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Burdeau JA, Stephenson BJK, Chavarro JE, Mahalingaiah S, Preston EV, Hivert MF, Oken E, Calafat AM, Rifas-Shiman SL, Zota AR, James-Todd T. Early Pregnancy Plasma Per- and Polyfluoroalkyl Substances (PFAS) and Maternal Midlife Adiposity. J Clin Endocrinol Metab 2024:dgae542. [PMID: 39235224 DOI: 10.1210/clinem/dgae542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Indexed: 09/06/2024]
Abstract
CONTEXT Evidence suggests that exposure to per- and polyfluoroalkyl substances (PFAS) increases the risk of developing cardiometabolic disease risk factors. Limited research has evaluated associations between PFAS, assessed during pregnancy, a sensitive window for maternal endocrine effects, and long-term maternal adiposity. OBJECTIVE Estimate associations of early pregnancy measures of individual PFAS, and PFAS mixtures, with maternal adiposity in midlife. METHODS We studied 547 Project Viva participants with measures of early pregnancy (mean gestation 10.0 weeks; mean age 32.5 years) plasma concentrations of 6 PFAS and midlife adiposity outcomes (mean follow-up 17.7 years; mean age 50.7 years), including weight, waist circumference (WC), trunk fat mass (TFM), and total body fat mass (TBFM). We used linear regression and Bayesian Kernel Machine Regression (BKMR). RESULTS Linear regression estimated higher midlife weight per doubling of perfluorooctane sulfonate (PFOS) (3.8 kg [95% CI: 1.6, 5.9]) and 2-(N-ethyl-perfluorooctane sulfonamido) acetate (2.3 kg [95% CI: 0.9, 3.7]). BKMR analyses of single PFAS plasma concentrations (comparing the 25th percentile concentration to the 75th percentile) showed a positive association between PFOS and midlife adiposity (weight: 7.7 kg [95% CI: 4.0, 11.5]; TFM: 1.2 kg [95% CI: 0.0, 2.3]; TBFM: 3.0 kg [95% CI: 0.8, 5.2]), but inverse associations with perfluorononanoate (weight: -6.0 kg [95% CI: -8.5, -3.5]; WC: -1.8 cm [95% CI: -3.2, -0.3]; TFM: -0.8 kg [95% CI: -1.5, -0.1]; TBFM: -1.4 kg [95% CI: -2.7, -0.3]) and perfluorohexane sulfonate (TFM: -0.8 kg [95% CI: -1.5, -0.1]; TBFM: -1.4 kg [95% CI: -2.6, -0.2]). No associations were observed with the overall PFAS mixture. CONCLUSION Select PFAS, assessed in pregnancy, may differentially affect maternal midlife adiposity, influencing later-life maternal cardiometabolic health.
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Affiliation(s)
- Jordan A Burdeau
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Briana J K Stephenson
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Jorge E Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Emma V Preston
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Emily Oken
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Ami R Zota
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Tamarra James-Todd
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
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Kurhaluk N. Palm oil as part of a high-fat diet: advances and challenges, or possible risks of pathology? Nutr Rev 2024:nuae038. [PMID: 38699959 DOI: 10.1093/nutrit/nuae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
Nutritional status disorders have the most significant impact on the development of cardiovascular and oncologic diseases; therefore, the interest in the study of palm oil as among the leading components of nutrition has been increasing. The data examined in this review were sourced from the Scopus, SCIE (Web of Science), PubMed and PubMed Central, MEDLINE, CAPlus/SciFinder, and Embase databases; experts in the field; bibliographies; and abstracts from review analyses from the past 15 years. This review summarizes recent research data focusing on the quantitative and qualitative composition of nutrition of modern humans; concepts of the relationship between high-fat diets and disorders of insulin functioning and transport and metabolism of fatty acids; analyses of data regarding the palmitic acid (16:0) to oleic acid (18:1) ratio; and the effect of diet based on palm oil consumption on cardiovascular risk factors and lipid and lipoprotein levels. Several studies suggest a potential vector contributing to the transmission of maternal, high-fat-diet-induced, addictive-like behaviors and obesogenic phenotypes across generations. The relationship between cholesterol accumulation in lysosomes that may lead to lysosome dysfunction and inhibition of the autophagy process is analyzed, as is the progression of inflammatory diseases, atherosclerosis, nonalcoholic liver inflammation, and obesity with associated complications. Data are discussed from analyses of differences between rodent models and human population studies in the investigated different effects of palm oil consumption as a high-fat diet component. A conclusion is reached that the results cannot be generalized in human population studies because no similar effects were observed. Although there are numerous published reports, more studies are necessary to elucidate the complex regulatory mechanisms in digestive and nutrition processes, because there are great differences in lipoprotein profiles between rodents and humans, which makes it difficult to reproduce the pathology of many diseases caused by different types of the high-fat diet.
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Affiliation(s)
- Natalia Kurhaluk
- Department of Animal Physiology, Institute of Biology, Pomeranian University in Słupsk, Słupsk, Poland
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Ding S, Ru Y, Wang J, Yang H, Xu Y, Zhou Q, Pan H, Wang M. Effects of episodic future thinking in health behaviors for weight loss: A systematic review and meta-analysis. Int J Nurs Stud 2024; 152:104667. [PMID: 38244405 DOI: 10.1016/j.ijnurstu.2023.104667] [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: 04/26/2023] [Revised: 09/15/2023] [Accepted: 11/30/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Obesity and related diseases have become one of the leading causes of death worldwide, which has been linked to biopsychosocial effects such as type 2 diabetes, cardiovascular disease, various cancers, depression, and weight stigma. Episodic future thinking (EFT) has been found to support the development of changes in health behaviors. However, the effectiveness of EFT in enhancing weight loss behavior and health outcomes is not well supported. OBJECTIVE To establish implementation options for the EFT intervention, and critically synthesize the data that assesses the impact of EFT on weight loss behavior and health outcomes. METHODS Searches were performed across 5 Chinese and 9 English databases systematically from inception to March 2023. Randomized controlled trials, written in English or Chinese were included. Two independent reviewers evaluated all relevant studies, who also assessed the risk of bias, and extracted the data. Meta-analyses were conducted using Review Manager 5.4.1. The quantity of evidence's certainty was assessed using the Risk bias assessment tool RoB2 (revised version 2019). This study was registered in PROSPERO. RESULTS A total of 1740 participants were included, and 18 studies were eligible for inclusion. Meta-analysis reported a statistically significant effect size favoring EFT on delay discounting (AUC) (MD = 0.1, 95 % CI: [0.02, 0.17], P = 0.01; I2 = 73 %), delay discounting (K) (MD = -0.85, 95 % CI: [-1.44, -0.26], P = 0.005; I2 = 77 %), energy intake (MD = -107.59, 95 % CI: [-192.21, -22.97], P = 0.01; I2 = 57 %), grocery purchased (SMD: -0.91, 95 % CI:[-1.48, -0.34], P = 0.002; I2 = 63 %), and BMI (MD = -2.73, 95 % CI: [-5.13, -0.32], P = 0.03; I2 = 0 %, two studies). CONCLUSIONS EFT was found to have favorable effects on delay discounting, energy intake, grocery purchased, and BMI of individuals. The presence of high heterogeneity is evident in most of the outcomes. The modalities of EFT intervention are still in the exploratory phase, there is no consensus on the valence, context type, longest delay time, and practice strategy, and it needs to be further explored for different populations. It is anticipated that additional well-designed studies will continue developing high-quality evidence in this field.
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Affiliation(s)
- Shanni Ding
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Yifan Ru
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jinrui Wang
- Zhejiang University, Hangzhou, Zhejiang, China
| | - Haili Yang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yihong Xu
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qianya Zhou
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hongying Pan
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Manjun Wang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Dias LM, Schmidt MI, Vigo Á, Drehmer M. Dietary Patterns in Pregnancy and the Postpartum Period and the Relationship with Maternal Weight up to One Year after Pregnancy Complicated by Gestational Diabetes. Nutrients 2023; 15:4258. [PMID: 37836542 PMCID: PMC10574553 DOI: 10.3390/nu15194258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 10/15/2023] Open
Abstract
This multicentric cohort study aimed to describe changes in dietary patterns during pregnancy and postpartum and the association with BMI variation at six and twelve months postpartum in women with gestational diabetes mellitus (GDM). Between 2014 and 2018, we enrolled women with GDM in prenatal clinics of the Brazilian National Health System and followed them for one year postpartum. The dietary patterns during pregnancy and the postpartum period were obtained by factorial analysis. The relationship between these patterns and variation in postpartum BMI was evaluated by Poisson regression with robust variance adjusted for confounders. We identified three dietary patterns in 584 women, two healthy (generally healthy and Dash type), which were associated with less weight gain (RR 0.77 CI 95% 0.62-0.96 and RR 0.71 CI 95% 0.57-0.88, respectively). The high-risk pattern (based on ultra-processed, high-calorie foods and sweetened drinks) was associated with weight gain (RR 1.31 CI 95% 1.07-1.61 and RR 1.26 CI 95% 1.01-1.59) in six and twelve months postpartum, respectively. Although the participants learned about healthy dieting during pregnancy, dietary habits worsened from pregnancy to postpartum, especially, with lower consumption of fruits and dairy and higher consumption of sweetened beverages, with consequent weight gain postpartum. Postpartum support is needed to prevent weight gain and obesity.
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Affiliation(s)
- Letícia Machado Dias
- Postgraduate Studies Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos St., 2nd Floor, Porto Alegre 90035-003, Brazil; (L.M.D.); (M.I.S.); (Á.V.)
| | - Maria Inês Schmidt
- Postgraduate Studies Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos St., 2nd Floor, Porto Alegre 90035-003, Brazil; (L.M.D.); (M.I.S.); (Á.V.)
- Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | - Álvaro Vigo
- Postgraduate Studies Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos St., 2nd Floor, Porto Alegre 90035-003, Brazil; (L.M.D.); (M.I.S.); (Á.V.)
| | - Michele Drehmer
- Postgraduate Studies Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos St., 2nd Floor, Porto Alegre 90035-003, Brazil; (L.M.D.); (M.I.S.); (Á.V.)
- Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
- Postgraduate Studies Program in Food, Nutrition and Health, Department of Nutrition, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
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Rohini HN, Punita P, Santhekadur PK, Ravishankar MV. Gestational Diabetes Mellitus - The Modern Indian Perspective. Indian J Endocrinol Metab 2023; 27:387-393. [PMID: 38107727 PMCID: PMC10723610 DOI: 10.4103/ijem.ijem_147_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/08/2023] [Accepted: 04/22/2023] [Indexed: 12/19/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a serious and most frequent health complication during pregnancy which is associated with a significant increase in the risk of maternal and neonatal outcomes. GDM is usually the result of β-cell dysfunction along with chronic insulin resistance during pregnancy. Seshiah et al. pioneer work led to the adoption of Diabetes in Pregnancy Study Group in India criteria as the norm to diagnose GDM, especially in the community setting. In 2014, the Maternal Health Division of the Ministry of Health and Family Welfare, Government of India, updated guidelines and stressed upon the proper use of guidelines such as using a glucometer for self-monitoring and the use of oral hypoglycaemic agents. The 2018 Government of India guidelines stress the importance of counselling about lifestyle modifications, weight control, exercise, and family planning.
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Affiliation(s)
- H N Rohini
- Department of Physiology, Meeankshi Medical College and Research Institute, Affiliated to Meenakshi Academy of Higher Education and Research, Mysore, India
| | - Pushpanathan Punita
- Department of Physiology, Meeankshi Medical College and Research Institute, Affiliated to Meenakshi Academy of Higher Education and Research, Mysore, India
| | - Prasanna Kumar Santhekadur
- Department of Biochemistry, Center of Excellence in Molecular Biology and Regenerative Medicine, JSS Medical College, Mysore, India
| | - MV Ravishankar
- Department of Anatomy, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
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Sharifan P, Darroudi S, Rafiee M, Toussi MSE, Sedgh Doust FN, Taghizadeh N, Fazl Mashhadi MR, Ghazizadeh H, Mohammadi MA, Dabagh AE, Ebrahimian AR, Yousefi M, Esmaily H, Ferns GA, Soflaei SS, Ghayour-Mobarhan M. Association of dietary and blood inflammatory indicators with depression, anxiety, and stress in adults with vitamin D deficiency. Int J Geriatr Psychiatry 2023; 38:e5972. [PMID: 37539817 DOI: 10.1002/gps.5972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 07/11/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND There is growing evidence that vitamin D may be related to mental health. The aim of the current study was to investigate the association of dietary and blood inflammatory factors with mental health disorders in subjects with vitamin D deficiency, shedding further light on the complex interplay of these conditions. METHOD In this cross-sectional study, 306 subjects completed the validated Depression, Anxiety, and Stress Scale questionnaire to evaluate their depression, anxiety, and stress scores. Dietary inflammatory index (DII) and healthy eating index (HEI) were calculated using a validated 65-item food frequency questionnaire. Blood samples were taken and vitamin D, cytokine, and hs-CRP levels were measured using enzyme-linked immunosorbent assay kits. Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) were calculated using standard laboratory methods. RESULTS The subjects were divided into two groups based on their vitamin D levels: a vitamin D < 20 μg/dl group (N = 257) and a vitamin D ≥ 20 μg/dl group (N = 49). Between group analysis revealed that only DII (p = 0.015), platelet (p = 0.04), and hs-CRP (p = 0.015) were significantly different. In adults with vitamin D levels below 20 μg/dl, NLR and DII were significantly higher in subjects with anxiety (p < 0.05), and this relationship remained significant only for NLR after adjusting for age and sex. Additionally, PLR and HEI were significantly different in depressed compared to non-depressed subjects, and this association remained significant only for HEI after adjusting for age and sex. CONCLUSION In subjects with vitamin D deficiency, increased levels of PLR, NLR, and DII were associated with depression and anxiety, while HEI was negatively associated with depression. These associations were not found in subjects with vitamin D levels ≥20 μg/dl.
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Affiliation(s)
- Payam Sharifan
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Rafiee
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Niloofar Taghizadeh
- Department of Biology, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | | | - Hamideh Ghazizadeh
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Ebrahimi Dabagh
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Yousefi
- Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Sara Saffar Soflaei
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
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Sadeghi S, Khatibi SR, Mahdizadeh M, Peyman N, Zare Dorniani S. Prevalence of Gestational Diabetes in Iran: A Systematic Review and Meta-analysis. Med J Islam Repub Iran 2023; 37:83. [PMID: 38021388 PMCID: PMC10657259 DOI: 10.47176/mjiri.37.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Indexed: 12/01/2023] Open
Abstract
Background Pregnant women who have gestational diabetes mellitus (GDM) are more prone to adverse pregnancy outcomes. We estimated the prevalence of GDM in Iran. Methods Web of Science, Scopus, PubMed, Google Scholar, and Persian databases (SID, Magiran, Irandoc, and) were searched using the MeSH and non-MeSH terms in abstract, title, or keywords of articles until June 2021, with no limitation in time. Random effects models were applied to summarize the GDM prevalence in Iran. The obtained data were quantitatively analyzed to determine an effect size for each paper. The pooled effect size was introduced as prevalence and 95% confidence interval. Sensitivity analyses and subgroup analyses were done to determine heterogeneity. Publication bias was assessed by the classic fail-safe N and Egger test. Results A total of 53 papers were considered for meta-analysis, involving 56,521 Iranians. The total GDM prevalence in Iran was 7.6% (95% CI, 6.1%-9.4%). Conclusion This meta-analysis was the newest to estimate the GDM prevalence among Iranian women. Our results suggest a high prevalence of GDM in Iran, showing that Iran might have many GDM patients.
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Affiliation(s)
- Sara Sadeghi
- Department of Health Education and Health Promotion, Student Research Committee,
Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Reza Khatibi
- Department of Epidemiology and Biostatistics, School of Health, Torbat
Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mehrsadat Mahdizadeh
- Department of Health Education and Health Promotion, Social Determinants of
Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Peyman
- Department of Health Education and Health Promotion, Social Determinants of
Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samira Zare Dorniani
- Department of Health Education and Health Promotion, Student Research Committee,
Mashhad University of Medical Sciences, Mashhad, Iran
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Kontochristopoulou AM, Karatzi K, Karaglani E, Cardon G, Kivelä J, Wikström K, Iotova V, Tsochev K, Tankova T, Rurik I, Radone AS, Liatis S, Makrilakis K, Moreno LA, Manios Y. Sociodemographic, anthropometric, and lifestyle correlates of prediabetes and type 2 diabetes in europe: The Feel4Diabetes study. Nutr Metab Cardiovasc Dis 2022; 32:1851-1862. [PMID: 35610084 DOI: 10.1016/j.numecd.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/18/2022] [Accepted: 03/25/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS The current work aimed to identify the predominant correlates of prediabetes and T2DM among a variety of socio-demographic, anthropometric and lifestyle indices, in a large sample of adults from families at high risk for T2DM. METHODS AND RESULTS In this cross-sectional study, 2816 adults were recruited from low-socioeconomic areas in high-income countries (HICs) (Belgium-Finland), HICs under austerity measures (Greece-Spain), and low/middle-income countries (LMICs) (Bulgaria-Hungary). A positive association between the male sex (OR, 95% C.I.2.77 (1.69-4.54)) and prediabetes was revealed compared to females, while there was a negative association between younger age (<45 years) (OR, 95% C.I. 0.58 (0.37-0.92)), and low/medium levels of waist circumference (OR, 95% C.I. 0.44 (0.22-0.89)) with prediabetes compared to older age and high levels of waist circumference, respectively. Concerning T2DM, 0-0.5 cups/day of fruits and berries (OR, 95% C.I.2. 13 (1.16-3.91)) and 150-300 g fish/week (OR, 95% C.I. 2.55 (1.01-6.41)) have a positive association compared to higher consumptions, respectively. Conversely, <1 cup/week legumes (OR, 95% C.I. 0.55 (0.31-0.99) as well as 0-0.5 servings (OR, 95% C.I. 0.34 (0.12-0.95) and 0.5-1 servings (OR, 95% C.I. 0.37 (0.19-0.71) of full-fat dairy/day have a negative association compared to higher consumptions, respectively. CONCLUSION These findings indicate the need for diabetes prevention measures targeting young adults and especially men, above 45 years of age, with central obesity and poor dietary habits and prioritize vulnerable groups and populations living in LMICs. NATIONAL CLINICAL TRIAL NUMBER NCT02393872.
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Affiliation(s)
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 75 Iera Odos, Athens, 11855, Greece
| | - Eva Karaglani
- Department of Nutrition and Dietetics, Harokopio University, 70 El Venizelou Avenue, Kallithea, Athens, 17671, Greece
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Jemina Kivelä
- Finnish Institute for Health and Welfare, Population Health Unit Helsinki, Finland
| | - Katja Wikström
- Finnish Institute for Health and Welfare, Population Health Unit Helsinki, Finland
| | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia, Sofia, Bulgaria
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Anett S Radone
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, School of Health Science (EUCS), Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 70 El Venizelou Avenue, Kallithea, Athens, 17671, Greece.
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Lotfi K, Saneei P, Hajhashemy Z, Esmaillzadeh A. Adherence to the Mediterranean Diet, Five-Year Weight Change, and Risk of Overweight and Obesity: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2022; 13:152-166. [PMID: 34352891 PMCID: PMC8803490 DOI: 10.1093/advances/nmab092] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/07/2021] [Accepted: 07/06/2021] [Indexed: 12/31/2022] Open
Abstract
Findings from earlier studies on the association between adherence to a Mediterranean diet and risk of overweight/obesity were inconsistent. We summarized cohort studies investigating the association between the Mediterranean diet and risk of overweight and/or obesity and weight change in adults. A systematic search of PubMed, Scopus, ISI Web of Science, and Google Scholar was conducted up to May 2021. Prospective cohorts that examined the Mediterranean diet adherence in adults as the exposure, and overweight and/or obesity or weight change as the outcomes, and reported RRs or β coefficients and 95% CIs as the effect sizes were included. Seven prospective cohort studies were included of which 6 studies (with 244,678 adult participants) reported the risk of overweight and/or obesity, and 4 cohorts (with 436,617 participants) reported the weight change (3 cohorts reported both overweight and/or obesity risk and weight change). Combining 15 effect sizes from 6 cohorts revealed that greater adherence to the Mediterranean diet was significantly associated with a 9% decreased risk of overweight and/or obesity (RR: 0.91; 95% CI: 0.88, 0.94; I2 = 44.7%; PQ-test = 0.031). This association was significant in the case of studies investigating combined overweight and obesity (RR: 0.92; 95% CI: 0.88, 0.96; I2 = 29.4%; PQ-test = 0.166), but not for studies that reported on obesity (RR: 0.68; 95% CI: 0.43, 1.10, I2 = 50.6%, PQ-test = 0.132). Linear dose-response analysis of 6 studies showed a 2% decreased risk of overweight and/or obesity for 1 additional Mediterranean diet score (RR: 0.98; 95% CI: 0.96, 0.99). Each unit increase in the Mediterranean diet score was associated with 0.04 kg less weight gain over 5 y (-0.04 kg; 95% CI: -0.07, -0.02 kg; 13 effect sizes from 4 cohorts). In conclusion, Mediterranean diet adherence is inversely associated with risk of overweight and/or obesity as well as 5-y weight gain and thus has practical importance for public health.
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Affiliation(s)
- Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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10
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Yang J, Zhang C, Chavarro JE, Rich-Edwards JW, Wang M, Fawzi WW, Manson JE, Lee IM, Hu FB, Tobias DK. Lifestyle Changes and Long-term Weight Gain in Women With and Without a History of Gestational Diabetes Mellitus: A Prospective Study of 54,062 Women in the Nurses' Health Study II. Diabetes Care 2022; 45:348-356. [PMID: 34880065 PMCID: PMC8914421 DOI: 10.2337/dc21-1692] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/12/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We examined lifestyle factors with midlife weight change according to history of gestational diabetes mellitus (GDM) in a large longitudinal female cohort. RESEARCH DESIGN AND METHODS In the Nurses' Health Study II, we categorized changes in lifestyle within 4-year periods and estimated their associations with concurrent changes in body weight (kilograms) among parous women after age 40 years by GDM history status (N = 54,062; 5.3% with a history of GDM) for the following: diet quality (Alternate Healthy Eating Index [AHEI]), leisure-time physical activity (PA), alcohol consumption, and smoking status. RESULTS Over a median follow-up of 13 years, average 4-year weight gain was 1.10 and 1.33 kg for women with and without prior GDM, respectively. Women with improved diet quality had favorable 4-year weight change, particularly those with a history of GDM (AHEI change [95% CI] from low to high -2.97 kg [-4.34, -1.60] vs. -1.19 kg [-1.41, -0.96] for GDM vs. non-GDM, respectively; P heterogeneity = 0.04). Increasing PA was associated with weight maintenance for GDM women only (PA increase [95% CI] from low to high 0.26 kg [-0.25, 0.77] vs. 0.90 kg [0.80, 1.01] for GDM vs. non-GDM, respectively; P heterogeneity = 0.02). For both GDM and non-GDM women, weight change did not differ significantly with change in alcohol consumption, while women who quit smoking had significant weight gain (4.38 kg for GDM and 3.85 kg for non-GDM). CONCLUSIONS Improvements in diet quality and PA were related to less weight gain in midlife among parous women, and the benefit of such improvements on weight management was particularly pronounced among women with a history of GDM.
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Affiliation(s)
- Jiaxi Yang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Cuilin Zhang
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Jorge E Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Wafaie W Fawzi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
| | - JoAnn E Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Frank B Hu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Deirdre K Tobias
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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11
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Choudhury AA, Devi Rajeswari V. Gestational diabetes mellitus - A metabolic and reproductive disorder. Biomed Pharmacother 2021; 143:112183. [PMID: 34560536 DOI: 10.1016/j.biopha.2021.112183] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 02/07/2023] Open
Abstract
Maternal health associated with Gestational Diabetes Mellitus (GDM) has been gaining significant research attention due to its severe risk and adverse health effects. GDM is the leading health disease in pregnant women. It is the most common metabolic disease and it can affect up to 25% of women during pregnancy. Pregnancy is a sensitive period that impacts both pregnant women and their unborn children's long-term health. It is a well-known fact that the leading causes of disease and mortality worldwide are diabetes mellitus and cancer, and specifically, women with diabetes mellitus are at a higher risk of developing breast cancer (BC). Women who have diabetes are equally vulnerable to reproductive diseases. Reproductive dysfunctions with diabetes are mainly attributed to coexisting polycystic ovarian syndrome (PCOS), obesity, and hyperinsulinemia, etc. Moreover, India has long been recognized as the world's diabetic capital, and it is widely acknowledged that particularly pregnant and lactating women are among the most affected by diabetes. In India, one-third (33%) of women with GDM had a history of maternal diabetes. Nevertheless, the latest research suggests that gestational diabetes is also a risk factor for cardiometabolic diseases of the mother and offspring. Therefore, in the 21st century, GDM imposes a major challenge for healthcare professionals. We intend to explore the role of diabetes on female reproductive function throughout various stages of life in the perspective of the changing prognosis, prevalence, and prevention of GDM.
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Affiliation(s)
- Abbas Alam Choudhury
- Department of Bio-Medical Sciences, School of Biosciences and Technology, VIT University, Vellore 632 014, Tamil Nadu, India
| | - V Devi Rajeswari
- Department of Bio-Medical Sciences, School of Biosciences and Technology, VIT University, Vellore 632 014, Tamil Nadu, India.
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12
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Potzel AL, Gar C, Seissler J, Lechner A. A Smartphone App (TRIANGLE) to Change Cardiometabolic Risk Behaviors in Women Following Gestational Diabetes Mellitus: Intervention Mapping Approach. JMIR Mhealth Uhealth 2021; 9:e26163. [PMID: 33973864 PMCID: PMC8150415 DOI: 10.2196/26163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/11/2021] [Accepted: 03/19/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is the most common complication during pregnancy and is associated with an increased risk for the development of cardiometabolic diseases. Behavioral interventions can reduce this risk, but current solutions insufficiently address the requirements for such a program. The systematic development of a scalable mobile health (mHealth) promotion program for mothers during the first years post-GDM may contribute to solving this problem. OBJECTIVE The aim of this project was to systematically plan and develop a theory- and evidence-based mHealth intervention to change cardiometabolic risk behaviors in women during the first 5 years post-GDM that meets women's expected standards of commercial health apps. METHODS The intervention mapping steps 1 to 4 structured the systematic planning and development of the mHealth program described in this paper. Steps 1 and 2 led to a theory- and evidence-based logic model of change for cardiometabolic health. Based on this model, the prevention program was designed (step 3) and produced (step 4) in cooperation with industrial partners to ensure a high technological standard of the resulting smartphone app for the iPhone (Apple Inc). Step 4 included a user study with women during the first 5 years post-GDM once a beta version of the app ("TRIANGLE") was available. The user study comprised 2 test rounds of 1 week (n=5) and 4 weeks (n=6), respectively. The tests included validated questionnaires on user acceptance, user logs, and think-alouds with semistructured interviews. RESULTS The novel TRIANGLE app is among the first self-paced smartphone apps for individual habit change in the 3 lifestyle areas of physical activity, nutrition, and psychosocial well-being. The 3 core features-a challenge system, human coaching, and a library-address 11 behavioral determinants with 39 behavior change methods to support lifestyle changes. Participants in the user study showed a high acceptance, high perceived quality, and high perceived impact of the TRIANGLE app on their health behaviors. Participants tested the app regularly, used it intuitively, and suggested improvements. We then adapted the TRIANGLE app according to the insights from the user study before the full TRIANGLE program production. CONCLUSIONS The intervention mapping approach was feasible to plan and develop an innovative and scalable smartphone solution for women during the first 5 years post-GDM. The resulting TRIANGLE intervention has the potential to support behavior change for cardiometabolic disease prevention. However, the app needs further refinement and testing in clinical trials. Intervention mapping steps 5 (implementation plan) and 6 (evaluation plan) may support the integration of the TRIANGLE intervention into routine care. TRIAL REGISTRATION German Clinical Trials Register DRKS00012736; https://www.drks.de/DRKS00012736.
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Affiliation(s)
- Anne Lotte Potzel
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Christina Gar
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Jochen Seissler
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Andreas Lechner
- Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
- CCG Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany
- German Center for Diabetes Research, Neuherberg, Germany
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13
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Assessing Overall Diet Quality: Development and Evaluation of the Performance of a Short Self-Administrated Questionnaire SCASA. Nutrients 2021; 13:nu13020677. [PMID: 33672629 PMCID: PMC7924174 DOI: 10.3390/nu13020677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 11/17/2022] Open
Abstract
Several tools assessing diet quality have been developed over the last decades, but their use in public health and clinical practice is limited because they necessitate detailed quantitative assessment of food intake. Our goal was to develop and validate a score (Score d’Alimentation Saine, SCASA) based on a short self-administrated online questionnaire to assess overall diet quality. SCASA targets the adult population in French-speaking Switzerland, but it was designed in a way enabling its adaptation for other regions. The choice of the items involved experts and lay volunteers. Construct validation and inter-method reliability were assessed by screening meal plans and by comparing the self-rated scores with food-record derived scores (kappa and Bland–Altman). SCASA (17 components) discriminated adequately balanced from imbalanced meal plans (93–95% and 44–46% of maximal score). Agreement between self-assessed and food record-based scores ranged between >90% (3 items), 80–89% (3 items), 70–79% (4 items), and <70% (5 items). The Bland–Altman plot showed a mean difference of −1.60 (95% CI −2.36 to −0.84), indicating a slight overestimation of the self-assessed diet quality compared to the food record. SCASA offers a reliable way to assess overall diet quality without requiring burdensome data collection or nutrient calculations.
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14
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Fedullo AL, Schiattarella A, Morlando M, Raguzzini A, Toti E, De Franciscis P, Peluso I. Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity. Int J Mol Sci 2021; 22:1213. [PMID: 33530554 PMCID: PMC7866163 DOI: 10.3390/ijms22031213] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.
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Affiliation(s)
- Anna Lucia Fedullo
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.S.); (M.M.); (P.D.F.)
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.S.); (M.M.); (P.D.F.)
| | - Anna Raguzzini
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
| | - Elisabetta Toti
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.S.); (M.M.); (P.D.F.)
| | - Ilaria Peluso
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
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15
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Socio-Demographic Characteristics and Body Weight Perceptions of Study Participants Benefitting Most from the Feel4Diabetes Program Based on Their Anthropometric and Glycaemic Profile Changes. Nutrients 2020; 12:nu12103117. [PMID: 33065990 PMCID: PMC7601567 DOI: 10.3390/nu12103117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 12/19/2022] Open
Abstract
The Feel4Diabetes program was comprised of a community-based screening and a two-year intervention phase aiming to prevent type 2 diabetes (T2D) in families at risk for diabetes across Europe. The current work aimed to identify the socio-demographic characteristics and body weight perceptions of participants who benefitted the most, achieving at least a 5% reduction in body weight, waist circumference and glycaemic indices (fasting plasma glucose, insulin, glycosylated haemoglobin levels), over two-year period. Following a two-stage screening procedure, 2294 high-risk parents were randomly allocated to standard care or more intensive intervention. The participants who benefitted most were living in Southern (OR 2.39–3.67, p < 0.001) and Eastern Europe (OR 1.55–2.47, p < 0.05), received more intensive intervention (OR 1.53–1.90, p = 0.002) and were younger (<40 years old) adults (OR 1.48–1.51, p < 0.05). Furthermore, individuals with tertiary education (OR 2.06, p < 0.001), who were unemployed (OR 1.62–1.68, p < 0.05) and perceived their body weight to be higher than normal (OR 1.58–3.00, p < 0.05) were more likely to benefit from the program. Lastly, males were more likely to show improvements in their glycaemic profiles compared to females (OR 1.40, p = 0.024). These findings point out the regions in Europe and the sociodemographic profile of individuals that benefitted the most in the current study, highlighting the need to prioritise regions in greater need for such interventions and also tailor future interventions to the characteristics and perceptions of the target populations.
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16
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Diet Quality among Women with Previous Gestational Diabetes Mellitus in Rural Areas of Hunan Province. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165942. [PMID: 32824308 PMCID: PMC7460136 DOI: 10.3390/ijerph17165942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 12/11/2022]
Abstract
Diet quality is critical for postpartum type 2 diabetes mellitus (T2DM) progression among women with a history of gestational diabetes mellitus (GDM). The Chinese Healthy Eating Index (CHEI) is a dietary index developed according to the latest Chinese Dietary Guidelines (CDG-2016). Our study aimed to assess the diet quality of women with previous GDM in rural areas of Hunan Province by applying the CHEI. Women with previous GDM in two counties of Hunan were enrolled. Their food intake data, which were used to calculate their CHEI scores, were collected by a 24-h dietary recall. The association of CHEI with sociodemographic and anthropometric variables was evaluated via linear regression models. 404 women were included in the final analysis. The mean score of the total CHEI was 54.9 (SD 7.9). The components of whole grains and mixed beans, seeds and nuts, tubers, dairy, and poultry scored extremely low. Ethnic minority groups and women younger than 30 years had lower CHEI scores. Our study observed an unsatisfactory diet quality among women with previous GDM in rural areas of Hunan Province. Future dietary education focusing on the CDG is needed to improve their diet quality and help in T2DM prevention among this population, especially young and ethnic minority women.
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17
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Maternal healthful dietary patterns during peripregnancy and long-term overweight risk in their offspring. Eur J Epidemiol 2020; 35:283-293. [PMID: 32185575 PMCID: PMC7154013 DOI: 10.1007/s10654-020-00621-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 03/09/2020] [Indexed: 12/13/2022]
Abstract
Adherence to healthful dietary patterns is associated with lower body mass index (BMI) in adults; however, whether maternal diet quality during peripregnancy is related to a lower overweight risk in the offspring remains to be elucidated. We investigated the associations between the Alternate Healthy Eating Index (AHEI), Alternate Mediterranean Diet (aMED) and Dietary Approach to Stop Hypertension (DASH) during peripregnancy and offspring weight outcomes in a study including 2729 mother–child pairs from the Nurses’ Health Study II and offspring cohort Growing Up Today Study II. Children, 12–14 years at baseline were 21–23 years at the last follow-up. Overweight or obesity was defined according to International Obesity Task Force (< 18 years) and World-Health-Organization guidelines (18 + years). Maternal dietary patterns were calculated from food frequency questionnaires. Log-binomial models were used to estimate relative risks (RR) and 95% confidence intervals. In models adjusted for sex, gestational age at delivery and maternal total energy intake, greater maternal adherence to aMED and DASH, but not AHEI, was associated with lower overweight risk in the offspring (RRQ5 vs Q1 = 0.82 [0.70–0.97] for aMED and 0.86 [0.72–1.04] for DASH, P for trend < 0.05 for both). After additional adjustment for maternal pre-pregnancy lifestyle factors and socio-demographic characteristic, none of the diet quality scores were significantly associated with offspring overweight risk. Maternal pre-pregnancy BMI did not modify any of these associations. In this population of generally well-nourished women, maternal healthful dietary patterns during the period surrounding pregnancy were not independently associated with offspring overweight risk at ages 12–23 years.
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18
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Martin JC, Joham AE, Mishra GD, Hodge AM, Moran LJ, Harrison CL. Postpartum Diet Quality: A Cross-Sectional Analysis from the Australian Longitudinal Study on Women's Health. J Clin Med 2020; 9:jcm9020446. [PMID: 32041231 PMCID: PMC7073585 DOI: 10.3390/jcm9020446] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/30/2020] [Accepted: 02/04/2020] [Indexed: 02/06/2023] Open
Abstract
Reproductive-aged women are at high risk of developing obesity, and diet quality is a potential modifiable risk factor. There is limited research exploring diet quality and its association with time since childbirth. Using data from the Australian Longitudinal Study on Women’s Health (ALSWH) survey 5 (2009) of women born between 1973–1978, who reported having previously given birth, we investigated the association between time since childbirth and diet quality, and differences in energy, macronutrients, micronutrient intake, and diet quality assessed by the dietary guideline index (DGI) in women stratified by time from last childbirth, early (0–6 months; n = 558) and late (7–12 months; n = 547), and all other women with children (>12 months post childbirth n = 3434). From this cohort, 8200 participants were eligible, of which 4539 participants completed a food frequency questionnaire (FFQ) and were included in this analysis. Overall, diet quality was higher in early and late postpartum women (mean DGI score 89.8 (SD 10.5) and mean DGI score 90.0 (SD 10.2), respectively) compared to all other women with children (>12 months post childbirth), mean DGI score 85.2 (SD 11.7), p < 0.001. Factors positively associated with diet quality included higher education, physical activity, health provider support, and vitamin and/or mineral supplement use. Conversely, increasing time from childbirth (>12 months), smoking compared with non-smoking and medium income level compared with no income was negatively associated with diet quality. A lower diet quality in women greater than 12 months post childbirth may be reflective of increased pressures, balancing childrearing and return to work responsibilities. This highlights the need to support women beyond the postpartum period to improve modifiable factors associated with weight gain, including diet quality, to optimize health and reduce chronic disease risk.
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Affiliation(s)
- Julie C. Martin
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne 3000, Australia; (J.C.M.); (A.E.J.); (L.J.M.)
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne 3000, Australia; (J.C.M.); (A.E.J.); (L.J.M.)
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton 3168, Australia
| | - Gita D. Mishra
- Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, Brisbane 4000, Australia;
| | - Allison M. Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne 3000, Australia;
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3000, Australia
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne 3000, Australia; (J.C.M.); (A.E.J.); (L.J.M.)
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne 3000, Australia; (J.C.M.); (A.E.J.); (L.J.M.)
- Correspondence: ; Tel.: +61-03-8572-2662
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The Dietary Inflammatory Index® and Alternative Healthy Eating Index 2010 in relation to leucocyte telomere length in postmenopausal women: a cross-sectional study. J Nutr Sci 2019; 8:e35. [PMID: 31723429 PMCID: PMC6842575 DOI: 10.1017/jns.2019.32] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/22/2019] [Accepted: 09/20/2019] [Indexed: 12/23/2022] Open
Abstract
Telomeres are nucleoprotein complexes that form the ends of eukaryotic chromosomes where they protect DNA from genomic instability, prevent end-to-end fusion and limit cellular replicative capabilities. Increased telomere attrition rates, and relatively shorter telomere length, is associated with genomic instability and has been linked with several chronic diseases, malignancies and reduced longevity. Telomeric DNA is highly susceptible to oxidative damage and dietary habits may make an impact on telomere attrition rates through the mediation of oxidative stress and chronic inflammation. The aim of this study was to examine the association between leucocyte telomere length (LTL) with both the Dietary Inflammatory Index® 2014 (DII®) and the Alternative Healthy Eating Index 2010 (AHEI-2010). This is a cross-sectional analysis using baseline data from 263 postmenopausal women from the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial, in Calgary and Edmonton, Alberta, Canada. No statistically significant association was detected between LTL z-score and the AHEI-2010 (P = 0·20) or DII® (P = 0·91) in multivariable adjusted models. An exploratory analysis of AHEI-2010 and DII® parameters and LTL revealed anthocyanidin intake was associated with LTL (P < 0·01); however, this association was non-significant after a Bonferroni correction was applied (P = 0·27). No effect modification by age, smoking history, or recreational physical activity was detected for either relationship. Increased dietary antioxidant and decreased oxidant intake were not associated with LTL in this analysis.
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Setiono FJ, Jock B, Trude A, Wensel CR, Poirier L, Pardilla M, Gittelsohn J. Associations between Food Consumption Patterns and Chronic Diseases and Self-Reported Morbidities in 6 American Indian Communities. Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
ABSTRACT
Background
American Indian (AI) have the highest rates of diet-related chronic diseases in the country. Yet, the relation between dietary patterns and chronic diseases in this population has not been well explored.
Objective
We aimed to characterize common dietary patterns among adults from 6 AI communities (N = 580) and assess their relation with BMI, percentage body fat, waist-to-hip ratio, hypertension, and self-reported type 2 diabetes and cardiovascular disease.
Methods
We conducted a baseline assessment of an obesity prevention study (N = 580). Dietary intake data were collected using a modified Block FFQ. Exploratory factor analysis was used to characterize dietary patterns. We used multivariate linear and logistic regression analyses to assess associations between dietary patterns and health outcomes, controlling for age, sex, employment status, smoking status, geographic region, and energy intake.
Results
Five dietary patterns, explaining 81.8% of variance in reported food consumption, were identified: “meat and fried foods,” “processed foods,” “fruits and vegetables,” “sugary snacks,” and “meat alternatives and high-protein foods.” “Those with higher consumption of “meat and fried foods” were associated with higher mean waist-to-hip ratio (0.03; 95% CI: 0.01, 0.04), higher mean BMI (2.45 kg/m2; 95% CI: 0.83, 4.07), and increased odds of being overweight or obese (OR: 2.63; 95% CI: 1.10, 6.31) compared to those with lower consumption of “meat and fried foods.” Higher consumption of “processed foods” was associated with increased odds of self-reported type 2 diabetes (OR: 3.41; 95% CI: 1.31, 8.90). No protective effect of consumption of “fruits and vegetables” was observed, although average consumption was below national recommendation levels.
Conclusions
AI dietary patterns corroborate nutritional concerns previously reported among AI populations. Future interventions should discourage overconsumption of meat, fried foods, and processed foods, and promote consumption of fruits and vegetables to reduce chronic disease burden in this population.
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Affiliation(s)
- Felicia J Setiono
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Brittany Jock
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Angela Trude
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Caroline R Wensel
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Lisa Poirier
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Marla Pardilla
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Joel Gittelsohn
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
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Omotoso GO, Olajide OJ, Gbadamosi IT, Adebayo JO, Enaibe BU, Akinola OB, Owoyele BV. Cuprizone toxicity and Garcinia kola biflavonoid complex activity on hippocampal morphology and neurobehaviour. Heliyon 2019; 5:e02102. [PMID: 31367687 PMCID: PMC6646876 DOI: 10.1016/j.heliyon.2019.e02102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/08/2019] [Accepted: 07/15/2019] [Indexed: 12/16/2022] Open
Abstract
Cuprizone-induced neurotoxicity has been employed to study the biology of remyelination in experimental models of multiple sclerosis. This study was aimed at determining the role of kolaviron, a biflavonoid from Garcinia kola, in mitigating the damaging effects of cuprizone on behaviour and the hippocampus. Twenty-four male albino mice aged 6–8 weeks were categorised into 4 equal groups: Group A (Control) received regular diet; Group B received 200 mg/kg/d of kolaviron in addition to their regular diet; Group C received 0.2% cuprizone diet only, while Group D received both kolaviron and cuprizone diet. The treatment lasted for 35 days after which behavioural tests (Morris water maze, Y maze and open field tests) were conducted and brain tissues were processed for histology, histochemistry (Nissl staining), immunohistochemistry (glial fibrillary acidic protein) and biochemistry (malondialdehyde, superoxide dismutase and glutathione peroxidase). Results showed that cuprizone toxicity led to weight loss, impairment in memory and exploratory drive, oxidative stress, chromatolysis and reactive astrocytosis; meanwhile administration of kolaviron prevented cuprizone-induced weight loss, memory decline, oxidative stress and neuromorphological alterations. In conclusion, administration of kolaviron might be useful in limiting the effects of cuprizone toxicity on the morphology and functions of the hippocampus.
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Affiliation(s)
- G O Omotoso
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Ilorin, P.M.B. 1515, Ilorin 240003, Nigeria
| | - O J Olajide
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Ilorin, P.M.B. 1515, Ilorin 240003, Nigeria
| | - I T Gbadamosi
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Ilorin, P.M.B. 1515, Ilorin 240003, Nigeria
| | - J O Adebayo
- Department of Biochemistry, Faculty of Life Sciences, University of Ilorin, P.M.B. 1515, Ilorin 240003, Nigeria
| | - B U Enaibe
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Ilorin, P.M.B. 1515, Ilorin 240003, Nigeria
| | - O B Akinola
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Ilorin, P.M.B. 1515, Ilorin 240003, Nigeria
| | - B V Owoyele
- Department of Physiology, Faculty of Basic Medical Sciences, University of Ilorin, P.M.B. 1515, Ilorin 240003, Nigeria
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22
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O'Reilly S, Versace V, Mohebbi M, Lim S, Janus E, Dunbar J. The effect of a diabetes prevention program on dietary quality in women with previous gestational diabetes. BMC WOMENS HEALTH 2019; 19:88. [PMID: 31269928 PMCID: PMC6610772 DOI: 10.1186/s12905-019-0788-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/24/2019] [Indexed: 12/12/2022]
Abstract
Background Women with gestational diabetes have low diet quality. We evaluated the effectiveness of a group-based lifestyle modification program for improvement of dietary quality in women with previous gestational diabetes predominantly within their first postnatal year. Methods Women were randomised to intervention (n = 284) or usual care (n = 289). Dietary data was collected at baseline and twelve months using a food frequency questionnaire and recoded into the Australian Recommended Food Score (ARFS). Mixed model analyses investigated the intervention effect on ARFS (per-protocol-set (PPS) excluded women without the minimum intervention exposure). Results Baseline mean total ARFS was low (31.8 ± 8.9, maximum score = 74) and no significant changes were seen in total ARFS (Cohen’s D = − 0.06). 2% reduction in alcohol for intervention (0.05, 0.26) compared with − 1% for usual care (Odds ratio: 0.68; 95%CI 0.46, 0.99). Dairy ARFS sub-category significantly improved (low fat/saturated fat foods) in the intervention group over time compared with usual care for the PPS analysis (dairy + 0.28 in intervention (95%CI 0.08, 0.48) compared with + 0.02 in usual care (95%CI -0.14, 0.18) (group-by-treatment interaction p = 0.05, Cohen’s D = 0.14)). Conclusions Engaging with the intervention improved aspects of diet quality that aligned with minimum intervention exposure, but the total diet quality remains low. Further research is needed to improve diabetes prevention program engagement. Trial registration Australian New Zealand Clinical Trials Registry ANZCTRN12610000338066, April 2010.
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Affiliation(s)
- Sharleen O'Reilly
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
| | - Vincent Versace
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Australia
| | | | - Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Edward Janus
- General Internal Medicine Unit, Western Health and Department of Medicine, Melbourne Medical School - Western Precinct, University of Melbourne, Melbourne, Australia
| | - James Dunbar
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Australia
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23
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Fang J, Gong C, Wan Y, Xu Y, Tao F, Sun Y. Polygenic risk, adherence to a healthy lifestyle, and childhood obesity. Pediatr Obes 2019; 14:e12489. [PMID: 30515989 DOI: 10.1111/ijpo.12489] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 10/14/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Both polygenic and unhealthy lifestyle factors contribute to individual-level risk of obesity during childhood. The extent to which increased polygenic risk can be offset by healthy lifestyle is unknown. OBJECTIVE To examine whether increased polygenic risk of obesity is modified by a healthy lifestyle during childhood. METHODS A total of 997 children (418 boys and 579 girls) who had complete DNA genotyping and body mass index (BMI) were eligible for the study were analyzed from an established prospective puberty cohort. The polygenic risk score (PRS) was computed based on 11 BMI-increasing single nucleotide polymorphisms (SNPs) derived from a published genome-wide association study (GWAS) for child obesity. Seven lifestyle factors were selected to determine a composite healthy lifestyle, such as food responsiveness, slowness in eating, satiety responsiveness, physical activity, screen time, sleep duration, and sugar-sweetened beverages consumption, and which was classified as healthy (<P25 ), intermediate (P25 -P75 ) and unhealthy (>P75 ) lifestyle. Linear and logistic regression analyses were conducted. RESULTS Children carrying additional BMI susceptibility alleles increased the BMI by 0.11 kg/m2 , after adjusting gender, age and socio-economic status (SES). A healthy lifestyle was associated with a substantially lower risk of obesity than an unhealthy lifestyle, regardless of the polygenic risk category. Among children at high polygenic risk, a healthy lifestyle was associated with an 85% lower risk of obesity than an unhealthy lifestyle (odds ratio, 0.15; 95% CI, 0.04 to 0.59; p = 0.007). CONCLUSIONS Our findings suggest that increased polygenic risk might be largely offset by healthy lifestyle as early as in childhood.
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Affiliation(s)
- Jiao Fang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Chun Gong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Yuanyuan Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
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24
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Martin JC, Moran LJ, Teede HJ, Ranasinha S, Lombard CB, Harrison CL. Diet Quality in a Weight Gain Prevention Trial of Reproductive Aged Women: A Secondary Analysis of a Cluster Randomized Controlled Trial. Nutrients 2018; 11:E49. [PMID: 30591672 PMCID: PMC6357112 DOI: 10.3390/nu11010049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/10/2018] [Accepted: 12/18/2018] [Indexed: 11/16/2022] Open
Abstract
Reproductive-aged women are at high risk for obesity development. Limited research exploring weight gain prevention initiatives and associated modifiable risk factors, including diet quality exists. In a secondary analysis of a 12 month, cluster randomized controlled trial for weight gain prevention in reproductive-aged women, we evaluated change in diet quality, macronutrient and micronutrient intake, predictors of change and associations with weight change at follow-up. Forty-one rural towns in Victoria, Australia were randomized to a healthy lifestyle intervention (n = 21) or control (n = 20). Women aged 18⁻50, of any body mass index and without conditions known to affect weight, were recruited. Diet quality was assessed by the Dietary Guideline Index (DGI) and energy, macronutrient, and micronutrient intake as well as anthropometrics (weight; kg) were measured at baseline and 12 months. Results were adjusted for group (intervention/control), town cluster, and baseline values of interest. Of 409 women with matched data at baseline and follow-up, 220 women were included for final analysis after accounting for plausible energy intake. At 12 months, diet quality had improved by 6.2% following the intervention, compared to no change observed in the controls (p < 0.001). Significant association was found between a change in weight and a change in diet quality score over time β -0.66 (95%CI -1.2, -0.12) p = 0.02. The percentage of energy from protein (%) 0.009 (95%CI 0.002, 0.15) p = 0.01 and glycemic index -1.2 (95%CI -2.1, -0.24) p = 0.02 were also improved following the intervention, compared to the control group. Overall, a low-intensity lifestyle intervention effectively improves diet quality, with associated weight gain preventions, in women of reproductive age.
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Affiliation(s)
- Julie C Martin
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
- Endocrinology and Diabetes Units, Monash Health, Melbourne, VIC 3004, Australia.
| | - Sanjeeva Ranasinha
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Catherine B Lombard
- Department of Nutrition and Dietetics, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
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25
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Kolaviron protects the brain in cuprizone-induced model of experimental multiple sclerosis via enhancement of intrinsic antioxidant mechanisms: Possible therapeutic applications? PATHOPHYSIOLOGY 2018; 25:299-306. [DOI: 10.1016/j.pathophys.2018.04.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/20/2018] [Accepted: 04/26/2018] [Indexed: 11/19/2022] Open
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Fulay AP, Rifas-Shiman SL, Oken E, Perng W. Associations of the dietary approaches to stop hypertension (DASH) diet with pregnancy complications in Project Viva. Eur J Clin Nutr 2018; 72:1385-1395. [PMID: 29339829 PMCID: PMC6050156 DOI: 10.1038/s41430-017-0068-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/14/2017] [Accepted: 11/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES The Dietary Approaches to Stop Hypertension (DASH) diet has been shown to improve cardiometabolic outcomes in non-pregnant populations. Little is known regarding the impact of this diet on health during pregnancy. The objective of this research is to examine associations of adherence to the DASH diet with hypertensive disorders of pregnancy (HDP) and other pregnancy outcomes. SUBJECTS/METHODS We conducted analyses with data that came from 1760 women in Project Viva, a Boston-area longitudinal cohort recruited in early pregnancy 1999-2002. We derived a DASH score using data from a food frequency questionnaire (FFQ) administered at median 11.1 weeks gestation. Next, we used multivariable linear regression models that accounted for the woman's age at enrollment, pre-pregnancy body mass index (BMI), education, smoking habits, race/ethnicity, gestational weight gain (GWG) up until the time of the FFQ, and total energy intake to examine associations of the DASH score with HDP, gestational diabetes, preterm delivery (<37 weeks), birth size, and GWG from FFQ to delivery. Models for HDP and GDM were additionally mutually adjusted for each other. Because pre-pregnancy weight status may modify these relationships, we tested for interactions between pre-pregnancy BMI and the DASH score. RESULTS Mean ± SD age of the women was 32.2 ± 4.9 years; 71.9% were white. Overall, the DASH diet score (mean: 24.0, SD: 5.0) was not associated with any of the pregnancy outcomes or complications. However, we found a positive association between the DASH diet and subsequent GWG among women who were obese before pregnancy (0.19 [95% CI: 0.05, 0.34], P ≤ 0.05 kg higher GWG per 1 unit DASH score). CONCLUSIONS Adherence to DASH diet during early pregnancy does not appear to be protective against HDP or other adverse pregnancy outcomes.
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Affiliation(s)
- Aarohee P Fulay
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 41809, USA
| | - Sheryl L Rifas-Shiman
- The Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute, 401 Park Drive, Boston, MA, 02215, USA
| | - Emily Oken
- The Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute, 401 Park Drive, Boston, MA, 02215, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Wei Perng
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 41809, USA.
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 41809, USA.
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27
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DeVon HA, Vuckovic K, Burke LA, Mirzaei S, Breen K, Robinson N, Zegre-Hemsey J. What's the Risk? Older Women Report Fewer Symptoms for Suspected Acute Coronary Syndrome than Younger Women. Biores Open Access 2018; 7:131-138. [PMID: 30237934 PMCID: PMC6146306 DOI: 10.1089/biores.2018.0020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The purpose of the study was to determine whether older (≥65 years) and younger (<65 years) women presenting to the emergency department (ED) with symptoms suggestive of acute coronary syndrome (ACS) varied on risk factors, comorbid conditions, functional status, and symptoms that have implications for emergent cardiac care. Women admitted to five EDs were enrolled. The ACS Symptom Checklist was used to measure symptoms. Comorbid conditions and functional status were measured with the Charlson Comorbidity Index and Duke Activity Status Index. Logistic regression models were used to evaluate symptom differences in older and younger women adjusting for ACS diagnosis, functional status, body mass index (BMI), and comorbid conditions. Analyses were stratified by age, and interaction of symptom by age was tested. Four hundred women were enrolled. Mean age was 61.3 years (range 21–98). Older women (n = 163) were more likely to have hypertension, hypercholesterolemia, never smoked, lower BMI, more comorbid conditions, and lower functional status. Younger women (n = 237) were more likely to be members of minority groups, be college-educated, and have a non-ACS discharge diagnosis. Younger women had higher odds of experiencing chest discomfort, chest pain, chest pressure, shortness of breath, nausea, sweating, and palpitations. Lack of chest symptoms and shortness of breath (key symptoms triggering a decision to seek emergency care) may cause older women to delay seeking treatment, placing them at risk for poorer outcomes. Younger African American women may require more comprehensive risk reduction strategies and symptom management.
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Affiliation(s)
- Holli A DeVon
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Karen Vuckovic
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Larisa A Burke
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Sahereh Mirzaei
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Katherine Breen
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Nadia Robinson
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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Abstract
PURPOSE OF THE REVIEW Women with a history of gestational diabetes mellitus (GDM) have an alarmingly high risk of developing type 2 diabetes (T2D); yet, mechanisms underlying this progression are largely unknown. RECENT FINDINGS Clinical characteristics of a GDM pregnancy and postpartum metabolomics may contribute to risk prediction of T2D to identify those women at highest risk of progression and need for intervention. Evidence for effective postpartum lifestyle interventions from observational studies include adherence to a healthy dietary pattern, increasing physical activity, and maintaining a healthy body weight. Larger clinical trials with greater participant engagement are warranted to confirm the effectiveness of lifestyle interventions in women with recent GDM. Research is needed to refine prediction models of T2D after GDM, and to determine the most effective strategies to delay or prevent T2D onset. Incorporating novel biomarkers in the postpartum period, such as metabolomics, could offer a powerful approach.
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Affiliation(s)
- Deirdre K Tobias
- Division of Preventive Medicine, 900 Commonwealth Avenue, Boston, MA, 02215, USA.
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29
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Wu PY, Lin MY, Tsai PS. Alternate healthy eating index and risk of depression: A meta-analysis and systemematic review. Nutr Neurosci 2018; 23:101-109. [PMID: 29804517 DOI: 10.1080/1028415x.2018.1477424] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: The alternate healthy eating index has been associated with depression. However, results reported in the literature are inconsistent. The present meta-analysis determined the association between the AHEI or AHEI-2010 and depression in adults without chronic disease.Methods: Nine electronic databases and the reference lists of identified studies were systematically searched for studies published up to December 2016. Articles examining the association between depression and the AHEI or AHEI-2010 in adults were included.Results: We identified eight observational studies with 10 effect sizes involving a total of 38,360 participants. When both the AHEI and AHEI-2010 were considered, the dietary index score was associated with a significant reduction in depression risk (odds ratio OR=0.70, 95% confidence interval CI=0.57-0.87). However, the subgroup analysis indicated that the AHEI-2010 (OR=0.69, 95% CI=0.56-0.89), but not the AHEI (OR=0.60, 95% CI=0.30-1.17), was significantly associated with reduced odds of depression. The heterogeneity among the included studies was significantly high (Q=48.9, P<0.01, I2=81.60%).Discussion: Our findings suggest that the AHEI-2010 is associated with a reduction in depression risk. However, well-designed randomized controlled trials must be conducted to confirm the causal relationship between the AHEI-2010 and depression.
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Affiliation(s)
- Pei-Yu Wu
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan 250 Wu-Hsing St., Taipei 110, Taipei, Taiwan
| | - Mei-Yu Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan 250 Wu-Hsing St., Taipei 110, Taipei, Taiwan
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan 250 Wu-Hsing St., Taipei 110, Taipei, Taiwan
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30
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Mercier R, Perron J, Weisnagel SJ, Robitaille J. Associations between fruit and vegetables intake and abnormal glucose tolerance among women with prior gestational diabetes mellitus. Eur J Nutr 2018; 58:689-696. [PMID: 29569007 DOI: 10.1007/s00394-018-1669-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 03/19/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Women with prior gestational diabetes mellitus (GDM) are at higher risk of type 2 diabetes (T2D). The aim of this study was to investigate the association between fruit and vegetables (FV) intake and abnormal glucose tolerance (AGT) among women with prior GDM. METHODS A total of 281 women with prior GDM have been recruited a mean of 6 years after their pregnancy in this cohort study. FV intake was obtained with a validated food frequency questionnaire (FFQ). Anthropometric and glycemic components were measured during their clinical visit and women were stratified according to normal glucose tolerance (NGT) or AGT. RESULTS A cross-sectional analysis showed that a total of 155 women had NGT and 126 AGT. Women with AGT had significantly lower FV (6.5 ± 0.2) and vegetables servings (3.9 ± 0.2) and tended to have lower fruit servings (2.6 ± 0.2) than women with NGT (7.4 ± 0.2, 4.5 ± 0.2 and 3.0 ± 0.1, respectively) (p = 0.001, p = 0.04 and p = 0.10, respectively, adjusted for age and BMI). FV intake, per one serving increase, was associated with a reduced likelihood of having AGT [OR = 0.88 (0.81-0.97) after adjustment for age and BMI]. Vegetables or fruit intake tended to be associated with a reduced likelihood of having AGT [OR = 0.88 (0.78-1.00) and OR = 0.88 (0.76-1.02), respectively, after adjustment for age and BMI]. CONCLUSIONS Higher intake of FV may be associated with a lower likelihood of AGT among women with prior GDM. Further studies are needed to confirm these results in this high-risk population.
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Affiliation(s)
- Roxanne Mercier
- School of Nutrition, Laval University, 2425 rue de l'Agriculture, Quebec City, G1V 0A6, Canada.,Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 boulevard Hochelaga, Quebec City, G1V 0A6, Canada
| | - Julie Perron
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 boulevard Hochelaga, Quebec City, G1V 0A6, Canada
| | - S John Weisnagel
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, 2705 boulevard Laurier, Quebec City, G1V 4G2, Canada.,Diabetes Research Unit, Laval University Medical Research Center, 2705 boulevard Laurier, Quebec City, G1V 4G2, Canada
| | - Julie Robitaille
- School of Nutrition, Laval University, 2425 rue de l'Agriculture, Quebec City, G1V 0A6, Canada. .,Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 boulevard Hochelaga, Quebec City, G1V 0A6, Canada. .,Endocrinology and Nephrology Axis, CHU de Québec Research Center, 2705 boulevard Laurier, Quebec City, G1V 4G2, Canada.
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31
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Wang T, Heianza Y, Sun D, Huang T, Ma W, Rimm EB, Manson JE, Hu FB, Willett WC, Qi L. Improving adherence to healthy dietary patterns, genetic risk, and long term weight gain: gene-diet interaction analysis in two prospective cohort studies. BMJ 2018; 360:j5644. [PMID: 29321156 PMCID: PMC5759092 DOI: 10.1136/bmj.j5644] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate whether improving adherence to healthy dietary patterns interacts with the genetic predisposition to obesity in relation to long term changes in body mass index and body weight. DESIGN Prospective cohort study. SETTING Health professionals in the United States. PARTICIPANTS 8828 women from the Nurses' Health Study and 5218 men from the Health Professionals Follow-up Study. EXPOSURE Genetic predisposition score was calculated on the basis of 77 variants associated with body mass index. Dietary patterns were assessed by the Alternate Healthy Eating Index 2010 (AHEI-2010), Dietary Approach to Stop Hypertension (DASH), and Alternate Mediterranean Diet (AMED). MAIN OUTCOME MEASURES Five repeated measurements of four year changes in body mass index and body weight over follow-up (1986 to 2006). RESULTS During a 20 year follow-up, genetic association with change in body mass index was significantly attenuated with increasing adherence to the AHEI-2010 in the Nurses' Health Study (P=0.001 for interaction) and Health Professionals Follow-up Study (P=0.005 for interaction). In the combined cohorts, four year changes in body mass index per 10 risk allele increment were 0.07 (SE 0.02) among participants with decreased AHEI-2010 score and -0.01 (0.02) among those with increased AHEI-2010 score, corresponding to 0.16 (0.05) kg versus -0.02 (0.05) kg weight change every four years (P<0.001 for interaction). Viewed differently, changes in body mass index per 1 SD increment of AHEI-2010 score were -0.12 (0.01), -0.14 (0.01), and -0.18 (0.01) (weight change: -0.35 (0.03), -0.36 (0.04), and -0.50 (0.04) kg) among participants with low, intermediate, and high genetic risk, respectively. Similar interaction was also found for DASH but not for AMED. CONCLUSIONS These data indicate that improving adherence to healthy dietary patterns could attenuate the genetic association with weight gain. Moreover, the beneficial effect of improved diet quality on weight management was particularly pronounced in people at high genetic risk for obesity.
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Affiliation(s)
- Tiange Wang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
- Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Dianjianyi Sun
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wenjie Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - JoAnn E Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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32
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Tobias DK, Stuart JJ, Li S, Chavarro J, Rimm EB, Rich-Edwards J, Hu FB, Manson JE, Zhang C. Association of History of Gestational Diabetes With Long-term Cardiovascular Disease Risk in a Large Prospective Cohort of US Women. JAMA Intern Med 2017; 177:1735-1742. [PMID: 29049820 PMCID: PMC5820722 DOI: 10.1001/jamainternmed.2017.2790] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
IMPORTANCE Previous studies identify gestational diabetes (GD) as a risk factor for intermediate markers of cardiovascular disease (CVD) risk; however, few are prospective, evaluate hard CVD end points, or account for shared risk factors including body weight and lifestyle. OBJECTIVE To prospectively evaluate history of GD in relation to incident CVD risk. DESIGN, SETTING, AND PARTICIPANTS The Nurses' Health Study II (NHS II) is an observational cohort study of US female nurses established in 1989, with ongoing follow-up. Biennial questionnaires updated behavioral characteristics, health outcomes, and lifestyle factors. Multivariable Cox models estimated the hazard ratio (HR) and 95% CI for CVD risk. We included 89 479 women who reported at least 1 pregnancy and were free of CVD and cancer at baseline. Follow-up through May 31, 2015, was complete for more than 90% of eligible participants. EXPOSURES History of GD was self-reported at baseline (1989) via questionnaire and updated every 2 years. MAIN OUTCOMES AND MEASURES We observed 1161 incident self-reported nonfatal or fatal myocardial infarction or stroke, confirmed via medical records. RESULTS Participants had a mean (SD) age of 34.9 (4.7) years. Adjusting for age, prepregnancy body mass index, and other covariates, GD vs no GD was associated with subsequent CVD (HR, 1.43; 95% CI, 1.12-1.81). Additional adjustment for weight gain since pregnancy and updated lifestyle factors attenuated the association (HR, 1.29; 95% CI, 1.01-1.65). Classifying GD by progression to T2D in relation to CVD risk indicated a positive association for GD with progression to T2D vs no GD or T2D (HR, 4.02; 95% CI, 1.94-8.31), and an attenuated relationship for GD only (HR, 1.30; 95% CI, 0.99-1.71). CONCLUSIONS AND RELEVANCE Gestational diabetes was positively associated with CVD later in life, although the absolute rate of CVD in this younger cohort of predominantly white women was low. This relationship is possibly mediated in part by subsequent weight gain and lack of healthy lifestyle.
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Affiliation(s)
- Deirdre K Tobias
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jennifer J Stuart
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Connors Center for Women's Health and Gender Biology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shanshan Li
- Boston University School of Medicine, Boston, Massachusetts
| | - Jorge Chavarro
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eric B Rimm
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Janet Rich-Edwards
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Connors Center for Women's Health and Gender Biology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Frank B Hu
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Connors Center for Women's Health and Gender Biology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Cuilin Zhang
- Boston University School of Medicine, Boston, Massachusetts.,Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
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33
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Pan J, Pan Q, Chen Y, Zhang H, Zheng X. Efficacy of probiotic supplement for gestational diabetes mellitus: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2017; 32:317-323. [PMID: 28927313 DOI: 10.1080/14767058.2017.1376318] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Probiotic supplement might be beneficial for gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of probiotic supplement in gestational diabetes mellitus. METHODS PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of probiotic supplement in gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome were fasting serum insulin and fasting plasma glucose. Meta-analysis was performed using the fixed-effect or random-effect model. RESULTS Six RCTs involving 830 patients were included in the meta-analysis. Overall, compared with control intervention in gestational diabetes mellitus, probiotic supplementation intervention was found to significantly reduce fasting serum insulin (Std. mean difference = -0.95; 95% CI = -1.73 to -0.17; p < .00001) and HOMA-IR (Std. mean difference = -1.12; 95% CI = -2.05 to -0.18; p = .02), but showed no substantial impact on fasting plasma glucose (Std. mean difference = -0.49; 95% CI = -1.05-0.08; p = .09), gestational age (Std. mean difference = 0.07; 95% CI = -0.20-0.34; p = .63), and gestational weight (Std. mean difference = -0.11; 95% CI = -0.38-0.16; p = .43). CONCLUSIONS Compared with control intervention in gestational diabetes mellitus, probiotic supplementation was found to significantly reduce insulin resistance (HOMA-IR) and fasting serum insulin, but had no substantial influence on fasting plasma glucose, gestational age and gestational weight.
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Affiliation(s)
- Jiajia Pan
- a Department of Obstetrics and Gynecology , Wenzhou People's Hospital, Wenzhou Maternal and Child Health Hospital , Wenzhou Zhejiang , PR China
| | - Qiangwei Pan
- a Department of Obstetrics and Gynecology , Wenzhou People's Hospital, Wenzhou Maternal and Child Health Hospital , Wenzhou Zhejiang , PR China
| | - Yumei Chen
- a Department of Obstetrics and Gynecology , Wenzhou People's Hospital, Wenzhou Maternal and Child Health Hospital , Wenzhou Zhejiang , PR China
| | - Hongping Zhang
- a Department of Obstetrics and Gynecology , Wenzhou People's Hospital, Wenzhou Maternal and Child Health Hospital , Wenzhou Zhejiang , PR China
| | - Xiaodong Zheng
- a Department of Obstetrics and Gynecology , Wenzhou People's Hospital, Wenzhou Maternal and Child Health Hospital , Wenzhou Zhejiang , PR China
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Martin JC, Moran LJ, Teede HJ, Ranasinha S, Lombard CB, Harrison CL. Exploring Diet Quality between Urban and Rural Dwelling Women of Reproductive Age. Nutrients 2017; 9:E586. [PMID: 28594351 PMCID: PMC5490565 DOI: 10.3390/nu9060586] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 11/29/2022] Open
Abstract
Health disparities, including weight gain and obesity exist between urban and rural dwelling women. The primary aim was to compare diet quality in urban and rural women of reproductive age, and secondary analyses of the difference in macronutrient and micronutrient intake in urban and rural women, and the predictors of diet quality. Diet quality was assessed in urban (n = 149) and rural (n = 394) women by a modified version of the Dietary Guideline Index (DGI) energy, macronutrient and micronutrient intake from a food frequency questionnaire (FFQ) and predictors of diet quality. Diet quality did not significantly differ between urban and rural women (mean ± standard deviation (SD), 84.8 ± 15.9 vs. 83.9 ± 16.5, p = 0.264). Rural women reported a significantly higher intake of protein, fat, saturated fat, monounsaturated fat, cholesterol and iron and a higher score in the meat and meat alternatives component of the diet quality tool in comparison to urban women. In all women, a higher diet quality was associated with higher annual household income (>$Australian dollar (AUD) 80,000 vs. <$AUD80,000 p = 0.013) and working status (working fulltime/part-time vs. unemployed p = 0.043). Total diet quality did not differ in urban and rural women; however, a higher macronutrient consumption pattern was potentially related to a higher lean meat intake in rural women. Women who are unemployed and on a lower income are an important target group for future dietary interventions aiming to improve diet quality.
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Affiliation(s)
- Julie C Martin
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
- Endocrinology and Diabetes Units, Monash Health, Melbourne 3004, Australia.
| | - Sanjeeva Ranasinha
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
| | - Catherine B Lombard
- Department of Nutrition and Dietetics, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
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