pós-Graduação em Nutrição, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373-Bloco J 2° andar, Cidade Universitária, Rio de Janeiro 21941-902, Brazil; (K.d.S.); (E.L.R.); (G.P.B.); (L.B.G.d.S.)
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Hao S, Tan S, Li J, Li W, Li J, Cai X, Hong Z. Dietary and Exercise Interventions for Perimenopausal Women: A Health Status Impact Study. Front Nutr 2022; 8:752500. [PMID: 35155511 PMCID: PMC8828936 DOI: 10.3389/fnut.2021.752500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/23/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose To explore the impact of different intervention methods on physical health indexes of perimenopausal women. Methods Seventy-eight perimenopausal women were divided into three groups. Group A received routine gynecological diagnosis and treatment and participated in centralized lifestyle health education. Group B was required to participate in all intensive education content, and professional dietitians gave individualized dietary guidance. Group C received intensive education, individualized diet intervention and intensified resistance exercise. Dietary scores, exercise habits, waist circumference, body mass index, fat and muscle mass were observed after three months. Results After the intervention, the total diet score of group C was higher than groups A and B, and the red meat score was significantly reduced. The number of patients in groups B and C who exercised >3 times per week and the number of resistance exercises were significantly increased, while the number of aerobic exercises per week in group C was significantly increased. The body fat and waist circumference were significantly reduced, and skeletal muscle weight was significantly increased. Body mass index, trunk fat ratio and waist-to-hip ratio were significantly decreased in groups B and C, while trunk muscle was significantly increased in group C. Conclusion The combined intervention of the three methods can give full play to the synergistic effect of various interventions. The improvement effect of increasing the appropriate amount of resistance exercise is more obvious, which is worthy of further promotion and application.
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Affiliation(s)
- Shuping Hao
- Department of Clinical Nutrition, Pinggu Hospital, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Sisi Tan
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Clinical Nutrition, Pinggu Hospital, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Weimin Li
- Department of Clinical Nutrition, Pinggu Hospital, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Jingyun Li
- Department of Clinical Nutrition, Pinggu Hospital, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Xiaochen Cai
- Department of Clinical Nutrition, Pinggu Hospital, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Zhongxin Hong
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Zhongxin Hong
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Latino C, Gianatti EJ, Mehta S, Lo J, Devine A, Christophersen C. Does a high dietary intake of resistant starch affect glycaemic control and alter the gut microbiome in women with gestational diabetes? A randomised control trial protocol. BMC Pregnancy Childbirth 2022; 22:46. [PMID: 35042457 PMCID: PMC8764780 DOI: 10.1186/s12884-021-04366-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/24/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Gestational Diabetes Mellitus (GDM) is prevalent with lasting health implications for the mother and offspring. Medical nutrition therapy is the foundation of GDM management yet achieving optimal glycaemic control often requires treatment with medications, like insulin. New dietary strategies to improve GDM management and outcomes are required. Gut dysbiosis is a feature of GDM pregnancies, therefore, dietary manipulation of the gut microbiota may offer a new avenue for management. Resistant starch is a fermentable dietary fibre known to alter the gut microbiota and enhance production of short-chain fatty acids. Evidence suggests that short-chain fatty acids improve glycaemia via multiple mechanisms, however, this has not been evaluated in GDM. METHODS An open-label, parallel-group design study will investigate whether a high dietary resistant starch intake or resistant starch supplement improves glycaemic control and changes the gut microbiome compared with standard dietary advice in women with newly diagnosed GDM. Ninety women will be randomised to one of three groups - standard dietary treatment for GDM (Control), a high resistant starch diet or a high resistant starch diet plus a 16 g resistant starch supplement. Measurements taken at Baseline (24 to 30-weeks' gestation), Day 10 and Day 56 (approximately 36 weeks' gestation) will include fasting plasma glucose levels, microbial composition and short-chain fatty acid concentrations in stool, 3-day dietary intake records and bowel symptoms questionnaires. One-week post-natal data collection will include microbial composition and short-chain fatty acid concentrations of maternal and neonatal stools, microbial composition of breastmilk, birthweight, maternal and neonatal outcomes. Mixed model analysis of variance will assess change in glycaemia and permutation-based multivariate analysis of variance will assess changes in microbial composition within and between intervention groups. Distance-based linear modelling will identify correlation between change in stool microbiota, short-chain fatty acids and measures of glycaemia. DISCUSSION To improve outcomes for GDM dyads, evaluation of a high dietary intake of resistant starch to improve glycaemia through the gut microbiome needs to be established. This will expand the dietary interventions available to manage GDM without medication. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry, ACTRN12620000968976p . Registered 28 September 2020.
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Affiliation(s)
- Cathy Latino
- School of Medical & Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
- Institute for Nutrition Research, Edith Cowan University, Joondalup, Western Australia, Australia.
- Department of Dietetics, Fiona Stanley Hospital, South Metropolitan Health Service, 11 Robin Warren Drive, Murdoch, 6150, Western Australia, Australia.
| | - Emily J Gianatti
- Department of Endocrinology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Shailender Mehta
- Department of Neonatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
- School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Amanda Devine
- School of Medical & Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Institute for Nutrition Research, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Claus Christophersen
- School of Medical & Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Centre for Integrative Metabolomics and Computational Biology, Edith Cowan University, Joondalup, Western Australia, Australia
- WA Human Microbiome Collaboration Centre - TrEnD Lab, School of Molecular & Life Sciences, Curtin University, Bentley, Western Australia, Australia
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Allehdan S, Basha A, Hyassat D, Nabhan M, Qasrawi H, Tayyem R. Effectiveness of carbohydrate counting and Dietary Approach to Stop Hypertension dietary intervention on managing Gestational Diabetes Mellitus among pregnant women who used metformin: A randomized controlled clinical trial. Clin Nutr 2021; 41:384-395. [PMID: 34999333 DOI: 10.1016/j.clnu.2021.11.039] [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] [Received: 11/03/2020] [Revised: 10/18/2021] [Accepted: 11/30/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common complication of pregnancy that has significant impacts on both mother and her offspring health. The present study aimed to examine the effect of carbohydrate counting, carbohydrate counting combined with DASH, and control dietary interventions on glycemic control, and maternal and neonatal outcomes. METHODS A total of 75 pregnant women with GDM at 24th - 30th week of gestation were enrolled and randomized to follow one of the three diets: control or carbohydrate counting, or carbohydrate counting combined with Dietary Approach to Stop Hypertension (DASH). Only 70 of them completed the study until delivery. Fasting blood samples were taken at baseline and the end of the study to measure fasting blood glucose (FBG), fasting insulin, glycated hemoglobin (HbA1c), and fructosamine. Homeostatic model assessment-insulin resistance (HOMA-IR) score was calculated using HOMA2 calculator program. The participants recorded at least four blood glucose readings per day. Maternal and neonatal outcomes were collected from medical records. Dietary intake was assessed by three-day food records at the baseline and the end of the study. RESULTS Adherence to the three dietary interventions, resulted in decreased FBG levels significantly among all the participants (P < 0.05). Consumption of the carbohydrate counting combined with the DASH diet showed significant reduction in serum insulin levels and HOMA-IR score compared to carbohydrate counting group and control group. Means of fructosamine and HbA1c did not differ significantly among the three intervention diet groups. Overall mean of 1-h postprandial glucose (1 h PG) level was significantly lower in the carbohydrate counting combined with DASH group compared with that in the carbohydrate counting group and the control group (P < 0.001). The number of women who were required to commence insulin therapy after dietary intervention was significantly lower in carbohydrate counting group and carbohydrate counting combined with DASH group (P = 0.026). There were no significant differences in other maternal and neonatal outcomes among the three dietary intervention groups. CONCLUSIONS The carbohydrate counting and the carbohydrate counting combined with DASH dietary interventions resulted in beneficial effects on FBG and 1 h PG compared with the control diet. The three dietary interventions produced similar maternal and neonatal outcomes in women with GDM. TRIAL REGISTRATION This trial was registered on ClinicalTrials.gov under the identification code: NCT03244579. https://clinicaltrials.gov/ct2/show/NCT03244579.
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Affiliation(s)
- Sabika Allehdan
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman 11942, Jordan; Department of Biology, College of Science, University of Bahrain. Zallaq, Sakhir Campus 32038, Bahrain.
| | - Asma Basha
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Jordan, Amman, Jordan.
| | - Dana Hyassat
- The National Centre for Diabetes Endocrinology and Genetics, Amman, Jordan.
| | - Mohammed Nabhan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Jordan, Amman, Jordan.
| | - Husam Qasrawi
- Department of Obstetrics and Gynaecology, Al-Bashir Hospital Amman, Jordan.
| | - Reema Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman 11942, Jordan; Department of Human Nutrition, College of Health Sciences, Qatar University, Doha 2713, Qatar.
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Impact of the Dietary Approaches to Stop Hypertension (DASH) diet on glycaemic control and consumption of processed and ultraprocessed foods in pregnant women with pre-gestational diabetes mellitus: a randomised clinical trial. Br J Nutr 2021; 126:865-876. [PMID: 33256869 DOI: 10.1017/s0007114520004791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of this study was to evaluate the impact of the Dietary Approaches to Stop Hypertension (DASH) diet on glycaemic control and consumption of processed (PF) and ultraprocessed (UPF) foods in pregnant women with pre-gestational diabetes mellitus (PGDM). This is a randomised, controlled, single-blind clinical trial with forty-nine adult women with PGDM, followed at a public maternity hospital in Rio de Janeiro, Brazil. The control group (CG) received a standard diet consisting of 45-55 % of the total energy intake of carbohydrates, 15-20 % of proteins and 25-30 % of lipids. The DASH group (DG) received an adapted DASH diet, which did not differ from the standard diet in the percentage of macronutrients, but had higher contents of fibre, unsaturated fats and minerals such as Ca, Mg and K; and lower contents of Na and saturated fats than the standard diet. In the analysis by protocol, the DG presented a higher incidence of glycaemic control after 12 weeks of intervention (57·1 v. 8·3 %, P = 0·01, moderate effect size) and a lower mean consumption of UPF (-9·9 %, P = 0·01) compared with the CG. There was no statistically significant difference in fasting and postprandial blood glucose concentrations, or in the consumption of PF between the groups (P > 0·05). The DASH diet may be a strategy for glycaemic control in pregnant women with PGDM, favouring the adoption of a nutritionally adequate diet with lower consumption of UPF. Further studies are needed to investigate the effect of the DASH diet on glycaemic profile, and maternal and perinatal outcomes in women with PGDM.
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Maternal Dietary Quality and Dietary Inflammation Associations with Offspring Growth, Placental Development, and DNA Methylation. Nutrients 2021; 13:nu13093130. [PMID: 34579008 PMCID: PMC8468062 DOI: 10.3390/nu13093130] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/31/2021] [Accepted: 09/04/2021] [Indexed: 12/14/2022] Open
Abstract
The ‘Developmental Origins of Health and Diseases’ hypothesis posits that prenatal maternal diet influences offspring growth and later life health outcomes. Dietary assessment has focused on selected nutrients. However, this approach does not consider the complex interactions between foods and nutrients. To provide a more comprehensive approach to public health, dietary indices have been developed to assess dietary quality, dietary inflammation and risk factors for non-communicable diseases. Thus far, their use in the context of placental development is limited and associations with offspring outcomes have been inconsistent. Although epidemiological studies have focused on the role of maternal diet on foetal programming, the underlying mechanisms are still poorly understood. Some evidence suggests these associations may be driven by placental and epigenetic changes. In this narrative review, we examine the current literature regarding relationships between key validated diet quality scores (Dietary Inflammatory Index [DII], Mediterranean diet [MD], Healthy Eating Index [HEI], Alternative Healthy Eating Index [AHEI], Dietary Approaches to Stop Hypertension [DASH], Glycaemic Index [GI] and Glycaemic Load [GL]) in pregnancy and birth and long-term offspring outcomes. We summarise findings, discuss potential underlying placental and epigenetic mechanisms, in particular DNA methylation, and highlight the need for further research and public health strategies that incorporate diet quality and epigenetics.
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Favorable effects of the Dietary Approaches to Stop Hypertension diet on glucose tolerance and lipid profiles in gestational diabetes: a randomised clinical trial - Expression of concern. Br J Nutr 2021; 127:151. [PMID: 34353383 DOI: 10.1017/s0007114521002002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sweeting A, Mijatovic J, Brinkworth GD, Markovic TP, Ross GP, Brand-Miller J, Hernandez TL. The Carbohydrate Threshold in Pregnancy and Gestational Diabetes: How Low Can We Go? Nutrients 2021; 13:2599. [PMID: 34444759 PMCID: PMC8398846 DOI: 10.3390/nu13082599] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 12/11/2022] Open
Abstract
The original nutrition approach for the treatment of gestational diabetes mellitus (GDM) was to reduce total carbohydrate intake to 33-40% of total energy (EI) to decrease fetal overgrowth. Conversely, accumulating evidence suggests that higher carbohydrate intakes (60-70% EI, higher quality carbohydrates with low glycemic index/low added sugars) can control maternal glycemia. The Institute of Medicine (IOM) recommends ≥175 g/d of carbohydrate intake during pregnancy; however, many women are consuming lower carbohydrate (LC) diets (<175 g/d of carbohydrate or <40% of EI) within pregnancy and the periconceptual period aiming to improve glycemic control and pregnancy outcomes. This report systematically evaluates recent data (2018-2020) to identify the LC threshold in pregnancy in relation to safety considerations. Evidence from 11 reports suggests an optimal carbohydrate range of 47-70% EI supports normal fetal growth; higher than the conventionally recognized LC threshold. However, inadequate total maternal EI, which independently slows fetal growth was a frequent confounder across studies. Effects of a carbohydrate intake <175 g/d on maternal ketonemia and plasma triglyceride/free fatty acid concentrations remain unclear. A recent randomized controlled trial (RCT) suggests a higher risk for micronutrient deficiency with carbohydrate intake ≤165 g/d in GDM. Well-controlled prospective RCTs comparing LC (<165 g/d) and higher carbohydrate energy-balanced diets in pregnant women are clearly overdue.
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Affiliation(s)
- Arianne Sweeting
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.S.); (T.P.M.); (G.P.R.)
- Charles Perkins Centre, Boden Initiative, University of Sydney, NSW 2006, Australia;
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Jovana Mijatovic
- Charles Perkins Centre, Boden Initiative, University of Sydney, NSW 2006, Australia;
- NHMRC Clinical Trials Unit, University of Sydney, Sydney, NSW 2006, Australia
| | - Grant D. Brinkworth
- Commonwealth Scientific and Industrial Research Organisation—Health and Biosecurity, Sydney, NSW 2113, Australia;
- School of Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia
| | - Tania P. Markovic
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.S.); (T.P.M.); (G.P.R.)
- Charles Perkins Centre, Boden Initiative, University of Sydney, NSW 2006, Australia;
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Glynis P. Ross
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.S.); (T.P.M.); (G.P.R.)
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Teri L. Hernandez
- College of Nursing, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
- Children’s Hospital Colorado, Aurora, CO 80045, USA
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Flor-Alemany M, Acosta P, Marín-Jiménez N, Baena-García L, Aranda P, Aparicio VA. Influence of the degree of adherence to the mediterranean diet and its components on cardiometabolic risk during pregnancy. The GESTAFIT project. Nutr Metab Cardiovasc Dis 2021; 31:2311-2318. [PMID: 34112581 DOI: 10.1016/j.numecd.2021.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/07/2021] [Accepted: 04/19/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Studies regarding dietary patterns and cardiometabolic risk markers during pregnancy are scarce. The aim of the present study was to analyse whether different degrees of adherence to the Mediterranean diet (MD) and the MD components were associated with cardiometabolic markers and a clustered cardiometabolic risk during pregnancy. METHODS AND RESULTS This study comprised 119 pregnant women from the GEStation and FITness (GESTAFIT) project. Dietary habits were assessed with a food frequency questionnaire at the 16th and 34th gestational weeks (g.w.). The Mediterranean Diet Score was employed to assess MD adherence. The following cardiometabolic markers were assessed: pre-pregnancy body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, triglycerides and high-density lipoprotein cholesterol (HDL-C). A greater MD adherence was associated with a better cardiometabolic status in cross-sectional (16th g.w. and 34th g.w.) and prospective analyses (MD adherence at the 16th g.w. and cardiometabolic markers at the 34th g.w.; SBP, DBP and HDL-C; all, p < 0.05). Participants with the highest MD adherence (Tertile 3) had a lower clustered cardiometabolic risk than those with the lowest MD adherence (Tertile 1) at the 16th and 34th g.w. (both, p < 0.05). A higher intake of fruits, vegetables and fish and a lower intake of refined cereals and red meat and subproducts were associated with a lower cardiometabolic risk during pregnancy (all, p < 0.05). CONCLUSION A higher MD adherence, a greater intake of fruits, vegetables and fish and a lower intake of refined cereals and red meat and subproducts showed a cardioprotective effect throughout gestation.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, University of Granada, Spain; Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain.
| | - Pedro Acosta
- Sport and Health University Research Institute (iMUDS), Granada, Spain; Physical Activity for Health Promotion, CTS-1018 research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Nuria Marín-Jiménez
- Sport and Health University Research Institute (iMUDS), Granada, Spain; Physical Activity for Health Promotion, CTS-1018 research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Pilar Aranda
- Department of Physiology, University of Granada, Spain; Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Virginia A Aparicio
- Department of Physiology, University of Granada, Spain; Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
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Tryggvadottir EA, Halldorsson TI, Landberg R, Hrolfsdottir L, Birgisdottir BE, Magnusdottir OK, Hreidarsdottir IT, Hardardottir H, Gunnarsdottir I. Higher Alkylresorcinol Concentrations, a Consequence of Whole-Grain Intake, are Inversely Associated with Gestational Diabetes Mellitus in Iceland. J Nutr 2021; 151:1159-1166. [PMID: 33693761 DOI: 10.1093/jn/nxaa449] [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: 08/31/2020] [Revised: 10/12/2020] [Accepted: 12/22/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A diet rich in whole grains may provide benefits for pregnant women due to whole grains' high nutritional value and dietary fiber content. OBJECTIVES To study the associations of whole-grain consumption, as well as the plasma alkylresorcinol concentration, a whole-grain consumption biomarker, in early pregnancy with gestational diabetes mellitus (GDM) diagnoses. METHODS Subjects were women from the prospective study Pregnant Women in Iceland II (PREWICE II; n = 853) who attended their ultrasound appointment in gestational weeks 11-14 during the period from October 2017 to March 2018. During that visit, whole-grain consumption was estimated using a diet screening questionnaire, and blood samples were collected for analysis of plasma alkylresorcinols (ARs). Information on GDM diagnoses was later extracted from medical records. Multivariate log-binomial regression was used to evaluate the association of dietary whole-grain and AR concentrations with GDM. RESULTS In total, 14.9% of the women adhered to the national food-based dietary guidelines (n = 127), which recommend 2 portions of whole grains daily. GDM was diagnosed in 127 women (14.9%). The frequency of whole-grain consumption was lower in women who were later diagnosed with GDM compared to the women without GDM (median, 5 times/week vs. 6 times/week, respectively; P = 0.02). This difference was reflected in the lower median concentration of total AR in women diagnosed with GDM (163 nmol/L vs. 209 nmol/L, respectively; P < 0.01). The quartile with the highest concentrations of AR had a RR of 0.50 (95% CI: 0.27-0.90) of being diagnosed with GDM, in comparison to the lowest quartile. There was a significant dose response in the GDM risk with higher AR levels. CONCLUSIONS We found that a higher consumption of whole grains, reflected both by reported consumption according to the FFQ and AR biomarkers, was associated with a decreased risk of receiving a GDM diagnosis.
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Affiliation(s)
- Ellen A Tryggvadottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Thorhallur I Halldorsson
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.,Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Rikard Landberg
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Laufey Hrolfsdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.,Institution of Health Science Research, University of Akureyri and Akureyri Hospital, Akureyri, Iceland
| | - Bryndis E Birgisdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Ola K Magnusdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | | | - Hildur Hardardottir
- Faculty of Medicine, University of Iceland Reykjavík, Reykjavík, Iceland.,Livio Reykjavík, Reproductive Center in Reykjavík, Reykjavík, Iceland
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
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Basu A, Feng D, Planinic P, Ebersole JL, Lyons TJ, Alexander JM. Dietary Blueberry and Soluble Fiber Supplementation Reduces Risk of Gestational Diabetes in Women with Obesity in a Randomized Controlled Trial. J Nutr 2021; 151:1128-1138. [PMID: 33693835 PMCID: PMC8112774 DOI: 10.1093/jn/nxaa435] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/09/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a growing public health concern and maternal obesity and poor dietary intakes could be implicated. Dietary polyphenols and fiber mitigate the risk of diabetes and its complications, but little is known about their efficacy in preventing GDM. OBJECTIVES We examined the effects of whole blueberry and soluble fiber supplementation on primary outcomes of cardiometabolic profiles in women at high risk of developing GDM. METHODS Women (n = 34; mean ± SD age: 27 ± 5 y; BMI: 35.5 ± 4.0 kg/m2; previous history of GDM ∼56%; Hispanic ∼79%) were recruited in early pregnancy (<20 weeks of gestation) and randomly assigned to 1 of the following 2 groups for 18 wk: intervention (280 g whole blueberries and 12 g soluble fiber per day) and standard prenatal care (control). Both groups received nutrition education and maintained 24-h food recalls throughout the study. Data on anthropometrics, blood pressure, and blood samples for biochemical analyses were collected at baseline (<20 weeks), midpoint (24-28 weeks), and end (32-36 weeks) of gestation. Diagnosis of GDM was based on a 2-step glucose challenge test (GCT). Data were analyzed using a mixed-model ANOVA. RESULTS Maternal weight gain was significantly lower in the dietary intervention than in the control group at the end of the trial (mean ± SD: 6.8 ± 3.2 kg compared with 12.0 ± 4.1 kg, P = 0.001). C-reactive protein was also lower in the intervention than in the control group (baseline: 6.1 ± 4.0 compared with 6.8 ± 7.2 mg/L; midpoint: 6.1 ± 3.7 compared with 7.5 ± 7.3 mg/L; end: 5.5 ± 2.2 compared with 9.5 ± 6.6 mg/L, respectively, P = 0.002). Blood glucose based on GCT was lower in the intervention than in the control (100 ± 33 mg/dL compared with 131 ± 40 mg/dL, P < 0.05). Conventional lipids (total, LDL, and HDL cholesterol and triglycerides) did not differ between groups over time. No differences were noted in infant birth weight. CONCLUSIONS Whole blueberry and soluble fiber supplementation may prevent excess gestational weight gain and improve glycemic control and inflammation in women with obesity.This trial was registered at clinicaltrials.gov as NCT03467503.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Du Feng
- School of Nursing, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Petar Planinic
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Jeffrey L Ebersole
- School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Timothy J Lyons
- Division of Endocrinology, Medical University of South Carolina, Charleston, SC, USA
| | - James M Alexander
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
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Perry CA, Van Guilder GP, Hossain M, Kauffman A. Cardiometabolic Changes in Response to a Calorie-Restricted DASH Diet in Obese Older Adults. Front Nutr 2021; 8:647847. [PMID: 33816541 PMCID: PMC8017169 DOI: 10.3389/fnut.2021.647847] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/24/2021] [Indexed: 12/13/2022] Open
Abstract
Objective: To examine the response of a calorie-restricted Dietary Approaches to Stop Hypertension diet on indicators of cardiometabolic health in a cohort of sedentary obese older adults. Design: This was a controlled-feeding trial with a parallel design. Each participant consumed either 3 oz (85 g; n = 15) or 6 oz (170.1 g; n = 13) of lean fresh beef within a standardized calorie-restricted DASH-like diet for 12-weeks. Fasted blood samples were collected and used to measure conventional biomarkers of cardiovascular, metabolic and inflammatory health. Participants: Caucasian older (70.8 years), obese (BMI: 32 ± 6.9 kg/m2; WC: 101 ± 16.4 cm) females (n = 17) and males (n = 11) from the rural community of Brookings, South Dakota. Results: 28 participants completed the 12-week feeding trial, with no differences (p > 0.05) among the biomarkers of cardiometabolic health between the 3 and 6 oz beef intake groups. However, when the beef intake groups were combined, all biomarkers changed concentration in response to the intervention diet. Total cholesterol (p < 0.001), LDL-C (p = 0.004), HDL-C (p < 0.0001), insulin (p = 0.014), glucose (p = 0.008), HOMA-IR (p < 0.05), IL-12 (p < 0.001), and CRP (p = 0.006) all decreased in response to the study diet. IGF-1 (p < 0.001) and IL-8 (p = 0.005) increased in response to the intervention. Correlations among cardiometabolic biomarkers and body composition measures were observed. By study end, the decrease in insulin (R 2 = 0.22; P = 0.012) and HOMA-IR (R 2 = 0.22; P = 0.01) was positively correlated with the decrease in waist circumference. The increase in IGF-1 was significantly correlated with the decrease in waist circumference (R 2 = 0.21; p = 0.014). The increase in IGF-1 was significantly correlated with the increase in sit-to-stand (R 2 = 0.21; p = 0.016). The increase in IL-8 was significantly correlated with decreases in total cholesterol (R 2 = 0.24; P = 0.008), LDL-C (R 2 = 0.17; P = 0.031) and glucose (R 2 = 0.44; P = 0.0001). Conclusions: These findings suggest that a DASH-like diet with restricted calories may potentially improve biomarkers of cardiometabolic health in sedentary obese older adults. These results also point to interrelationships between body composition changes and changes in cardiometabolic biomarkers. Lastly, regardless of meat intake amount, positive impacts on cardiometabolic biomarkers were observed in this cohort of older adults with an obese phenotype.
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Affiliation(s)
- Cydne A Perry
- Department of Applied Health Science, Indiana University Bloomington School of Public Health, Bloomington, IN, United States
| | - Gary P Van Guilder
- High Altitude Exercise Physiology Department, Western Colorado University, Gunnison, CO, United States
| | - Mosharraf Hossain
- Department of Health and Nutritional Sciences, South Dakota State University, Brookings, SD, United States
| | - Alyssa Kauffman
- Department of Health and Nutritional Sciences, South Dakota State University, Brookings, SD, United States
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Kapur K, Kapur A, Hod M. Nutrition Management of Gestational Diabetes Mellitus. ANNALS OF NUTRITION & METABOLISM 2021; 76:1-13. [PMID: 33524988 DOI: 10.1159/000509900] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/02/2020] [Indexed: 11/19/2022]
Abstract
Medical nutrition therapy (MNT) is the bedrock for the management of gestational diabetes mellitus (GDM). Several different types of dietary approaches are used globally, and there is no consensus among the various professional groups as to what constitutes an ideal approach. The conventional approach of limiting carbohydrates at the cost of increasing energy from the fat source may not be most optimal. Instead, allowing higher levels of complex, low-to-medium glycaemic index carbohydrates and adequate fibre through higher consumption of vegetables and fruits seems more beneficial. No particular diet or dietary protocol is superior to another as shown in several comparative studies. However, in each of these studies, one thing was common - the intervention arm included more intensive diet counselling and more frequent visits to the dieticians. For MNT to work, it is imperative that diet advice and nutrition counselling is provided by a dietician, which is easy to understand and use and includes healthy food options, cooking methods, and practical guidance that empower and motivate to make changes towards a healthy eating pattern. Various simple tools to achieve these objectives are available, and in the absence of qualified dieticians, they can be used to train other health care professionals to provide nutrition counselling to women with GDM. Given the impact of GDM on the future health of the mother and offspring, dietary and lifestyle behaviour changes during pregnancy in women with GDM are not only relevant for immediate pregnancy outcomes, but continued adherence is also important for future health.
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Affiliation(s)
| | - Anil Kapur
- World Diabetes Foundation, FIGO Pregnancy and NCD Committee, Bagsvaerd, Denmark
| | - Moshe Hod
- Clalit Health Services and Mor Women's Health Center, FIGO Pregnancy and NCD Committee, Tel Aviv, Israel,
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Meloncelli N, Wilkinson SA, de Jersey S. Searching for Utopia, the Challenge of Standardized Medical Nutrition Therapy Prescription in Gestational Diabetes Mellitus Management: A Critical Review. Semin Reprod Med 2021; 38:389-397. [PMID: 33429445 DOI: 10.1055/s-0040-1722316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Gestational diabetes mellitus (GDM) is a common pregnancy disorder and the incidence is increasing worldwide. GDM is associated with adverse maternal outcomes which may be reduced with proper management. Lifestyle modification in the form of medical nutrition therapy and physical activity, as well as self-monitoring of blood glucose levels, is the cornerstone of GDM management. Inevitably, the search for the "ultimate" diet prescription has been ongoing. Identifying the amount and type of carbohydrate to maintain blood glucose levels below targets while balancing the nutritional requirements of pregnancy and achieving gestational weight gain within recommendations is challenging. Recent developments in the area of the gut microbiota and its impact on glycemic response add another layer of complexity to the success of medical nutrition therapy. This review critically explores the challenges to dietary prescription for GDM and why utopia may never be found.
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Affiliation(s)
- Nina Meloncelli
- Nutrition and Dietetics, Sunshine Coast University Hospital, Birtinya, Australia.,Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Shelley A Wilkinson
- School of Human Movements and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia.,Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Susan de Jersey
- Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
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Vasile FC, Preda A, Ștefan AG, Vladu MI, Forțofoiu MC, Clenciu D, Gheorghe IO, Forțofoiu M, Moța M. An Update of Medical Nutrition Therapy in Gestational Diabetes Mellitus. J Diabetes Res 2021; 2021:5266919. [PMID: 34840988 PMCID: PMC8616668 DOI: 10.1155/2021/5266919] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/25/2021] [Accepted: 11/09/2021] [Indexed: 12/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is a serious and frequent pregnancy complication that can lead to short and long-term risks for both mother and fetus. Different health organizations proposed different algorithms for the screening, diagnosis, and management of GDM. Medical Nutrition Therapy (MNT), together with physical exercise and frequent self-monitoring, represents the milestone for GDM treatment in order to reduce maternal and fetal complications. The pregnant woman should benefit from her family support and make changes in their lifestyles, changes that, in the end, will be beneficial for the whole family. The aim of this manuscript is to review the literature about the Medical Nutrition Therapy in GDM and its crucial role in GDM management.
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Affiliation(s)
| | - Agnesa Preda
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical County Emergency Hospital, Craiova, Dolj, Romania
| | - Adela Gabriela Ștefan
- Department of Diabetes Nutrition and Metabolic Diseases, Calafat Municipal Hospital, Calafat, Dolj, Romania
| | - Mihaela Ionela Vladu
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical Municipal Hospital “Philanthropy”, Craiova, Romania
| | - Mircea-Cătălin Forțofoiu
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical Municipal Hospital “Philanthropy”, Craiova, Romania
| | - Diana Clenciu
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical Municipal Hospital “Philanthropy”, Craiova, Romania
| | - Ioan Ovidiu Gheorghe
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Public Health Department Gorj, Romania
| | - Maria Forțofoiu
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical Municipal Hospital “Philanthropy”, Craiova, Romania
| | - Maria Moța
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
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Wiertsema CJ, Mensink-Bout SM, Duijts L, Mulders AGMGJ, Jaddoe VWV, Gaillard R. Associations of DASH Diet in Pregnancy With Blood Pressure Patterns, Placental Hemodynamics, and Gestational Hypertensive Disorders. J Am Heart Assoc 2020; 10:e017503. [PMID: 33356384 PMCID: PMC7955484 DOI: 10.1161/jaha.120.017503] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background The Dietary Approaches to Stop Hypertension (DASH) diet improves blood pressure in nonpregnant populations. We hypothesized that adherence to the DASH diet during pregnancy improves hemodynamic adaptations, leading to a lower risk of gestational hypertensive disorders. Methods and Results We examined whether the DASH diet score was associated with blood pressure, placental hemodynamics, and gestational hypertensive disorders in a population-based cohort study among 3414 Dutch women. We assessed DASH score using food-frequency questionnaires. We measured blood pressure in early-, mid-, and late pregnancy (medians, 95% range: 12.9 [9.8-17.9], 20.4 [16.6-23.2], 30.2 [28.6-32.6] weeks gestation, respectively), and placental hemodynamics in mid- and late pregnancy (medians, 95% range: 20.5 [18.7-23.1], 30.4 [28.5-32.8] weeks gestation, respectively). Information on gestational hypertensive disorders was obtained from medical records. Lower DASH score quartiles were associated with a higher mid pregnancy diastolic blood pressure, compared with the highest quartile (P<0.05). No associations were present for early- and late pregnancy diastolic blood pressure and systolic blood pressure throughout pregnancy. Compared with the highest DASH score quartile, the lower DASH score quartiles were associated with a higher mid- and late pregnancy umbilical artery pulsatility index (P≤0.05) but not with uterine artery resistance index. No associations with gestational hypertensive disorders were present. Conclusions A higher DASH diet score is associated with lower mid pregnancy diastolic blood pressure and mid- and late pregnancy fetoplacental vascular function but not with uteroplacental vascular function or gestational hypertensive disorders within a low-risk population. Further studies need to assess whether the effects of the DASH diet on gestational hemodynamic adaptations are more pronounced among higher-risk populations.
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Affiliation(s)
- Clarissa J Wiertsema
- The Generation R Study Group Erasmus MC, University Medical Center Rotterdam the Netherlands.,Department of Pediatrics Erasmus MC, University Medical Center Rotterdam the Netherlands
| | - Sara M Mensink-Bout
- The Generation R Study Group Erasmus MC, University Medical Center Rotterdam the Netherlands.,Division of Respiratory Medicine and Allergology Department of Pediatrics Erasmus MC, University Medical Center Rotterdam The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics Erasmus MC, University Medical Center Rotterdam the Netherlands.,Division of Respiratory Medicine and Allergology Department of Pediatrics Erasmus MC, University Medical Center Rotterdam The Netherlands
| | - Annemarie G M G J Mulders
- Departments of Obstetrics and Gynaecology Erasmus MC, University Medical Center Rotterdam the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group Erasmus MC, University Medical Center Rotterdam the Netherlands.,Department of Pediatrics Erasmus MC, University Medical Center Rotterdam the Netherlands
| | - Romy Gaillard
- The Generation R Study Group Erasmus MC, University Medical Center Rotterdam the Netherlands.,Department of Pediatrics Erasmus MC, University Medical Center Rotterdam the Netherlands
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Pretorius RA, Palmer DJ. High-Fiber Diet during Pregnancy Characterized by More Fruit and Vegetable Consumption. Nutrients 2020; 13:nu13010035. [PMID: 33374192 PMCID: PMC7824257 DOI: 10.3390/nu13010035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 11/19/2022] Open
Abstract
Higher dietary fiber intakes during pregnancy may have the potential health benefits of increasing gut microbiome diversity, lowering the risk of glucose intolerance and pre-eclampsia, achieving appropriate gestational weight gain, and preventing constipation. In this observational cohort study, we have assessed the dietary fiber intakes of 804 women in late pregnancy, using a semi-quantitative food frequency questionnaire (SQ-FFQ). Overall, the median (interquartile range) dietary fiber intake was 24.1 (19.0–29.7) grams per day (g/day). Only 237/804 (29.5%) women met the recommended Adequate Intake (AI) of dietary fiber during pregnancy of 28 g/day. Women consuming the highest quartile of fiber intakes (34.8 (IQR 32.1–39.5) g/day) consumed more fruit, especially apples and bananas, than women consuming the lowest quartile of fiber intakes (15.9 (IQR 14.4–17.5) g/day). These women in the highest fiber-intake quartile were older (p < 0.01), more had completed further education after secondary school (p = 0.04), and they also consumed more vegetables (67 g/day) compared to the women in the lowest fiber consumption quartile (17 g vegetables/day). Bread intakes of 39–42 g/day were consistent in quantities consumed across all four fiber-intake quartiles. Our findings suggest that antenatal education advice targeting increased fruit and vegetable consumption before and during pregnancy may be a simple strategy to achieve increased total dietary fiber intakes to reach recommended quantities.
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Affiliation(s)
- Rachelle A. Pretorius
- School of Medicine, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia;
| | - Debra J. Palmer
- School of Medicine, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia;
- Telethon Kids Institute, University of Western Australia, 15 Hospital Ave, Nedlands, WA 6009, Australia
- Correspondence: ; Tel.: +61-8-6319-1750
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Rahimi H, Yuzbashian E, Zareie R, Asghari G, Djazayery A, Movahedi A, Mirmiran P. Dietary approaches to stop hypertension (DASH) score and obesity phenotypes in children and adolescents. Nutr J 2020; 19:112. [PMID: 33012284 PMCID: PMC7534156 DOI: 10.1186/s12937-020-00631-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/30/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The prevalence of obesity and its two important phenotypes, the metabolically healthy obese (MHO) and the metabolically unhealthy obese (MUO) are 10.9, 9.1, and 1.8%, respectively, among children and adolescents in Iran. Data on the link between diet quality indices and obesity phenotypes in children and adolescents is scarce. The present study aimed to assess the association of the Dietary Approaches to Stop Hypertension (DASH) score with MHO and MUO, as well as with cardiometabolic risk factors (RFs) in children and adolescents with excess weight. METHODS This cross-sectional study was conducted on 341 children and adolescents with excess weight aged 6-13 years, selected from primary schools of Tehran. The DASH score was determined based on eight components using a valid and reliable food frequency questionnaire. Anthropometric measures, insulin, fasting plasma glucose, lipid profile, and physical activity levels were collected. MUO was classified based on two definitions: having 2 or more cardiometabolic RFs, or being insulin resistant determined by a homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 3.16. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for MUO phenotypes and cardiometabolic RFs in each tertile of the DASH score after adjustment for confounders. RESULTS The mean ± SD for age and DASH score was 9.3 ± 1.7 years and 24.0 ± 4.9, respectively. The prevalence of MUO was 62.2% based on RFs, and 43.4% based on HOMA-IR. Participants in the highest tertile of the DASH score had significantly decreased odds for MUO based on HOMA-IR (OR = 0.49; 95% CI: 0.28-0.87) compared with those in the lowest tertile, after adjustment for confounders. However, there were no associations between the DASH score and any of cardiometabolic RFs, or MUO based on RFs (OR = 0.68; 95% CI: 0.38-1.20). CONCLUSION The DASH score was inversely associated with MUO based on HOMA-IR, but not associated with MUO based on cardiometabolic RFs in this sample of children and adolescents. A DASH-style diet may have favourable effects on insulin sensitivity among children and adolescents with excess weight. Universal definitions for MHO/MUO are required, and longitudinal studies recommended to shed light upon this subject.
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Affiliation(s)
- Hamed Rahimi
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran
| | - Emad Yuzbashian
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran
| | - Rahim Zareie
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran.
| | - Abolghassem Djazayery
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ariyo Movahedi
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413, Iran
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Effects of the Dietary Approaches to Stop Hypertension (DASH) on Pregnancy/Neonatal Outcomes and Maternal Glycemic Control: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Complement Ther Med 2020; 54:102551. [PMID: 33183669 DOI: 10.1016/j.ctim.2020.102551] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/26/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND & OBJECTIVE No systematic review to date has appraised the impact of the Dietary Approaches to Stop Hypertension (DASH) eating plan on maternal glycemic control and pregnancy outcomes. Thus, we conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) to ascertain whether the DASH diet in pregnant women ameliorates their glycemic control and neonatal outcomes when compared to standard diets. METHODS We performed a comprehensive systematic review and meta-analysis of RCTs on PubMed/MEDLINE, Web of Science, SCOPUS, and Embase from the inception until October 2019. RESULTS Six studies met the eligibility criteria and were included in the quantitative meta-analysis. The pregnant women had cardiometabolic disorders such as gestational diabetes, obesity, and hypertension. The meta-analysis suggested a significant effect of DASH diet on fasting plasma levels of glucose (WMD = -6.239 mg/dl; 95% CI: -11.915, -0.563, p = 0.031), but not for the homeostasis model assessment of insulin resistance (WMD = -1.038; 95% CI: -2.704, 0.627, p = 0.22). Following the DASH diet during pregnancy decreased the risk of gestational preeclampsia (RR = 0.667; 95% CI: 0.451, 0.987, p = 0.043), macrosomia (birth weight >4000 g) (RR = 0.294; 95% CI: 0.120, 0.721, p = 0.043), and large for gestational age (RR = 0.452; 95% CI: 0.211, 0.969, p = 0.041). Consuming DASH diet during pregnancy neither increased nor decreased the risk of cesarean section, polyhydramnios, preterm birth (<37 weeks), and small for gestational age. The mean newborn head circumference (cm) (WMD = -0.807; 95% CI: -1.283, -0.331, p = 0.001) and ponderal index (kg/m3) (RR = -0.396; 95% CI: -0.441, -0.350, p = 0.000) in the group receiving the DASH diet were lower than in the control group. CONCLUSION The adherence of pregnant women with cardiometabolic disorders to DASH eating pattern has a significant effect on decreasing fasting plasma glucose levels, ponderal index, incidence of preeclampsia, fetal macrosomia, large for gestational age, and newborn head circumference.
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Abbasnezhad A, Falahi E, Gonzalez MJ, Kavehi P, Fouladvand F, Choghakhori R. Effect of different dietary approaches compared with a regular diet on systolic and diastolic blood pressure in patients with type 2 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2020; 163:108108. [PMID: 32259613 DOI: 10.1016/j.diabres.2020.108108] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/13/2020] [Accepted: 03/02/2020] [Indexed: 12/28/2022]
Abstract
AIMS We aimed to investigate the effect of different dietary approaches on systolic and diastolic blood pressure (SBP and DBP) in Type II diabetes (T2D). METHODS A systematic search was performed in Web of Science, PubMed, Scopus and Cochrane library without any language and time restriction up to December 2018, to retrieve the randomized controlled trials (RCTs) which examined the effects of different dietary approaches on SBP and DBP in T2D patients. Meta-analyses were carried out using a random effects model. I2 index was used to evaluate the heterogeneity. RESULTS Twenty four RCTs with 1130 patients were eligible. The dietary modifications were more effective in reducing both SBP and DBP vs. control diet. The Low-sodium, High-fiber, DASH, Low-fat, Low-protein and Vegan dietary approach were significantly more effective in reducing SBP compared to a control diet. The High-fiber, Low-fat, Low-protein and Vegan diet were significantly more effective in reducing DBP. The Low-sodium and High fiber diets had the greatest lowering effect on SBP and DBP in T2D patients. CONCLUSIONS Adopting healthful dietary modifications were more effective in reducing both SBP and DBP vs. control. The High-fiber and Low-sodium diets had the greatest lowering effect on SBP and DBP in T2D.
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Affiliation(s)
- Amir Abbasnezhad
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ebrahim Falahi
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Michael J Gonzalez
- School of Public Health, Department of Human Development, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Parivash Kavehi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Faezeh Fouladvand
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Razieh Choghakhori
- Razi Herbal Medicines Research Center, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Contreras-Duarte S, Carvajal L, Garchitorena MJ, Subiabre M, Fuenzalida B, Cantin C, Farías M, Leiva A. Gestational Diabetes Mellitus Treatment Schemes Modify Maternal Plasma Cholesterol Levels Dependent to Women´s Weight: Possible Impact on Feto-Placental Vascular Function. Nutrients 2020; 12:E506. [PMID: 32079298 PMCID: PMC7071311 DOI: 10.3390/nu12020506] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 02/11/2020] [Indexed: 12/19/2022] Open
Abstract
: Gestational diabetes mellitus (GDM) associates with fetal endothelial dysfunction (ED), which occurs independently of adequate glycemic control. Scarce information exists about the impact of different GDM therapeutic schemes on maternal dyslipidemia and obesity and their contribution to the development of fetal-ED. The aim of this study was to evaluate the effect of GDM-treatments on lipid levels in nonobese (N) and obese (O) pregnant women and the effect of maternal cholesterol levels in GDM-associated ED in the umbilical vein (UV). O-GDM women treated with diet showed decreased total cholesterol (TC) and low-density lipoproteins (LDL) levels with respect to N-GDM ones. Moreover, O-GDM women treated with diet in addition to insulin showed higher TC and LDL levels than N-GDM women. The maximum relaxation to calcitonin gene-related peptide of the UV rings was lower in the N-GDM group compared to the N one, and increased maternal levels of TC were associated with even lower dilation in the N-GDM group. We conclude that GDM-treatments modulate the TC and LDL levels depending on maternal weight. Additionally, increased TC levels worsen the GDM-associated ED of UV rings. This study suggests that it could be relevant to consider a specific GDM-treatment according to weight in order to prevent fetal-ED, as well as to consider the possible effects of maternal lipids during pregnancy.
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Affiliation(s)
- Susana Contreras-Duarte
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; (L.C.); (M.J.G.); (M.S.); (B.F.); (C.C.); (M.F.)
| | - Lorena Carvajal
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; (L.C.); (M.J.G.); (M.S.); (B.F.); (C.C.); (M.F.)
| | - María Jesús Garchitorena
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; (L.C.); (M.J.G.); (M.S.); (B.F.); (C.C.); (M.F.)
| | - Mario Subiabre
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; (L.C.); (M.J.G.); (M.S.); (B.F.); (C.C.); (M.F.)
| | - Bárbara Fuenzalida
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; (L.C.); (M.J.G.); (M.S.); (B.F.); (C.C.); (M.F.)
| | - Claudette Cantin
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; (L.C.); (M.J.G.); (M.S.); (B.F.); (C.C.); (M.F.)
| | - Marcelo Farías
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; (L.C.); (M.J.G.); (M.S.); (B.F.); (C.C.); (M.F.)
| | - Andrea Leiva
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; (L.C.); (M.J.G.); (M.S.); (B.F.); (C.C.); (M.F.)
- School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Santiago 8330024, Chile
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