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Nguyen É, Wong K, Lalanne-Mistrih ML, Rabasa-Lhoret R, Brazeau AS. Association between low-carbohydrate-diet score, glycemia and cardiovascular risk factors in adults with type 1 diabetes. Nutr Metab Cardiovasc Dis 2024; 34:2143-2154. [PMID: 38866607 DOI: 10.1016/j.numecd.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND AND AIMS Low-carbohydrate-diets (LCDs) are gaining popularity in individuals with type 1 diabetes (T1D). However, the impact of such diets on glycemia and cardiovascular risk factors is debated. This study aims to evaluate associations between low-carbohydrate intakes using LCD score with glycemia and cardiovascular risk factors (lipid profile) in adults with T1D or LADA in Québec, Canada. METHODS AND RESULTS This is a cross-sectional study using data collected in the BETTER registry (02/2019 and 04/2021) including self-reported 24-h dietary recalls to calculate LCD scores, waist circumference, level-2 and level-3 hypoglycemic episodes and measured biochemical data (HbA1c, LDL-cholesterol and non-HDL-cholesterol). Participants were divided into quartiles (Q) based on LCD scores. Two hundred eighty-five adults (aged 48.2 ± 15.0 years; T1D duration 25.9 ± 16.2 years) were included. Categorical variables underwent Chi-squared/Fisher's Exact tests, while continuous variables underwent ANOVA tests. Mean carbohydrate intake ranged from 31.2 ± 6.9% (Q1) to 56.5 ± 6.8% (Q4) of total daily energy. Compared to Q4, more people in Q1 reported HbA1c ≤ 7% [≤53.0 mmol/mol] (Q1: 53.4% vs. Q4: 29.4%; P = 0.011). The same results were found in the models adjusted for age, sex and T1D duration. A greater proportion of participants in Q1 never experienced level-3 hypoglycemia compared to Q3 (Q1: 60.0% vs. Q3: 31.0%; P = 0.004). There were no differences across quartiles for frequency of level-2 hypoglycemia events and lipid profile (LDL-cholesterol and non-HDL-cholesterol). CONCLUSIONS Low-carbohydrate intakes are associated with higher probabilities of reaching HbA1c target and of never having experienced level-3 hypoglycemia. No associations with level-2 hypoglycemia frequency, nor cardiovascular risk factors were observed.
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Affiliation(s)
- Élisabeth Nguyen
- Montreal Clinical Research Institute, 110 Pine Ave W, Montreal, Quebec, H2W 1R7, Canada; Department of Nutrition, Faculty of Medicine, University of Montreal, 2405 Chem. De La Côte-Sainte-Catherine, Montreal, Quebec, H3T 1A8, Canada.
| | - Kayla Wong
- Montreal Clinical Research Institute, 110 Pine Ave W, Montreal, Quebec, H2W 1R7, Canada; School of Human Nutrition, McGill University, 21111 Lakeshore Dr., Sainte-Anne-de-Bellevue, Quebec, H9X 2V9, Canada.
| | - Marie-Laure Lalanne-Mistrih
- Montreal Clinical Research Institute, 110 Pine Ave W, Montreal, Quebec, H2W 1R7, Canada; Department of Nutrition, "UTDN-CSO", University Hospital of Guadeloupe, Rte de Chauvel, Les Abymes, Guadeloupe, France; Faculty of Medicine, University of Antilles, 6FQ8+39G, Pointe-à-Pitre, Guadeloupe, France.
| | - Rémi Rabasa-Lhoret
- Montreal Clinical Research Institute, 110 Pine Ave W, Montreal, Quebec, H2W 1R7, Canada; Department of Nutrition, Faculty of Medicine, University of Montreal, 2405 Chem. De La Côte-Sainte-Catherine, Montreal, Quebec, H3T 1A8, Canada; Department of Endocrinology, University of Montreal Health Center, 1051 Rue Sanguinet, Montréal, Quebec, H2X 3E4, Canada; Montreal Diabetes Research Centre, 900 Saint-Denis, Montreal, Quebec, H2X 0A9, Canada.
| | - Anne-Sophie Brazeau
- Montreal Clinical Research Institute, 110 Pine Ave W, Montreal, Quebec, H2W 1R7, Canada; School of Human Nutrition, McGill University, 21111 Lakeshore Dr., Sainte-Anne-de-Bellevue, Quebec, H9X 2V9, Canada; Montreal Diabetes Research Centre, 900 Saint-Denis, Montreal, Quebec, H2X 0A9, Canada.
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Xue L, Chen X, Sun J, Fan M, Qian H, Li Y, Wang L. Maternal Dietary Carbohydrate and Pregnancy Outcomes: Quality over Quantity. Nutrients 2024; 16:2269. [PMID: 39064712 PMCID: PMC11280101 DOI: 10.3390/nu16142269] [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: 06/06/2024] [Revised: 06/30/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Dietary nutrition plays a crucial role in determining pregnancy outcomes, with poor diet being a major contributor to pregnancy metabolic syndrome and metabolic disorders in offspring. While carbohydrates are essential for fetal development, the excessive consumption of low-quality carbohydrates can increase the risk of pregnancy complications and have lasting negative effects on offspring development. Recent studies not only highlighted the link between carbohydrate intake during pregnancy, maternal health, and offspring well-being, but also suggested that the quality of carbohydrate foods consumed is more critical. This article reviews the impacts of low-carbohydrate and high-carbohydrate diets on pregnancy complications and offspring health, introduces the varied physiological effects of different types of carbohydrate consumption during pregnancy, and emphasizes the importance of both the quantity and quality of carbohydrates in nutritional interventions during pregnancy. These findings may offer valuable insights for guiding dietary interventions during pregnancy and shaping the future development of carbohydrate-rich foods.
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Affiliation(s)
- Lamei Xue
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Xiaofang Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Juan Sun
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Mingcong Fan
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Haifeng Qian
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Yan Li
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Li Wang
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
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Li Y, Li Y, Wang C, Mao Z, Huo W, Xing W, Li J, Yang TY, Li L. Association of low-carbohydrate diet scores and type 2 diabetes in Chinese rural adults: The Henan Rural Cohort Study. Endocrine 2024; 84:459-469. [PMID: 38324107 DOI: 10.1007/s12020-023-03602-5] [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: 08/30/2023] [Accepted: 11/07/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To investigate the association between low-carbohydrate diet scores (LCDs) and the risk of type 2 diabetes in rural China. METHODS A total of 38,100 adults were included in the Henan Rural Cohort Study. Macronutrient intake was assessed via a validated food-frequency questionnaire to create low-carbohydrate diet (LCD) scores. Multivariate logistic regression models and subgroup analysis were performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI). RESULTS After multivariable adjustment, participants with a high total low-carbohydrate diet score have a high risk of T2D (extreme-quartile OR = 1.23, 95% CI: 1.04-1.41; P = 0.007), whereas plant-based LCD score is not related to T2D risk. Among individuals with a BMI < 24 (extreme-quartile OR = 1.22, 95% CI: 1.01-1.47; P < 0.001) or high levels of physical activity (extreme-quartile OR = 1.42, 95% CI: 1.17-1.72; P < 0.001), the animal-based LCD score is positively correlated with the risk of T2D. CONCLUSION Among Chinese rural populations, high-fat-low carbohydrate diet is associated with an increased risk of type 2 diabetes. High intake of animal protein and fat also increases T2D risk in those who are overweight or have high physical activity.
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Affiliation(s)
- Yan Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhenxing Mao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wenqian Huo
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wenguo Xing
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jia Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Tian Yu Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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Mavroeidi I, Manta A, Asimakopoulou A, Syrigos A, Paschou SA, Vlachaki E, Nastos C, Kalantaridou S, Peppa M. The Role of the Glycemic Index and Glycemic Load in the Dietary Approach of Gestational Diabetes Mellitus. Nutrients 2024; 16:399. [PMID: 38337683 PMCID: PMC10857473 DOI: 10.3390/nu16030399] [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: 12/14/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a common metabolic disorder that often develops during pregnancy, characterized by glucose intolerance and insulin resistance (IR). To ensure the well-being of both the mother and the fetus, the body undergoes multiple metabolic and immunological changes that result in peripheral IR and, under certain hereditary or acquired abnormalities, GDM in predisposed women. The adverse short- and long-term effects of GDM impact both the mother and the fetus. Nutrition seems to play an important role to prevent GDM or improve its evolution. An emphasis has been given to the proportion of carbohydrates (CHO) relative to protein and lipids, as well as dietary patterns, in GDM. The effects of CHO on postprandial glucose concentrations are reflected in the glycemic index (GI) and glycemic load (GL). Diets rich in GI and GL may induce or exacerbate IR, whereas diets low in GI and GL appear to enhance insulin sensitivity and improve glycemic control. These positive outcomes may be attributed to direct interactions with insulin and glucose homeostasis or indirect effects through improved body composition and weight management. This comprehensive narrative review aims to explore the significance of nutrition, with a focus on the critical evaluation of GI and GL in the dietary management of women with GDM.
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Affiliation(s)
- Ioanna Mavroeidi
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Aspasia Manta
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Athina Asimakopoulou
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
| | - Alexandros Syrigos
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Efthimia Vlachaki
- Hematological Laboratory, 2nd Department of Internal Medicine, Hippokrateion Hospital, Aristotle University, 54640 Thessaloniki, Greece
| | - Constantinos Nastos
- 3rd Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Sophia Kalantaridou
- Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Melpomeni Peppa
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
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Semnani-Azad Z, Gaillard R, Hughes AE, Boyle KE, Tobias DK, Perng W. Precision stratification of prognostic risk factors associated with outcomes in gestational diabetes mellitus: a systematic review. COMMUNICATIONS MEDICINE 2024; 4:9. [PMID: 38216688 PMCID: PMC10786838 DOI: 10.1038/s43856-023-00427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/12/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND The objective of this systematic review is to identify prognostic factors among women and their offspring affected by gestational diabetes mellitus (GDM), focusing on endpoints of cardiovascular disease (CVD) and type 2 diabetes (T2D) for women, and cardiometabolic profile for offspring. METHODS This review included studies published in English language from January 1st, 1990, through September 30th, 2021, that focused on the above outcomes of interest with respect to sociodemographic factors, lifestyle and behavioral characteristics, traditional clinical traits, and 'omics biomarkers in the mothers and offspring during the perinatal/postpartum periods and across the lifecourse. Studies that did not report associations of prognostic factors with outcomes of interest among GDM-exposed women or children were excluded. RESULTS Here, we identified 109 publications comprising 98 observational studies and 11 randomized-controlled trials. Findings indicate that GDM severity, maternal obesity, race/ethnicity, and unhealthy diet and physical activity levels predict T2D and CVD in women, and greater cardiometabolic risk in offspring. However, using the Diabetes Canada 2018 Clinical Practice Guidelines for studies, the level of evidence was low due to potential for confounding, reverse causation, and selection biases. CONCLUSIONS GDM pregnancies with greater severity, as well as those accompanied by maternal obesity, unhealthy diet, and low physical activity, as well as cases that occur among women who identify as racial/ethnic minorities are associated with worse cardiometabolic prognosis in mothers and offspring. However, given the low quality of evidence, prospective studies with detailed covariate data collection and high fidelity of follow-up are warranted.
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Affiliation(s)
- Zhila Semnani-Azad
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Romy Gaillard
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Alice E Hughes
- Faculty of Health and Life Sciences, University of Exeter Medical School, Exeter, UK
| | - Kristen E Boyle
- Department of Pediatrics and the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Deirdre K Tobias
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Wei Perng
- Department of Epidemiology and the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Titcomb TJ, Liu B, Wahls TL, Snetselaar LG, Shadyab AH, Tabung FK, Saquib N, Arcan C, Tinker LF, Wallace RB, Bao W. Comparison of the Ketogenic Ratio of Macronutrients With the Low-Carbohydrate Diet Score and Their Association With Risk of Type 2 Diabetes in Postmenopausal Women: A Secondary Analysis of the Women's Health Initiative. J Acad Nutr Diet 2023; 123:1152-1161.e4. [PMID: 36549565 PMCID: PMC10279805 DOI: 10.1016/j.jand.2022.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 10/27/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Previous attempts to identify low-carbohydrate diets (LCDs) in epidemiological studies relied on the LCD Score, which is unable to identify ketogenic dieters. Ketogenic ratios of macronutrients are clinical equations proposed to predict ketogenic diets; however, their utility in epidemiological studies is unknown. OBJECTIVE To determine the number of participants consuming a ketogenic diet, compare ketogenic ratios to the LCD Score, and evaluate their association with type 2 diabetes mellitus (T2DM). DESIGN Secondary analysis of the Women's Health Initiative with 17.9 ± 6.03 years of follow-up. Baseline food frequency questionnaires were used to calculate the ketogenic ratio as follows: (0.9 × grams fat + 0.46 × grams protein) / (0.1 × grams fat + 0.58 × grams protein + grams net carbohydrate), a value ≥1.5 is the minimum threshold for a ketogenic diet. PARTICIPANTS/SETTING One hundred twenty-five nine hundred eighty-two postmenopausal women without diabetes (aged 50 to 79 years) enrolled in the multicenter Women's Health Initiative observational study and clinical trials were included. MAIN OUTCOME MEASURES Risk of self-reported incident T2DM. STATISTICAL ANALYSES PERFORMED Cox proportional hazards models, adjusted for age, race, ethnicity, education, income, health insurance, relationship status, geographic region, Women's Health Initiative study component, female hormone use, smoking status, alcohol use, recreational physical activity, total energy intake, diet quality, body mass index, hyperlipidemia, and hypertension, were used to compare hazard ratios and 95% CIs for T2DM among quintiles of the ketogenic ratio. RESULTS A total of 18,775 incident cases of T2DM occurred. The median ketogenic ratio was 0.35 (interquartile range 0.28 to 0.42) and 15 individuals (0.01%) exceeded the threshold for a ketogenic diet. Higher ketogenic ratio quintiles were associated with increased risk of T2DM in a dose-dependent manner. Comparing extreme quintiles of the ketogenic ratio, the hazard ratio for diabetes was 1.24 (95% CI 1.18 to 1.31; Ptrend < 0.001) in fully adjusted models. Similarly, comparing extreme quintiles, the hazard ratio for diabetes was 1.36 (95% CI 1.29 to 1.43; Ptrend < 0.001) for the LCD Score and 1.13 (95% CI 1.07 to 1.19; Ptrend < 0.001) for the simplified ketogenic ratio in fully adjusted models. CONCLUSIONS Increasing ketogenic ratio values are associated with increased risk of T2DM and align well with LCD Scores; however, too few participants consumed a ketogenic diet to determine its association with T2DM.
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Affiliation(s)
- Tyler J Titcomb
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa; Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa; Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa.
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Terry L Wahls
- Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Linda G Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California
| | - Fred K Tabung
- Department of Internal Medicine, College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Nazmus Saquib
- Department of Research, Sulaiman AlRajhi University, Al Bukayriah, Saudi Arabia
| | - Chrisa Arcan
- Department of Family Medicine & Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Lesley F Tinker
- Department of Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Robert B Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa; Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa; Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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Hasbullah FY, Mohd Yusof BN, Shyam S, Abdul Ghani R, Mohamed Khir HI. Dietary Patterns Associated with Abnormal Glucose Tolerance following Gestational Diabetes Mellitus: The MyNutritype Study. Nutrients 2023; 15:2819. [PMID: 37375723 DOI: 10.3390/nu15122819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/14/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Abnormal glucose tolerance (AGT), which includes type 2 diabetes and pre-diabetes, is highly prevalent in women post gestational diabetes mellitus (post-GDM). Dietary patterns have been associated with the risk of developing AGT in women post-GDM, but evidence in Asian populations is sparse. This study aimed to determine the association between a posteriori dietary patterns and AGT in women post-GDM. This cross-sectional study recruited 157 women post-GDM (mean age 34.8 years) from Seri Kembangan Health Clinic and Universiti Putra Malaysia. AGT was diagnosed according to the Malaysian Clinical Practice Guidelines using a 75 g 2 h oral glucose tolerance test or HbA1c. Food intake was assessed using the 2014 Malaysian Adult Nutrition Survey food frequency questionnaire. Five dietary patterns were derived using principal component analysis: 'Unhealthy', 'Fish-eggs-fruits-vegetables', 'Cereals-confectionaries', 'Legumes-dairy', and 'Meat-sugar-sweetened-beverages'. After adjusting for sociodemographic characteristics and total energy intake, the 'Cereals-confectionaries' dietary pattern was significantly associated with AGT (adjusted odds ratio 1.536, p = 0.049). Targeted lifestyle modification, including dietary intervention, for women post-GDM is warranted to reduce their risk of AGT and its complications.
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Affiliation(s)
- Farah Yasmin Hasbullah
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Barakatun-Nisak Mohd Yusof
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Diabetes Research Unit, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Institute for Social Science Studies, Putra Infoport, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Sangeetha Shyam
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43204 Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Centre for Translational Research, IMU Institute for Research and Development (IRDI), International Medical University (IMU), Kuala Lumpur 57000, Malaysia
| | - Rohana Abdul Ghani
- Department of Internal Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
- The Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
| | - Hannah Izzati Mohamed Khir
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
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Karbasi S, Binabaj MM, Khorasanchi Z, Bideh M, Zarban A, Bahrami A. Association between adherence to a low carbohydrate dietary (LCD) pattern with breast milk characteristics and oxidative markers in infants' urine: a cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:40. [PMID: 37149671 PMCID: PMC10163718 DOI: 10.1186/s41043-023-00381-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/18/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Breast milk (BM) is a dynamic fluid that varies over time and between women. The variations in BM components are most likely associated with maternal diet quality. This study aimed to assess adherence to a low carbohydrate dietary (LCD) pattern with oxidative stress markers of BM characteristics and infants' urine. MATERIALS AND METHODS In this cross-sectional study 350 breastfeeding mothers and their infants were recruited. BM samples were collected from mothers, and urine specimens were obtained from each infant. To evaluate LCD scores, subjects were divided into 10 deciles according to the percent of energy obtained from carbohydrates, proteins, and fats. Determination of total antioxidant activity was conducted using the ferric reducing antioxidant power (FRAP), 2, 2'-diphenyl-1-picrylhydrazyl (DPPH), thiobarbituric acid reactive substances (TBARs), and Ellman's assay. Biochemical assays of samples including calcium, total protein, and triglyceride level were also performed using commercial kits. RESULTS Participants with the greatest LCD pattern adherence were placed into the last quartile (Q4), and those with the minimum LCD were in the first quartile (Q1). Individuals in the highest LCD quartile had significantly higher levels of milk FRAP, thiol, and protein, as well as infant urinary FRAP and lower milk MDA levels than those in the lowest quartile. Multivariate linear regression analyses indicated that higher score of the LCD pattern was associated with a higher level of milk thiol, protein, and lower level of milk MDA (p < 0.05). CONCLUSION Our findings show that adherence to a LCD, as defined by a low level of carbohydrates in daily food intake, is linked with improved BM quality and markers of oxidative stress in infant urine.
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Affiliation(s)
- Samira Karbasi
- Department of Molecular Medicine, School of Medicine, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Maryam Moradi Binabaj
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Zahra Khorasanchi
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Milad Bideh
- Department of Biochemistry, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Asghar Zarban
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.
- Clinical Biochemistry Department, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran.
| | - Afsane Bahrami
- Clinical Research Development Unit of Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
- Clinical Research Unit, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
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Semnani-Azad Z, Gaillard R, Hughes AE, Boyle KE, Tobias DK, Perng W. Predictors and risk factors of short-term and long-term outcomes among women with gestational diabetes mellitus (GDM) and their offspring: Moving toward precision prognosis? MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.14.23288199. [PMID: 37131686 PMCID: PMC10153333 DOI: 10.1101/2023.04.14.23288199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
As part of the American Diabetes Association Precision Medicine in Diabetes Initiative (PMDI) - a partnership with the European Association for the Study of Diabetes (EASD) - this systematic review is part of a comprehensive evidence evaluation in support of the 2 nd International Consensus Report on Precision Diabetes Medicine. Here, we sought to synthesize evidence from empirical research papers published through September 1 st , 2021 to evaluate and identify prognostic conditions, risk factors, and biomarkers among women and children affected by gestational diabetes mellitus (GDM), focusing on clinical endpoints of cardiovascular disease (CVD) and type 2 diabetes (T2D) among women with a history of GDM; and adiposity and cardiometabolic profile among offspring exposed to GDM in utero. We identified a total of 107 observational studies and 12 randomized controlled trials testing the effect of pharmaceutical and/or lifestyle interventions. Broadly, current literature indicates that greater GDM severity, higher maternal body mass index, belonging to racial/ethnic minority group; and unhealthy lifestyle behaviors would predict a woman's risk of incident T2D and CVD, and an unfavorable cardiometabolic profile among offspring. However, the level of evidence is low (Level 4 according to the Diabetes Canada 2018 Clinical Practice Guidelines for diabetes prognosis) largely because most studies leveraged retrospective data from large registries that are vulnerable to residual confounding and reverse causation bias; and prospective cohort studies that may suffer selection and attrition bias. Moreover, for the offspring outcomes, we identified a relatively small body of literature on prognostic factors indicative of future adiposity and cardiometabolic risk. Future high-quality prospective cohort studies in diverse populations with granular data collection on prognostic factors, clinical and subclinical outcomes, high fidelity of follow-up, and appropriate analytical approaches to deal with structural biases are warranted.
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Lewandowski S, Neale E, D'Arcy E, Hodge AM, Schoenaker DAJM. Quality of low-carbohydrate diets among Australian post-partum women: Cross-sectional analysis of a national population-based cohort study. MATERNAL & CHILD NUTRITION 2023:e13502. [PMID: 36938942 DOI: 10.1111/mcn.13502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/17/2023] [Accepted: 03/01/2023] [Indexed: 03/21/2023]
Abstract
Low-carbohydrate diets (LCDs) are popular among people attempting weight loss and recommended for pregnant women with gestational diabetes (GDM), but they may increase health risks if nutritionally inadequate. We aimed to describe the dietary intake of post-partum women according to their relative carbohydrate intake, overall, and among women attempting weight loss or diagnosed with GDM in their recent pregnancy. This cross-sectional population-based cohort study included 2093 post-partum women aged 25-36 years who participated in the Australian Longitudinal Study on Women's Health. Dietary intake was assessed using a validated food frequency questionnaire. Relative carbohydrate intake was determined using a previously developed LCD score. Data were weighted to account for oversampling of women from rural/remote areas. More than half of women (n[weighted] = 1362, 66.3%) were trying to lose weight, and 4.6% (n[weighted]=88) had GDM in their recent pregnancy. Women with the lowest relative carbohydrate intake (LCD score quartile 4) consumed 36.8% of total energy intake from carbohydrates, and had a lower intake of refined grains, whole grains, fruit and fruit juice, and a higher intake of red and processed meat, compared with women with the highest relative carbohydrate intake (quartile 1). Different food groups, both healthy and unhealthy, were restricted depending on whether women were attempting weight loss and had recent GDM. These findings may reflect a lack of knowledge among post-partum women on carbohydrates and dietary guidelines. Health professionals may have an important role in providing advice and support for post-partum women who wish to restrict their carbohydrate intake, to ensure optimal diet quality.
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Affiliation(s)
- Sophie Lewandowski
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elizabeth Neale
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Ellie D'Arcy
- Integrated Care, Western New South Wales Local Health District, New South Wales, Dubbo, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Danielle A J M Schoenaker
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.,School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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11
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Yaegashi A, Kimura T, Hirata T, Iso H, Tamakoshi A. Association between low-carbohydrate diet score and incidence of type 2 diabetes among Japanese adults: the JACC Study. J Nutr Sci 2023; 12:e50. [PMID: 37123394 PMCID: PMC10131049 DOI: 10.1017/jns.2022.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 05/02/2023] Open
Abstract
We prospectively examined the association between low-carbohydrate diet (LCD) score and incidence of type 2 diabetes (T2D) in Japanese adults using Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) data. A total of 19 084 (7052 men and 12 032 women) Japanese non-diabetic participants aged 40-79 years, who enrolled in the JACC study between 1988 and 1990, were included in our analysis. Dietary intake was evaluated using a validated food-frequency questionnaire. The overall, animal and vegetable LCD scores were calculated by dividing the study participants into eleven categories based on the percentages of energy from carbohydrates, protein and fat. The incidence of T2D was assessed using a self-administered questionnaire. We used multivariable logistic regression analysis to estimate the odds ratios (ORs) and 95 % confidence intervals (CIs) of incident T2D across the quintile of each LCD score, with adjustment for potential confounders. During the 5-year study period, 490 adults (247 men and 243 women) developed T2D. The multivariable-adjusted OR of incident T2D for the highest v. lowest quintiles of overall and animal LCD scores, respectively, were 0·64 (95 % CI 0·42, 0·99) and 0·83 (95 % CI 0·55, 1·27) for men, 0·78 (95 % CI 0·51, 1·18) and 0·84 (95 % CI 0·57, 1·24) for women. The vegetable LCD score was associated with a lower risk of T2D in men (OR 0·51; 95 % CI 0·33, 0·77). Our results suggest that diets lower in carbohydrates and higher in fat and protein are unlikely to higher the T2D risk among Japanese individuals.
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Affiliation(s)
- Akinori Yaegashi
- Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
- Department of Health and Nutrition, Faculty of Human Science, Hokkaido Bunkyo University, 5-196-1, Kogane-chuo, Eniwa 061-1449, Japan
| | - Takashi Kimura
- Faculty of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | - Takumi Hirata
- Faculty of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
- Institute for Clinical and Translational Science, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Hiroyasu Iso
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Akiko Tamakoshi
- Faculty of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
- Corresponding author: Akiko Tamakoshi, fax 011-706-7805, Email
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12
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Sripongpun P, Churuangsuk C, Bunchorntavakul C. Current Evidence Concerning Effects of Ketogenic Diet and Intermittent Fasting in Patients with Nonalcoholic Fatty Liver. J Clin Transl Hepatol 2022; 10:730-739. [PMID: 36062288 PMCID: PMC9396320 DOI: 10.14218/jcth.2021.00494] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/04/2022] [Accepted: 04/10/2022] [Indexed: 12/04/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is emerging globally, while no therapeutic medication has been approved as an effective treatment to date, lifestyle intervention through dietary modification and physical exercise plays a critical role in NAFLD management. In terms of dietary modification, Mediterranean diet is the most studied dietary pattern and is recommended in many guidelines, however, it may not be feasible and affordable for many patients. Recently, a ketogenic diet and intermittent fasting have gained public attention and have been studied in the role of weight management. This article reviews specifically whether these trendy dietary patterns have an effect on NAFLD outcomes regarding intrahepatic fat content, fibrosis, and liver enzymes, the scientific rationales behind these particular dietary patterns, as well as the safety concerns in some certain patient groups.
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Affiliation(s)
- Pimsiri Sripongpun
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Chaitong Churuangsuk
- Nutrition and Obesity Management Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Chalermrat Bunchorntavakul
- Division of Gastroenterology and Hepatology, Department of Medicine, Rajavithi Hospital, Rangsit University, Bangkok, Thailand
- Correspondence to: Chalermrat Bunchorntavakul, Division of Gastroenterology and Hepatology, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Phayathai Road, Ratchathewi District, Bangkok 10400, Thailand. ORCID: https://orcid.org/0000-0002-8842-032X. Tel.: +66-2-354-8108-9, Fax: +66-2-3548179, E-mail:
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13
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Wan Z, Shan Z, Geng T, Lu Q, Li L, Yin J, Liu L, Pan A, Liu G. Associations of Moderate Low-Carbohydrate Diets With Mortality Among Patients With Type 2 Diabetes: A Prospective Cohort Study. J Clin Endocrinol Metab 2022; 107:e2702-e2709. [PMID: 35429400 DOI: 10.1210/clinem/dgac235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT A statement of context for the abstract was added in Objective as follows: Lower-carbohydrate-diet (LCD) has been reported to have beneficial effects on cardiovascular risk factor profile in general population. However, whether adherence to an LCD could benefit long-term survival among individuals with diabetes is unclear. OBJECTIVE This work aimed to investigate the associations of different types of lower-carbohydrate diets with mortality among individuals with type 2 diabetes (T2D). METHODS This prospective study included 5677 patients with T2D. The overall, unhealthy, and healthy lower-carbohydrate-diet (LCD) scores were calculated based on the percentage of energy from total and subtypes of carbohydrate, protein, and fat. Deaths were determined via linkage to the National Death Index records until December 31, 2015. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% CIs of mortality. RESULTS During a median of 6.3 years of follow-up (39 401 person-years), 1432 deaths were documented. After multivariable adjustment including lifestyle factors, diabetes duration, and glycated hemoglobin A1c, patients in the third quartile of overall LCD score had the lowest risk of mortality (HR: 0.65; 95% CI, 0.50-0.85), compared with the first quartile. The multivariable-adjusted HRs (95% CIs) of mortality across quartiles of healthy lower-carbohydrate-diet score were 1.00 (reference), 0.78 (0.64-0.96), 0.73 (0.58-0.91), and 0.74 (0.58-0.95) (Ptrend = .01). Isocalorically replacing 2% of energy from carbohydrates with plant-based protein or polyunsaturated fatty acids was associated with 23% to approximately 37% lower total mortality. Similar results were observed when analyses were stratified by age, sex, race/ethnicity, smoking status, body mass index, physical activity, and diabetes duration. CONCLUSION Healthy LCD score was significantly associated with a lower risk of mortality in adults with T2D. Adherence to a well-balanced moderate lower-carbohydrate diet that emphasizes healthy carbohydrates, plant-based protein, and polyunsaturated fat may prevent premature death among patients with T2D.
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Affiliation(s)
- Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030Wuhan, China
| | - Zhilei Shan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030Wuhan, China
| | - Tingting Geng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030Wuhan, China
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030 Wuhan, China
| | - Qi Lu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030Wuhan, China
| | - Lin Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030Wuhan, China
| | - Jiawei Yin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030Wuhan, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030 Wuhan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030Wuhan, China
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Kawamura MY, Mau MK, Soon R, Yamasato K. A Scoping Review on Gestational Diabetes in Hawai'i: A "Window of Opportunity" to Address Intergenerational Risk for Type 2 Diabetes Mellitus. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2022; 81:58-70. [PMID: 35261986 PMCID: PMC8899083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The health of women over the entire span of their reproductive years is crucial - beginning in adolescence and extending through the postpartum period. This paper provides a scoping review of the relevant literature on risk factors for gestational diabetes mellitus (GDM) and progression from GDM to type 2 diabetes mellitus (T2DM), particularly among women of Native Hawaiian and Pacific Islander (NHPI) and Asian racial/ethnic backgrounds in Hawai'i, using the PubMed database (July 2010 to July 2020). NHPI and Asian populations have a greater likelihood of developing GDM compared to their White counterparts. Risk factors such as advanced maternal age, high maternal body mass index, and lack of education about GDM have varying levels of impact on GDM diagnosis between ethnic populations. Mothers who have a history of GDM are also at higher risk of developing T2DM. Common risk factors include greater increase in postpartum body mass index and use of diabetes medications during pregnancy. However, few studies investigate the progression from GDM to T2DM in Hawai'i's Asian and NHPI populations, and no studies present upstream preconception care programs to prevent an initial GDM diagnosis among Hawai'i's women. Thus, updated reports are necessary for optimal early interventions to prevent the onset of GDM and break the intergenerational cycle of increased susceptibility to T2DM and GDM in both mother and child. Further attention to the development of culturally sensitive interventions may reduce disparities in GDM and improve the health for all affected by this condition.
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Affiliation(s)
- Megan Y. Kawamura
- Department of Native Hawaiian Health Summer 2020 Research Intern, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI
| | - Marjorie K. Mau
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI
| | - Reni Soon
- Department of Obstetrics, Gynecology and Women’s Health, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI
| | - Kelly Yamasato
- Department of Obstetrics, Gynecology and Women’s Health, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI
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15
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Hosseini F, Jayedi A, Khan TA, Shab-Bidar S. Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose-response meta-analysis of prospective cohort studies. Sci Rep 2022; 12:2491. [PMID: 35169172 PMCID: PMC8847553 DOI: 10.1038/s41598-022-06212-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/05/2022] [Indexed: 12/12/2022] Open
Abstract
We did this study to clarify the association between carbohydrate intake and the risk of type 2 diabetes (T2D) and potential effect modification by geographical location. PubMed, Scopus and Web of Science were searched to find prospective cohort studies of dietary carbohydrate intake and T2D risk. A random-effects dose-response meta-analysis was performed to calculate the summary hazard ratios (HRs) and 95%CIs. The quality of cohort studies and the certainty of evidence was rated using the Newcastle-Ottawa Scale and GRADE tool, respectively. Eighteen prospective cohort studies with 29,229 cases among 607,882 participants were included. Thirteen studies were rated to have high quality, and five as moderate quality. The HR for the highest compared with the lowest category of carbohydrate intake was 1.02 (95%CI: 0.91, 1.15; I2 = 67%, GRADE = low certainty). The HRs were 0.93 (95%CI: 0.82, 1.05; I2 = 58%, n = 7) and 1.26 (95%CI: 1.11, 1.44; I2 = 6%, n = 6) in Western and Asian countries, respectively. Dose-response analysis indicated a J shaped association, with the lowest risk at 50% carbohydrate intake (HR50%: 0.95, 95%CI: 0.90, 0.99) and with risk increasing significantly at 70% carbohydrate intake (HR70%: 1.18, 95%CI: 1.03, 1.35). There was no association between low carbohydrate diet score and the risk of T2D (HR: 1.14, 95%CI: 0.89, 1.47; I2 = 90%, n = 5). Carbohydrate intake within the recommended 45-65% of calorie intake was not associated with an increased risk of T2D. Carbohydrate intake more than 70% calorie intake might be associated with a higher risk.
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Affiliation(s)
- Fatemeh Hosseini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ahmad Jayedi
- Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Tauseef Ahmad Khan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, P. O. Box 14155/6117, Tehran, Iran.
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Gong Y, Li N, Lai M, Fang F, Yang J, Kang M, Shen T, Peng Y, Wang Y. Consistently Low Levels of Osteocalcin From Late Pregnancy to Postpartum Are Related to Postpartum Abnormal Glucose Metabolism in GDM Patients. Front Endocrinol (Lausanne) 2022; 13:803624. [PMID: 35321337 PMCID: PMC8936089 DOI: 10.3389/fendo.2022.803624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/02/2022] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Increasing evidence suggests that osteocalcin (OC), a marker of bone formation, plays an important role in glucose homoeostasis. Few studies have investigated the relationship between OC levels in gestational diabetes mellitus (GDM) patients and their postpartum glucose metabolism. This study evaluated the relationship between OC levels in late pregnancy, their longitudinal changes, and postpartum glucose metabolism among GDM patients. MEASURES Serum OC was measured in late pregnancy and the postpartum period for 721 GDM patients. All patients underwent a 75-g oral glucose tolerance test (OGTT) at 6-8 weeks postpartum. According to postpartum OGTT outcomes, patients were categorized into abnormal glucose metabolism (AGM) (n=255) and normal glucose tolerance (NGT) groups (n=466). Glucose metabolism-related indices were measured and calculated. Logistic regression analysis and linear mixed-effects model were used to assess the association between OC and postpartum AGM. RESULTS In late pregnancy, OC levels were lower in the AGM group than in the NGT group (13.93 ± 6.90 vs 15.33 ± 7.63 ng/ml, P=0.015). After delivery, OC levels increased in both groups. However, OC levels remained lower in the AGM group than in the NGT group (23.48 ± 7.84 vs 25.65 ± 8.37 ng/ml, P=0.001). Higher OC levels in late pregnancy were associated with decreased risk of progressing to postpartum AGM (OR:0.96, 95%CI:0.94-0.99). Linear mixed-effects analysis showed that postpartum AGM patients exhibited consistently lower OC levels than NGT group from late pregnancy to the postpartum period after adjustment for cofactors (β=-1.70, 95% CI: -2.78- -0.62). CONCLUSIONS In GDM patients, consistently low levels of OC from late pregnancy to postpartum were associated with increased postpartum AGM risk. The increase in serum OC may act as a protective factor to curb the progression of AGM at postpartum for GDM patients.
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Affiliation(s)
- Yujia Gong
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Li
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengyu Lai
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang Fang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaying Yang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mei Kang
- Clinical Research Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tingting Shen
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongde Peng
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufan Wang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Yufan Wang,
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The low-carbohydrate-diet score is associated with resting metabolic rate: an epidemiologic study among Iranian adults. J Diabetes Metab Disord 2021; 20:1145-1153. [PMID: 34900768 DOI: 10.1007/s40200-021-00832-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/08/2021] [Indexed: 12/24/2022]
Abstract
Purpose Low-carbohydrate diet (LCD) has been used for weight loss and preventing obesity, but the association of adherence to LCD and resting metabolic rate (RMR) has not been investigated. This study aimed to investigate the association between the low-carbohydrate-diet score (LCDS) and RMR among Iranian adults. Methods This cross-sectional study was conducted on 270 Iranian adults 18-70 y of age. To assess dietary intakes, participants completed a validated food frequency questionnaire. The LCDS was calculated based on carbohydrate, protein and fat intake, expressed as a percentage of energy. The higher score indicates the lower carbohydrate and the higher protein and fat intake. RMR was measured by indirect calorimetry after an overnight fast. Results Multivariate-adjusted means showed that RMR significantly increased across tertiles (p = 0.041). However, there were no significant differences in the mean of fat mass (FM) and fat-free mass (FFM) across tertiles of LCDS (p = 0.986 and p = 0.621, respectively). Also LCDS and RMR (r = 0.14, p = 0.021) were found to be correlated, but LCDS and FFM (r = 0.06, p = 0.323), FM (r = -0.05, p = 0.412), had no statistically significant correlation. RMR had a significant positive association with LCDs in the crude model (β = 18.81, 95% CI: 2.55, 35.07, P = 0.024). Moreover, after controlling for covariates this association changed to non-significant (β = -0.14, 95% CI: -7.05, 19.25, P = 0.03). Conclusion Adherence to diets lower in carbohydrates and higher in fat and protein were associated with higher RMR. Further studies with a larger sample size are needed to confirm these findings.
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Abstract
Few studies have suggested that long-term adherence to low-carbohydrate diets (LCD) may affect maternal glucose metabolism in Western countries. We aimed to investigate the association between LCD during pregnancy and glucose metabolism in a Chinese population. A total of 1018 women in mid-pregnancy were recruited in 2017-2018. Participants underwent a 75 g oral glucose tolerance test (OGTT). Daily dietary intakes over the past month were accessed using a validated FFQ. The overall, animal and vegetable LCD scores which represent adherence to different low-carbohydrate dietary patterns were calculated. Mixed linear regression and generalised linear mixed regression were conducted to evaluate the associations between LCD scores and maternal glucose metabolism. Of the 1018 subjects, 194 (19·1 %) were diagnosed with gestational diabetes mellitus (GDM). The overall LCD score (β: 0·024, se 0·008, PFDR = 0·02) and animal LCD score (β: 0·023, se 0·008, PFDR = 0·02) were positively associated with OGTT 1-h glucose. No significant associations were found between the three different LCD scores with fasting plasma glucose, OGTT 2-h glucose, or insulin resistance, respectively. Compared with the lowest quartile, the crude OR of GDM for the highest quartile were 1·84 (95 % CI 1·14, 2·95) for overall LCD score (Pfor trend = 0·02) and 1·56 (95 % CI 1·00, 2·45) for animal LCD score (Pfor trend = 0·02). However, these associations became non-significant after adjustment for covariates. In conclusion, a low-carbohydrate dietary pattern with high animal protein and fat is associated with higher postprandial 1-h glucose levels in Chinese pregnant women.
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Tang N, Wu Y, Chen Y, Chen Q, Wu W, Jing J, Cai L. Association between postpartum low-carbohydrate-diet scores and glucose levels in Chinese women. Nutrition 2021; 89:111305. [PMID: 34166894 DOI: 10.1016/j.nut.2021.111305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/22/2021] [Accepted: 04/21/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Views on the relationship between a low-carbohydrate diet (LCD) and glucose levels are controversial, and no study, to our knowledge, has examined this association in postpartum women. We aimed to explore the association between postpartum LCD scores and glucose levels. METHODS We included 500 postpartum women from a prospective cohort study in Guangzhou, China, during 2017 and 2018. Dietary information during the first month after delivery was assessed via a validated food frequency questionnaire. The overall, animal, and plant LCD scores were determined based on percentages of energy from carbohydrate, protein, and fat. Higher scores reflected higher intakes of fat and protein and lower intakes of carbohydrate. At 6 to 8 wk postpartum, women with previous gestational diabetes mellitus underwent oral glucose tolerance tests (n = 104), and the others had fasting plasma glucose (FPG) tests (n = 396). Multivariable linear, quantile, and logistic regressions were conducted. RESULTS Of the 500 participants, 71 (14.20%) developed impaired fasting glucose. Animal LCD score was positively associated with FPG levels (β = 0.007, P = 0.017), but quantile regression showed that LCD scores were related to FPG only in women with lower FPG levels; they had no significant association in those with higher FPG levels. No significant interaction effect on FPG was found between LCD scores and history of gestational diabetes mellitus (Pinteraction > 0.40). Furthermore, the relationships between the three LCD scores and risk of developing impaired fasting glucose were not statistically significant. CONCLUSIONS Animal LCD score during puerperium may be positively associated with FPG levels in the early postpartum period in Chinese women, but no interactions with history of gestational diabetes mellitus were observed. Stronger associations were observed in women with lower FPG levels.
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Affiliation(s)
- Nu Tang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yang Wu
- Department of Sociology, Jiangxi University of Finance and Economics, Nanchang, China; Center for Asian & Pacific Economic & Social Development, Jiangxi University of Finance and Economics, Nanchang, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qian Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weijia Wu
- Department of Scientific Research, Hainan Women and Children's Medical Center, Haikou, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.
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20
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Kishimoto M, Kato R, Oshiba Y. Impact of dietary counseling on the perception of diet in patients with gestational diabetes mellitus. Diabetol Int 2021; 12:151-160. [PMID: 33786270 PMCID: PMC7943672 DOI: 10.1007/s13340-020-00454-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/01/2020] [Indexed: 12/13/2022]
Abstract
AIMS/INTRODUCTION Medical nutrition therapy is the cornerstone of gestational diabetes mellitus (GDM) treatment. Patients with GDM should receive dietary counseling regarding diet and exercise. MATERIALS AND METHODS To study patients' perception level of diet and their level of understanding after dietary counseling, we analyzed 225 reports of dietary counseling of patients with GDM prepared by dieticians. We also assessed the patients' level of understanding after dietary counseling by asking questions regarding the counseling content. The answers to the questions were aggregated, and substantially similar answers were grouped and categorized. RESULTS The dieticians' suggestions were well understood by the patients. Moreover, the patients also identified their previous incorrect eating habits, such as excessive carbohydrate restriction or inappropriate fruit intake. Although distributed frequent meals were recommended by the dieticians, few patients actually practiced this for various reasons. Some patients were apparently influenced by dietary information from the mass media. CONCLUSION Dietary counseling was regarded as helpful and acceptable to most patients with GDM in our hospital, and many suggestions were recognized as informative for modification of previous dietary habits. By providing the results of the questionnaire survey to the dieticians, they can improve the quality of their counseling, which is expected to result in better individual care of the patients.
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Affiliation(s)
- Miyako Kishimoto
- Department of Medicine, Clinical Research Center, International University of Health and Welfare, 8-10-16 Akasaka Minato, 107-0052 Tokyo, Japan
- Department of Internal Medicine, Sanno Hospital, 8-10-16 Akasaka Minato, Tokyo, 107-0052 Japan
| | - Ryutaro Kato
- Department of Nutrition, Sanno Hospital, 8-10-16 Akasaka Minato, Tokyo, 107-0052 Japan
| | - Yoko Oshiba
- Department of Medicine, Clinical Research Center, International University of Health and Welfare, 8-10-16 Akasaka Minato, 107-0052 Tokyo, Japan
- Department of Obstetrics and Gynecology, Sanno Hospital, 8-10-16 Akasaka Minato, Tokyo, 107-0052 Japan
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21
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Qiao T, Chen Y, Duan R, Chen M, Xue H, Tian G, Liang Y, Zhang J, He F, Yang D, Gong Y, Zhou R, Cheng G. Beyond protein intake: does dietary fat intake in the year preceding pregnancy and during pregnancy have an impact on gestational diabetes mellitus? Eur J Nutr 2021; 60:3461-3472. [PMID: 33661377 PMCID: PMC8354989 DOI: 10.1007/s00394-021-02525-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/19/2021] [Indexed: 01/16/2023]
Abstract
Purpose Studies regarding the association between dietary fat intake and gestational diabetes mellitus (GDM) are limited and provide conflicting findings. Thus, the study aims to examine the association of dietary fat intake in the year preceding pregnancy and during pregnancy with the risk of GDM, taking the relevance of dietary protein intake on GDM into consideration. Methods A prospective study was conducted in 6299 singleton pregnancies, using the data from the Nutrition in Pregnancy and Growth in Southwest China (NPGSC). A validated food frequency questionnaire was used to assess dietary fat intake in the year preceding pregnancy and during the first and second trimesters of pregnancy. Logistic regression analysis was used to assess the prospective associations of dietary fat intake and the type and source of dietary fats in different time windows with GDM risk. Results Higher intake of total fat [OR (95% CI): 2.21 (1.19–4.20), P = 0.02] during 12–22 weeks of gestation was associated with higher GDM risk. However, adjustment for animal protein intake greatly attenuated this association [OR (95% CI): 1.81 (0.93, 3.64), P = 0.11]. Total fat intake neither in the year preceding pregnancy nor during the early pregnancy was associated with GDM risk. Moreover, insignificant associations were observed between intakes of vegetable fat, animal fat, cholesterol, saturated fatty acid, monounsaturated fatty acid and polyunsaturated fatty acid one year before pregnancy and during the first and second trimesters and GDM risk. Conclusion Our study indicated that dietary fat intake one year before pregnancy and across the two pregnancy trimesters preceding the diagnosis of GDM has no relevance on GDM risk among Chinese women, particularly those with normal BMI, low, or normal calorie intake.
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Affiliation(s)
- Tian Qiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yue Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Ruonan Duan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Mengxue Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Hongmei Xue
- West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China.,College of Public Health, Hebei University, Baoding, People's Republic of China
| | - Guo Tian
- West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China
| | - Yi Liang
- West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China.,Department of Clinical Nutrition, Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, People's Republic of China
| | - Jieyi Zhang
- West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China.,Sichuan Provincial Center for Disease Control and Prevention, No. 6 Middle School Road, Chengdu, People's Republic of China
| | - Fang He
- West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China
| | - Dagang Yang
- Department of Clinical Nutrition, Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, People's Republic of China
| | - Yunhui Gong
- West China Second University Hospital and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Sichuan University, Chengdu, People's Republic of China
| | - Rong Zhou
- West China Second University Hospital and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Sichuan University, Chengdu, People's Republic of China
| | - Guo Cheng
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
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Quan W, Zeng M, Jiao Y, Li Y, Xue C, Liu G, Wang Z, Qin F, He Z, Chen J. Western Dietary Patterns, Foods, and Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2021; 12:1353-1364. [PMID: 33578428 PMCID: PMC8321835 DOI: 10.1093/advances/nmaa184] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/16/2020] [Accepted: 12/29/2020] [Indexed: 12/12/2022] Open
Abstract
An increasing number of epidemiological studies suggest that adherence to Western dietary patterns (WDPs) is associated with risk of gestational diabetes mellitus (GDM), but results remain inconsistent. Therefore, we conducted a systematic review and meta-analysis of the effect of WDPs and typical Western dietary foods on GDM. A literature search was performed in PubMed, Embase, Web of Knowledge, and the Cochrane Library up to December 2019. Cohort studies investigating the combined associations of WDPs with incidence of GDM were included. Reviewers were paired, and they independently reviewed and assessed studies, extracted data, and evaluated study quality. Pooled HRs were calculated using random-effects models. Heterogeneity and publication bias tests were also conducted. Twenty-one prospective cohort studies with 191,589 participants, including 12,331 women with GDM, were included in our analysis. The pooled risk ratio (RR) of WDPs was 1.52 (95% CI: 1.21, 1.91), indicating a significant association with GDM risk in Western countries. Potatoes (pooled RR: 1.12; 95% CI: 0.93, 1.35) showed a nonsignificant (P > 0.05) relation to GDM risk. However, consumption of animal meat (pooled RR: 1.35; 95% CI: 1.16, 1.57) and fast food (pooled RR: 1.75; 95% CI: 1.41, 2.19) showed a positive association with the risk of developing GDM. Subgroup analysis demonstrated that the consumption of red meat and processed red meat increased the risk of GDM more than either poultry or fish intake. Our study provides further evidence for understanding the relation between dietary factors and increased GDM risk and contributes to reducing the incidence of GDM through healthy diets.
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Affiliation(s)
- Wei Quan
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Maomao Zeng
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Ye Jiao
- School of Chemistry and Food Engineering, Changsha University of Science & Technology, Changsha, China
| | - Yong Li
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Chaoyi Xue
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Guoping Liu
- Wuxi People's Hospital, Nanjing Medical University, Wuxi, China
| | - Zhaojun Wang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Fang Qin
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
| | | | - Jie Chen
- Address correspondence to JC (e-mail: )
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23
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Hehua Z, Yang X, Qing C, Shanyan G, Yuhong Z. Dietary patterns and associations between air pollution and gestational diabetes mellitus. ENVIRONMENT INTERNATIONAL 2021; 147:106347. [PMID: 33385926 DOI: 10.1016/j.envint.2020.106347] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/19/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
The prevalence of gestational diabetes mellitus (GDM) has been increasing worldwide. Dietary patterns and air pollution are closely related to the occurrence of GDM. No previous study has explored the interaction effect of air pollution exposure and dietary patterns on GDM. We explored the interaction effect between main dietary patterns and pre-pregnancy exposure to air pollution on the development of GDM based on a prospective birth cohort in Northeast China. A total of 2244 participants were included in this study. Factor analysis was used to identify dietary patterns. We found that long-term exposure to nitrogen dioxide (NO2) and carbon monoxide (CO) before pregnancy was significantly associated with an increased risk of GDM; the animal foods pattern significantly modified these associations. The sub-group analysis showed that compared with a lower intake in the animal foods pattern (NO2, odds ratio [OR] = 1.07, 95% confidence interval [CI]: 0.84, 1.35; CO, OR = 1.05, 95% CI: 0.81, 1.34), higher intake in the animal foods pattern (NO2, OR = 1.41, 95% CI: 1.09, 1.83; CO, OR = 1.36, 95% CI: 1.05, 1.76) before pregnancy increased the hazardous effects of NO2 and CO on GDM development. The intake of animal blood, animal organs, preserved eggs, and processed meat products in animal food pattern could all aggravate the effect of exposure to air pollution due to NO2 and CO on GDM. Our study demonstrated that there was a significant interaction effect between animal foods pattern and exposure to air pollution on GDM. These results provide further scientific evidence of the associations among air pollution, dietary intake, and GDM, and may help as well as the prevention of GDM.
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Affiliation(s)
- Zhang Hehua
- Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning Province 110004, China
| | - Xia Yang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning Province 110004, China
| | - Chang Qing
- Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning Province 110004, China
| | - Gao Shanyan
- Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning Province 110004, China
| | - Zhao Yuhong
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning Province 110004, China.
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24
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Zhong GC, Li QJ, Yang PF, Wang YB, Hao FB, Wang K, Hu JJ, Wu JJ. Low-carbohydrate diets and the risk of pancreatic cancer: a large prospective cohort study. Carcinogenesis 2021; 42:724-732. [PMID: 33480980 DOI: 10.1093/carcin/bgab006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/24/2020] [Accepted: 01/18/2021] [Indexed: 12/14/2022] Open
Abstract
Low-carbohydrate diets have become a popular approach for weight loss in recent years. However, whether low-carbohydrate diets are associated with the risk of pancreatic cancer remains to be elucidated. Hence, we examined the association of low-carbohydrate diets with the risk of pancreatic cancer in a US population. A population-based cohort of 95 962 individuals was identified. A low-carbohydrate-diet score was calculated to quantify adherence to this dietary pattern, with higher scores indicating greater adherence. Cox regression was used to calculate risk estimate for the association of the low-carbohydrate-diet score with the risk of pancreatic cancer. Subgroup analysis was used to identify the potential effect modifiers. After an average follow-up of 8.87 years (875856.9 person-years), we documented a total of 351 pancreatic cancer cases. In the fully adjusted model, the highest versus the lowest quartiles of the overall low-carbohydrate-diet score were found to be associated with a reduced risk of pancreatic cancer (hazard ratioquartile 4 versus 1: 0.61; 95% confidence interval: 0.45, 0.82; Ptrend < 0.001). Subgroup analysis found that the inverse association of low-carbohydrate diets with the risk of pancreatic cancer was more pronounced in individuals aged ≥65 years than in those aged <65 years (Pinteraction = 0.015). Similar results were obtained for animal and vegetable low-carbohydrate-diet scores. In conclusion, low-carbohydrate diets, regardless of the type of protein and fat, are associated with a lower risk of pancreatic cancer in the US population, suggesting that adherence to low-carbohydrate diets may be beneficial for pancreatic cancer prevention. Future studies should validate our findings in other populations.
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Affiliation(s)
- Guo-Chao Zhong
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qu-Jin Li
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng-Fei Yang
- Department of Nephrology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yun-Bing Wang
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fa-Bao Hao
- Department of Neurosurgery, Qingdao Women and Children's Hospital, Qingdao University, Qingdao, Shandong, China
| | - Kang Wang
- Department of Endocrine and Breast Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie-Jun Hu
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jing-Jing Wu
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
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25
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Churuangsuk C, Lean MEJ, Combet E. Lower carbohydrate and higher fat intakes are associated with higher hemoglobin A1c: findings from the UK National Diet and Nutrition Survey 2008-2016. Eur J Nutr 2020; 59:2771-2782. [PMID: 31686204 PMCID: PMC7413867 DOI: 10.1007/s00394-019-02122-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Evidence of low-carbohydrate, high-fat diets (LCHF) for type 2 diabetes (T2DM) prevention is scarce. We investigated how carbohydrate intake relates to HbA1c and T2DM prevalence in a nationally representative survey dataset. METHODS We analyzed dietary information (4-day food diaries) from 3234 individuals aged ≥ 16 years, in eight waves of the UK National Diet and Nutrition Survey (2008-2016). We calculated LCHF scores (0-20, higher score indicating lower %food energy from carbohydrate, with reciprocal higher contribution from fat) and UK Dietary Reference Value (DRV) scores (0-16, based on UK dietary recommendations). Associations between macronutrients and diet scores and diabetes prevalence were analyzed (in the whole sample) using multivariate logistic regression. Among those without diabetes, analyses between exposures and %HbA1c (continuous) were analyzed using multivariate linear regression. All analyses were adjusted for age, sex, body mass index, ethnicity, smoking status, total energy intake, socioeconomic status and survey years. RESULTS In the overall study sample, 194 (6.0%) had diabetes. Mean intake was 48.0%E for carbohydrates, and 34.9%E for total fat. Every 5%E decrease in carbohydrate, and every 5%E increase in fat, was associated with 12% (95% CI 0.78-0.99; P = 0.03) and 17% (95% CI 1.02-1.33; P = 0.02) higher odds of diabetes, respectively. Each two-point increase in LCHF score is related to 8% (95% CI 1.02-1.14; P = 0.006) higher odds of diabetes, while there was no evidence for association between DRV score and diabetes. Among the participants without diagnosed diabetes (n = 3130), every 5%E decrease in carbohydrate was associated with higher %HbA1c by + 0.016% (95% CI 0.004-0.029; P = 0.012), whereas every 5%E increase in fat was associated with higher %HbA1c by + 0.029% (95% CI 0.015-0.043; P < 0.001). Each two-point increase in LCHF score is related to higher %HbA1c by + 0.010% (0.1 mmol/mol), while each two-point increase in the DRV score is related to lower %HbA1c by - 0.023% (0.23 mmol/mol). CONCLUSIONS Lower carbohydrate and higher fat intakes were associated with higher HbA1c and greater odds of having diabetes. These data do not support low(er) carbohydrate diets for diabetes prevention.
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Affiliation(s)
- Chaitong Churuangsuk
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, Room 2.22, Level 2, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK
| | - Michael E J Lean
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, Room 2.22, Level 2, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK
| | - Emilie Combet
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, Room 2.22, Level 2, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK.
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26
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Ha K, Nam K, Song Y. A moderate-carbohydrate diet with plant protein is inversely associated with cardiovascular risk factors: the Korea National Health and Nutrition Examination Survey 2013-2017. Nutr J 2020; 19:84. [PMID: 32795306 PMCID: PMC7427735 DOI: 10.1186/s12937-020-00603-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 08/10/2020] [Indexed: 12/22/2022] Open
Abstract
Background Because a moderate-carbohydrate diet reportedly has minimal risks, the substitution of carbohydrate for protein has been emphasized. Few studies have explored the effect of moderate-carbohydrate diets with higher protein intake in Asians, who typically consume a high-carbohydrate low-fat diet. Therefore, this study evaluated the associations of moderate- versus high- carbohydrate diets with cardiovascular risk factors among Korean adults by protein source. Methods This study included 7965 adults (3196 men, 4769 women) aged ≥ 19 years who participated in the 2013–2017 Korea National Health and Nutrition Examination Survey. Dietary intake was assessed by a 24-h recall method and four types of diet were defined: a moderate-carbohydrate diet with plant protein (MCP) or animal protein (MCA) and a high-carbohydrate diet with plant protein (HCP) or animal protein (HCA). Results Compared with the MCP group, men in the other three groups had significantly higher odds ratios (ORs) for elevated total cholesterol, reduced high-density lipoprotein (HDL)-cholesterol, and metabolic syndrome. Among women, only the HCP group had an increased OR for reduced HDL-cholesterol, compared with the MCP group. Similar associations were observed in younger adults (19–49 years). In addition, younger adults in the MCA group exhibited higher ORs for elevated triglycerides in men and elevated total cholesterol in women, compared with those in the MCP group. Conclusions A moderate-carbohydrate diet with a high intake of plant protein was inversely associated with cardiovascular risk factors, especially among younger Korean adults. Further intervention studies are required to confirm this relationship and develop the optimal diet for cardiovascular health in the Korean population.
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Affiliation(s)
- Kyungho Ha
- Graduate School of Public Health, Seoul National University, Seoul, 08826, Korea
| | - Kisun Nam
- Health & Nutrition Research Center, Pulmuone Co., Ltd., Seoul, 06367, Korea
| | - YoonJu Song
- Major of Food and Nutrition, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14662, Republic of Korea.
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Qi XX, Shen P. Associations of dietary protein intake with all-cause, cardiovascular disease, and cancer mortality: A systematic review and meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis 2020; 30:1094-1105. [PMID: 32451273 DOI: 10.1016/j.numecd.2020.03.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS The relationships between dietary protein intake and risk of all-cause, cardiovascular disease (CVD), and cancer mortality are still unclear. We conducted a systematic review with meta-analysis of cohort studies to summarize the evidence. METHODS AND RESULTS We searched PubMed and Web of Science for relevant studies through February 2020. The associations of total, animal, and plant proteins with all-cause, CVD, and cancer mortality were evaluated. Study-specific relative risks (RR) were pooled using the fixed effect model when no significant heterogeneity was detected; otherwise the random effect model was employed. Twelve cohort studies were eligible for the study. Increased total protein showed no clear association with risk of all-cause, CVD, and cancer mortality. In the stratified analysis by protein sources, higher plant protein intake was associated with a reduced risk of all-cause mortality (highest vs lowest intake: RR = 0.92; 95% CI: 0.88, 0.96; each 3% increment of intake: RR = 0.97; 95% CI: 0.94, 0.99), and may be associated with a reduced risk of CVD mortality (highest vs lowest intake: RR = 0.90; 95% CI: 0.80, 1.01; each 3% increment of intake: RR = 0.95; 95% CI: 0.91, 0.99). Moreover, higher intake of animal protein may be associated with an increased risk of CVD mortality (highest vs lowest intake: RR = 1.11; 95% CI: 1.01, 1.22; each 3% increment of intake: RR = 1.02; 95% CI: 0.98, 1.06). CONCLUSION This study demonstrates that higher plant protein intake is associated with a reduced risk of all-cause and CVD-related mortality. Persons should be encouraged to increase their plant protein intake to potentially decrease their risk of death.
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Affiliation(s)
- Xiang-Xiu Qi
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Peng Shen
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China.
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Rayner J, D'Arcy E, Ross LJ, Hodge A, Schoenaker DAJM. Carbohydrate restriction in midlife is associated with higher risk of type 2 diabetes among Australian women: A cohort study. Nutr Metab Cardiovasc Dis 2020; 30:400-409. [PMID: 31822429 DOI: 10.1016/j.numecd.2019.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/16/2019] [Accepted: 11/01/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Low-carbohydrate diets (LCDs) are increasingly popular but may be nutritionally inadequate. We aimed to examine if carbohydrate restriction in midlife is associated with risk of developing type 2 diabetes (T2DM), and if this association differs by previous gestational diabetes (GDM) diagnosis. METHODS AND RESULTS Dietary intake was assessed for 9689 women from the Australian Longitudinal Study on Women's Health in 2001 (aged 50-55) and 2013 (aged 62-67) via validated food frequency questionnaires. Average long-term carbohydrate restriction was assessed using a low-carbohydrate diet score (highest quartile (Q4) indicating lowest proportion of energy from carbohydrates). Incidence of T2DM between 2001 and 2016 was self-reported at 3-yearly surveys. Log-binomial regression was used to estimate relative risks (RR) and 95% CIs. During 15 years of follow-up, 959 women (9.9%) developed T2DM. Carbohydrate restriction was associated with T2DM after adjustment for sociodemographic factors, history of GDM diagnosis and physical activity (Q4 vs Q1: RR 1.27 [95% CI 1.10, 1.48]), and this was attenuated when additionally adjusted for BMI (1.10 [0.95, 1.27]). Carbohydrate restriction was associated with lower consumption of fruit, cereals and high-fibre bread, and lower intakes of these food groups were associated with higher T2DM risk. Associations did not differ by history of GDM (P for interaction >0.15). CONCLUSION Carbohydrate restriction was associated with higher T2DM incidence in middle-aged women, regardless of GDM history. Health professionals should advise women to avoid LCDs that are low in fruit and grains, and to consume a diet in line with current dietary recommendations.
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Affiliation(s)
- Jessica Rayner
- Nutrition and Dietetics, School of Allied Health, Griffith University, Queensland, Australia
| | - Ellie D'Arcy
- Nutrition and Dietetics, School of Allied Health, Griffith University, Queensland, Australia; Integrated Primary Care and Partnerships, Western New South Wales Local Health District, NSW, Australia
| | - Lynda J Ross
- Nutrition and Dietetics, School of Allied Health, Griffith University, Queensland, Australia
| | - Allison Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Danielle A J M Schoenaker
- School of Medicine, Faculty of Science, Medicine and Health, and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia; The Robinson Research Institute and Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, South Australia, Australia; Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.
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Churuangsuk C, Lean MEJ, Combet E. Low and reduced carbohydrate diets: challenges and opportunities for type 2 diabetes management and prevention. Proc Nutr Soc 2020; 79:1-16. [PMID: 32131904 DOI: 10.1017/s0029665120000105] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Low-carbohydrate diets (LCD) have been promoted for weight control and type 2 diabetes (T2D) management, based on an emerging body of evidence, including meta-analyses with an indication of publication bias. Proposed definitions vary between 50 and 130 g/d, or <10 and <40 % of energy from carbohydrate, with no consensus on LCD compositional criteria. LCD are usually followed with limited consideration for other macronutrients in the overall diet composition, introducing variance in the constituent foods and in metabolic responses. For weight management, extensive evidence supports LCD as a valid weight loss treatment, up to 1-2 years. Solely lowering carbohydrate intake does not, in the medium/long term, reduce HbA1c for T2D prevention or treatment, as many mechanisms interplay. Under controlled feeding conditions, LCD are not physiologically or clinically superior to diets with higher carbohydrates for weight-loss, fat loss, energy expenditure or glycaemic outcomes; indeed, all metabolic improvements require weight loss. Long-term evidence also links the LCD pattern to increased CVD risks and mortality. LCD can lead to micronutrient deficiencies and increased LDL-cholesterol, depending on food selection to replace carbohydrates. Evidence is limited but promising regarding food choices/sources to replace high-carbohydrate foods that may alleviate the negative effects of LCD, demanding further insight into the dietary practice of medium to long term LCD followers. Long-term, high-quality studies of LCD with different food sources (animal and/or plant origins) are needed, aiming for clinical endpoints (T2D incidence and remission, cardiovascular events, mortality). Ensuring micronutrient adequacy by food selection or supplementation should be considered for people who wish to pursue long-term LCD.
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Affiliation(s)
- Chaitong Churuangsuk
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, GlasgowG31 2ER, UK
- Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Michael E J Lean
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, GlasgowG31 2ER, UK
| | - Emilie Combet
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, GlasgowG31 2ER, UK
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30
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Sali S, Farhadnejad H, Asghari G, Teymoori F, Mirmiran P, Djazayeri A, Azizi F. Animal based low carbohydrate diet is associated with increased risk of type 2 diabetes in Tehranian adults. Diabetol Metab Syndr 2020; 12:87. [PMID: 33042230 PMCID: PMC7539407 DOI: 10.1186/s13098-020-00596-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/29/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND To investigate the association of low carbohydrate diet (LCD) score with the risk of type 2 diabetes among adults. METHODS This cohort study was conducted on 4356 healthy participants aged ≥ 19 years old, who were followed-up for a mean duration of 3 years within the framework of the Tehran Lipid and Glucose Study. LCD score was calculated using a food frequency questionnaire according to intake of carbohydrate, protein, and fat at baseline. Diabetes was defined according to the criteria of the American Diabetes Association. Multivariable logistic regression models, adjusted for potential confounders, were used to estimate risk of diabetes across quartiles of LCD score. RESULTS Mean ± SD age of the study participants (44.4% men) was 40.5 ± 13.0 years. The median (25-75 interquartile range) of LCD score was 17.0 (12.0-21.0) and after a 3 year follow-up period, 123 (2.8%) incident cases of diabetes were ascertained. After adjustment for confounding variables, including age, sex, smoking status, physical activity, total calorie intake, saturated fatty acid, waist circumference, educational level, and family history of diabetes, the multivariable-adjusted ORs (95% CIs) of type 2 diabetes, comparing the highest with the lowest quartiles, were 2.16 (1.16-4.04) for total LCD score (P-value = 0.015), 1.81 (1.06-3.11) for animal-based LCD score (P-value = 0.029), and 1.47 (0.85-2.52) for plant-based LCD score (P-value = 0.160). CONCLUSION Our findings suggest that a higher adherence to LCD, mostly with higher intakes of protein and fat from animal-source foods, can increase the incidence of diabetes; however, a plant-based low-carbohydrate dietary pattern is not significantly associated with risk of type 2 diabetes.
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Affiliation(s)
- Sohrab Sali
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4741, Tehran, Iran
| | - Hossein Farhadnejad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4741, Tehran, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4741, Tehran, Iran
| | - Farshad Teymoori
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4741, Tehran, Iran
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4741, Tehran, Iran
| | - Abolghassem Djazayeri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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31
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Dietary habits contribute to define the risk of type 2 diabetes in humans. Clin Nutr ESPEN 2019; 34:8-17. [DOI: 10.1016/j.clnesp.2019.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/02/2019] [Indexed: 12/25/2022]
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32
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Ebrahimpour-Koujan S, Shayanfar M, Benisi-Kohansal S, Mohammad-Shirazi M, Sharifi G, Esmaillzadeh A. Adherence to low carbohydrate diet in relation to glioma: A case-control study. Clin Nutr 2019; 38:2690-2695. [DOI: 10.1016/j.clnu.2018.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/24/2018] [Accepted: 11/15/2018] [Indexed: 01/04/2023]
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33
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D'Arcy E, Rayner J, Hodge A, Ross LJ, Schoenaker DAJM. The Role of Diet in the Prevention of Diabetes among Women with Prior Gestational Diabetes: A Systematic Review of Intervention and Observational Studies. J Acad Nutr Diet 2019; 120:69-85.e7. [PMID: 31636052 DOI: 10.1016/j.jand.2019.07.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/26/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Women with prior gestational diabetes (GDM) have an increased lifetime risk of developing type 2 diabetes mellitus (T2DM). There are no up-to-date systematic reviews analyzing the relationship of diet with risk of developing T2DM following GDM. OBJECTIVE To systematically review the evidence from intervention and observational studies on effects of dietary interventions and associations of dietary intake with T2DM outcomes in women with a GDM history. METHODS Six electronic databases were searched (Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, Cochrane Central, Proquest, and Scopus) for articles published until May 2019. This review includes intervention and observational studies among women of any age with a history of GDM that reported on the effects of dietary interventions or association of dietary intake (energy, nutrients, foods, dietary patterns) with T2DM, impaired glucose tolerance, impaired fasting glucose, or prediabetes. RESULTS The systematic review identified five articles reporting results from four intervention studies, and seven articles reporting results from four observational studies. Findings from intervention studies indicated trends toward beneficial effects of a low-glycemic index diet, a low-carbohydrate diet, and a diet in line with general population dietary guidelines, but studies had unclear or high risk of bias. Findings from two cross-sectional and one prospective study indicated poorer diabetes outcomes for women with higher intakes of branched-chain amino acids, total and heme iron, and a diet relatively low in carbohydrates and high in animal fat and protein, and better outcomes among those consuming diets rich in fruit, vegetables, nuts, fish, and legumes, and low in red and processed meats and sugar-sweetened beverages, after adjustment for confounders, including body mass index. CONCLUSIONS Findings from observational studies support current dietary guidelines for the prevention of T2DM. Further dietary intervention studies are needed to confirm whether or not dietary modification following a GDM pregnancy reduces women's risk of developing T2DM.
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34
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Farabi SS, Hernandez TL. Low-Carbohydrate Diets for Gestational Diabetes. Nutrients 2019; 11:E1737. [PMID: 31357598 PMCID: PMC6723585 DOI: 10.3390/nu11081737] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/12/2019] [Accepted: 07/23/2019] [Indexed: 02/07/2023] Open
Abstract
Nutrition therapy provides the foundation for treatment of gestational diabetes (GDM), and has historically been based on restricting carbohydrate (CHO) intake. In this paper, randomized controlled trials (RCTs) are reviewed to assess the effects of both low- and higher CHO nutrition approaches in GDM. The prevailing pattern across the evidence underscores that although CHO restriction improves glycemia at least in the short-term, similar outcomes could be achievable using less restrictive approaches that may not exacerbate IR. The quality of existing studies is limited, in part due to dietary non-adherence and confounding effects of treatment with insulin or oral medication. Recent evidence suggests that modified nutritional manipulation in GDM from usual intake, including but not limited to CHO restriction, improves maternal glucose and lowers infant birthweight. This creates a platform for future studies to further clarify the impact of multiple nutritional patterns in GDM on both maternal and infant outcomes.
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Affiliation(s)
- Sarah S Farabi
- Goldfarb School of Nursing, Office of Nursing Research, Barnes-Jewish College, St. Louis, MO 63110, USA
- Department of Medicine, Division of Nutritional Science, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Teri L Hernandez
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA.
- College of Nursing, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA.
- Department of Research, Innovation, and Professional Practice, Children's Hospital Colorado, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA.
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35
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Zhang C, Olsen SF, Hinkle SN, Gore-Langton RE, Vaag A, Grunnet LG, Yeung EH, Bao W, Bowers K, Liu A, Mills JL, Sherman S, Gaskins AJ, Ley SH, Madsen CM, Chavarro JE, Hu FB. Diabetes & Women's Health (DWH) Study: an observational study of long-term health consequences of gestational diabetes, their determinants and underlying mechanisms in the USA and Denmark. BMJ Open 2019; 9:e025517. [PMID: 31048434 PMCID: PMC6502016 DOI: 10.1136/bmjopen-2018-025517] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Women who experience gestational diabetes mellitus (GDM) are at exceptionally high-risk of developing type 2 diabetes (T2DM) later in life. However, limited information is available about genetic and environmental factors that are implicated in the progression from GDM to T2DM. PARTICIPANTS The Diabetes & Women's Health (DWH) Study applied a hybrid design, which combined new prospective data collection with existing data in two prospective cohorts, the Danish National Birth Cohort (DNBC) and the Nurses' Health Study II (NHS II). In total, the DWH Study identified 7759 women with a GDM diagnosis from both cohorts; 4457 women participated in the DWH Study data collection, which included two cycles of follow-up from 2012 to 2014 and 2014 to 2016. FINDINGS TO DATE Progression from GDM to T2DM was high. In the NHS II group, by 2013, 23.1% (n=846/3667) developed T2DM. In the DNBC group, at cycle 1 (2012-2014), the progression rate was even higher: 27.2% (n=215/790) had developed T2DM. Furthermore, we have shown that women who had GDM experienced a significantly greater risk of hypertension and cardiovascular diseases, as well as early stages of glomerular hyperfiltration and renal damage. Moreover, the DWH Study findings have shown that healthful diet and lifestyle factors and weight control were related to a lower risk of T2DM, hypertension and cardiovascular diseases. FUTURE PLANS Primary data collection for the DWH Study is complete and investigators are currently investigating interactions of the abovementioned modifiable factors with T2DM genetic susceptibility in determining the risk of progression from GDM to T2DM. Findings from ongoing work will provide further insights for identifying more precise prevention strategies for T2DM and comorbidities in this high-risk population. Future work will examine novel biomarkers of health and disease in this cohort.
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Affiliation(s)
- Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | - Sjurdur F Olsen
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Stefanie N Hinkle
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | | | - Allan Vaag
- Cardiovascular and Metabolic Disease (CVMD)Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Mölndal, Sweden
- Department of Endocrinology, Diabetes and Bone-metabolicResearch Unit, Rigshospitalet, Copenhagen, Denmark
| | - Louise Groth Grunnet
- Department of Endocrinology, Diabetes and Bone-metabolicResearch Unit, Rigshospitalet, Copenhagen, Denmark
- The Danish Diabetes Academy, Odense, Denmark
| | - Edwina H Yeung
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Katherine Bowers
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice KennedyShriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | - James L Mills
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | | | - Audrey J Gaskins
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Sylvia H Ley
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Camilla M Madsen
- Department of Endocrinology, Diabetes and Bone-metabolicResearch Unit, Rigshospitalet, Copenhagen, Denmark
| | - Jorge E Chavarro
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Frank B Hu
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA
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36
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Churuangsuk C, Kherouf M, Combet E, Lean M. Low-carbohydrate diets for overweight and obesity: a systematic review of the systematic reviews. Obes Rev 2018; 19:1700-1718. [PMID: 30194696 DOI: 10.1111/obr.12744] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/17/2018] [Accepted: 06/14/2018] [Indexed: 01/06/2023]
Abstract
Low-carbohydrate diets are being widely recommended, but with apparently conflicting evidence. We have conducted a formal systematic review of the published systematic reviews of RCTs between low-carbohydrate vs. control (low-fat/energy-restricted) diets in adults with overweight and obesity. In MEDLINE, Embase, Web of Knowledge and Cochrane Database of Systematic Reviews, searched from inception to September 2017, we identified 12 systematic reviews, 10 with meta-analyses. Differences in methods, study quality, weight change and citations of published systematic reviews were assessed by AMSTAR-2. Review methods varied in definitions of low-carbohydrate diet, databases searched and bias assessment. Overall review quality was high in two, moderate in three, critically low in seven. Among meta-analyses, 4/5 with critically low quality showed low-carbohydrate diet superiority for weight loss (0.7-4.0 kg), while high quality meta-analyses reported little or no difference between diets. Greater numbers of participants correlated with smaller differences in weight loss (r = 0.73, p = 0.03). More citations correlated with lower review quality (rho = -0.9, p = 0.037), with larger differences in weight loss (rho = -0.9, p = 0.037), and with journal impact factor (rho = 1.0, p = 0.01). In conclusion, publication acceptance and citations appear to favour apparently larger effect sizes above methodological quality. Better quality reviews and RCTs are needed, before recommending low-carbohydrate diets as preferred to other approaches for energy restriction.
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Affiliation(s)
- C Churuangsuk
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - M Kherouf
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - E Combet
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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37
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Tobias DK, Clish C, Mora S, Li J, Liang L, Hu FB, Manson JE, Zhang C. Dietary Intakes and Circulating Concentrations of Branched-Chain Amino Acids in Relation to Incident Type 2 Diabetes Risk Among High-Risk Women with a History of Gestational Diabetes Mellitus. Clin Chem 2018; 64:1203-1210. [PMID: 29945965 DOI: 10.1373/clinchem.2017.285841] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/11/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Circulating branched-chain amino acids (BCAAs; isoleucine, leucine, valine) are consistently associated with increased type 2 diabetes (T2D) risk, but the relationship with dietary intake of BCAAs is less clear. METHODS The longitudinal Nurses' Health Study II cohort conducted a blood collection from 1996 to 1999. We profiled plasma metabolites among 172 incident T2D cases and 175 age-matched controls from women reporting a history of gestational diabetes before blood draw. We estimated dietary energy-adjusted BCAAs from food frequency questionnaires. We used conditional logistic regression models to estimate odds ratios (OR) and 95% CI of T2D risk across quartiles (Q1-Q4) of BCAAs, adjusting for age, body mass index (BMI), physical activity, family history, and other established risk factors. We also assessed joint exposure to below/above medians of diet and plasma concentrations, with lower diet/lower plasma as reference. RESULTS Dietary and plasma BCAA concentrations were positively associated with incident T2D (diet Q4 vs Q1 OR = 4.6, CI = 1.6, 13.4; plasma Q4 vs Q1 OR = 4.4, CI = 1.4, 13.4). Modeling the joint association indicated that higher diet BCAAs were associated with T2D when plasma concentrations were also higher (OR = 6.0, CI = 2.1, 17.2) but not when concentrations were lower (OR = 1.6, CI = 0.61, 4.1). Conversely, higher plasma BCAAs were associated with increased T2D for either lower or higher diet. CONCLUSIONS Independent of BMI and other risk factors, higher diet and plasma BCAA concentrations were associated with an increased incident T2D risk among high-risk women with a history of gestational diabetes, supporting impaired BCAA metabolism as conferring T2D risk.
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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, MA
| | - Clary Clish
- Broad Institute of MIT and Harvard, Cambridge, MA
| | - Samia Mora
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Center for Lipid Metabolomics and Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jun Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Liming Liang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,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
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Mary Horrigan Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
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38
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Mijatovic-Vukas J, Capling L, Cheng S, Stamatakis E, Louie J, Cheung NW, Markovic T, Ross G, Senior A, Brand-Miller JC, Flood VM. Associations of Diet and Physical Activity with Risk for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:E698. [PMID: 29849003 PMCID: PMC6024719 DOI: 10.3390/nu10060698] [Citation(s) in RCA: 175] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 12/11/2022] Open
Abstract
Rising rates of gestational diabetes mellitus (GDM) and related complications have prompted calls to identify potentially modifiable risk factors that are associated with gestational diabetes mellitus (GDM). We systematically reviewed the scientific literature for observational studies examining specific dietary and/or physical activity (PA) factors and risk of GDM. Our search included PubMed, Medline, CINAHL/EBSCO, Science Direct and EMBASE, and identified 1167 articles, of which 40 met our inclusion criteria (e.g., singleton pregnancy, reported diet or PA data during pre-pregnancy/early pregnancy and GDM as an outcome measure). Studies were assessed for quality using a modified Quality Criteria Checklist from American Dietetic Association. Of the final 40 studies, 72% obtained a positive quality rating and 28% were rated neutral. The final analysis incorporated data on 30,871 pregnant women. Dietary studies were categorised into either caffeine, carbohydrate, fat, protein, calcium, fast food and recognized dietary patterns. Diets such as Mediterranean Diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH) diet and Alternate Healthy Eating Index diet (AHEI) were associated with 15–38% reduced relative risk of GDM. In contrast, frequent consumption of potato, meat/processed meats, and protein (% energy) derived from animal sources was associated with an increased risk of GDM. Compared to no PA, any pre-pregnancy or early pregnancy PA was associated with 30% and 21% reduced odds of GDM, respectively. Engaging in >90 min/week of leisure time PA before pregnancy was associated with 46% decreased odds of GDM. We conclude that diets resembling MedDiet/DASH diet as well as higher PA levels before or in early pregnancy were associated with lower risks or odds of GDM respectively. The systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42016027795.
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Affiliation(s)
- Jovana Mijatovic-Vukas
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- The School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia.
| | - Louise Capling
- Faculty of Health Sciences, The University of Sydney, Lidcombe 2141, Australia.
| | - Sonia Cheng
- Faculty of Health Sciences, The University of Sydney, Lidcombe 2141, Australia.
| | - Emmanuel Stamatakis
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney 2006, Australia.
| | - Jimmy Louie
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - N Wah Cheung
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Westmead Hospital, Western Sydney Local Health District, Westmead 2145, Australia.
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead 2145, Australia.
- Department of Diabetes and Endocrinology, Westmead Hospital, Westmead 2145, Australia.
| | - Tania Markovic
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown 2050, Australia.
| | - Glynis Ross
- Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown 2050, Australia.
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia.
| | - Alistair Senior
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- The School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia.
- School of Mathematics and Statistics, The University of Sydney, Sydney 2006, Australia.
| | - Jennie C Brand-Miller
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- The School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia.
| | - Victoria M Flood
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Faculty of Health Sciences, The University of Sydney, Lidcombe 2141, Australia.
- Westmead Hospital, Western Sydney Local Health District, Westmead 2145, Australia.
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Feng R, Liu L, Zhang YY, Yuan ZS, Gao L, Zuo CT. Unsatisfactory Glucose Management and Adverse Pregnancy Outcomes of Gestational Diabetes Mellitus in the Real World of Clinical Practice: A Retrospective Study. Chin Med J (Engl) 2018; 131:1079-1085. [PMID: 29692380 PMCID: PMC5937317 DOI: 10.4103/0366-6999.230718] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Facing the increasing prevalence of gestational diabetes mellitus (GDM), this study aimed to evaluate the management of GDM and its association with adverse pregnancy outcomes. METHODS The data of 996 inpatients with GDM who terminated pregnancies in our hospital from January 2011 to December 2015 were collected. Treatments during pregnancy and the last hospital admission before delivery were analyzed. Pregnancy outcomes of the GDM patients were compared with 996 nondiabetic subjects matched by delivery year and gestational age. The association between fasting plasma glucose (FPG) and adverse pregnancy outcomes was examined by logistic regression analyses. RESULTS The average prevalence of GDM over the 5 years was 4.4% (1330/30,191). Within the GDM patients, 42.8% (426/996) received dietary intervention, whereas 19.1% (190/996) received insulin treatment. Adverse outcomes were more likely to occur in patients with unsatisfactory control of blood glucose such as respiratory distress syndrome (RDS, χ2 = 13.373, P < 0.01). Elevated FPG was identified as an independent risk factor for premature birth (odds ratio [OR] = 1.460, P < 0.001), neonatal care unit admission (OR = 1.284, P < 0.001), RDS (OR = 1.322, P = 0.001), and stillbirth (OR = 1.427, P < 0.001). CONCLUSIONS Management of GDM in the real world of clinical practice was unsatisfactory, which might have contributed to adverse pregnancy outcomes.
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Affiliation(s)
- Ru Feng
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University; Shandong Clinical Medical Center of Endocrinology and Metabolism; Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong 250021, China
| | - Lu Liu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University; Shandong Clinical Medical Center of Endocrinology and Metabolism; Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong 250021, China
| | - Yuan-Yuan Zhang
- Department of Obstetrics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China
| | - Zhong-Shang Yuan
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong 250012, China
| | - Ling Gao
- Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong 250021, China; Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China
| | - Chang-Ting Zuo
- Department of Obstetrics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China
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Horsch A, Gilbert L, Lanzi S, Gross J, Kayser B, Vial Y, Simeoni U, Hans D, Berney A, Scholz U, Barakat R, Puder JJ. Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial, a randomised controlled trial. BMJ Open 2018; 8:e020462. [PMID: 29487077 PMCID: PMC5855393 DOI: 10.1136/bmjopen-2017-020462] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/10/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) carries prenatal and perinatal risk for the mother and her offspring as well as longer-term risks for both the mother (obesity, diabetes, cardiovascular disease) and her child (obesity, type 2 diabetes). Compared with women without GDM, women with GDM are twice as likely to develop perinatal or postpartum depression. Lifestyle interventions for GDM are generally limited to physical activity and/or nutrition, often focus separately on the mother or the child and take place either during or after pregnancy, while their results are inconsistent. To increase efficacy of intervention, the multifactorial origins of GDM and the tight link between mental and metabolic as well as maternal and child health need to be heeded. This calls for an interdisciplinary transgenerational approach starting in, but continuing beyond pregnancy. METHODS AND ANALYSIS This randomised controlled trial will assess the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention aimed at improving the metabolic and mental health of 200 women with GDM and their offspring. Women with GDM at 24-32 weeks gestational age who understand French or English, and their offspring and partners can participate. The intervention components will be delivered on top of usual care during pregnancy and the first year postpartum. Metabolic and mental health outcomes will be measured at 24-32 weeks of pregnancy, shortly after birth and at 6-8 weeks and 1 year after childbirth. Data will be analysed using intention-to-treat analyses. The MySweetHeart Trial is linked to the MySweetHeart Cohort (clinicaltrials.gov/ct2/show/NCT02872974). ETHICS AND DISSEMINATION We will disseminate the findings through regional, national and international conferences and through peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02890693; Pre-results.
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Affiliation(s)
- Antje Horsch
- Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Leah Gilbert
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Stefano Lanzi
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- Service of Angiology, Heart and Vessel Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Justine Gross
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Yvan Vial
- Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Umberto Simeoni
- DOHad Laboratory, Pediatrics Division, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Didier Hans
- Center of Bone Diseases, Rheumatology Service, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Alexandre Berney
- Consultation Liaison Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Urte Scholz
- Applied Social and Health Psychology, Department of Psychology, University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Lausanne, Switzerland
| | - Ruben Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Jardena J Puder
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Service of Pediatric Endocrinology, Diabetology and Obesity, Lausanne University Hospital, Lausanne, Switzerland
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Weickert MO, Pfeiffer AFH. Impact of Dietary Fiber Consumption on Insulin Resistance and the Prevention of Type 2 Diabetes. J Nutr 2018; 148:7-12. [PMID: 29378044 DOI: 10.1093/jn/nxx008] [Citation(s) in RCA: 263] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/17/2017] [Indexed: 12/22/2022] Open
Abstract
Large prospective cohort studies consistently show associations of a high dietary fiber intake (>25 g/d in women and >38 g/d in men) with a 20-30% reduced risk of developing type 2 diabetes (T2D), after correction for confounders. It is less well recognized that these effects appear to be mainly driven by high intakes of whole grains and insoluble cereal fibers, which typically are nonviscous and do not relevantly influence postprandial glucose responses [i.e., glycemic index (GI)] or are strongly fermented by the gut microbiota in the colon. In contrast, a dietary focus on soluble, viscous, gel-forming, more readily fermentable fiber intakes derived from fruit and certain vegetables yields mixed results and generally does not appear to reduce T2D risk. Although disentangling types of fiber-rich foods and separating these from possible effects related to the GI is an obvious challenge, the common conclusion that key metabolic effects of high-fiber intake are explained by mechanisms that should mainly apply to the soluble, viscous type can be challenged. More recently, studies in humans and animal models focused on gaining mechanistic insights into why especially high-cereal-fiber (HCF) diets appear to improve insulin resistance (IR) and diabetes risk. Although effects of HCF diets on weight loss are only moderate and comparable to other types of dietary fibers, possible novel mechanisms have emerged, which include the prevention of the absorption of dietary protein and modulation of the amino acid metabolic signature. Here we provide an update of our previous review from 2008, with a focus on mechanistic insights of how HCF diets may improve IR and the risk of developing T2D.
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Affiliation(s)
- Martin O Weickert
- Department of Endocrinology and Diabetes, University Hospitals Coventry and Warwickshire NHS Trust, United Kingdom.,Centre of Applied Biological & Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Andreas F H Pfeiffer
- German Institute of Human Nutrition, Department of Clinical Nutrition.,Department of Endocrinology, Diabetes and Nutrition, Charité-University-Medicine-Berlin, Berlin, Germany
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Abstract
PURPOSE OF REVIEW Cravings for carbohydrates have been known about for hundreds of years but the mechanisms behind it were unclear. This review will highlight recent advances in our knowledge of mechanisms to detect carbohydrates in the diet. RECENT FINDINGS Recent work has begun to identify the physiological mechanisms by which carbohydrates and glucose are detected and how this drives their intake. Recently, evidence has been found for systems that regulate carbohydrate and glucose intake via taste, hedonic, and homeostatic pathways. SUMMARY Identification of the physiological mechanisms that regulate carbohydrate intake will allow a better understanding of how their intake is regulated and responds to changes in dietary intake. Such an understanding will be a key for developing a more rational approach to the development of successful weight loss diets.
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Affiliation(s)
- Yue Ma
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Risheka Ratnasabapathy
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - James Gardiner
- Section of Endocrinology and Investigative Medicine, Department of Medicine, Imperial College London, London, United Kingdom
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Koning SH, Hoogenberg K, Lutgers HL, van den Berg PP, Wolffenbuttel BHR. Gestational Diabetes Mellitus:current knowledge and unmet needs. J Diabetes 2016; 8:770-781. [PMID: 27121958 DOI: 10.1111/1753-0407.12422] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/30/2016] [Accepted: 04/23/2016] [Indexed: 01/12/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a global health concern, not only because its prevalence is high and on the increase, but also because of the potential implications for the health of mothers and their offspring. Unfortunately, there is considerable controversy in the literature surrounding the diagnosis and treatment of GDM, as well as the possible long-term consequences for the offspring. As a result, worldwide there is a lack of uniformly accepted diagnostic criteria and the advice regarding the treatment of GDM, including diet, insulin therapy, and the use of oral blood glucose-lowering agents, is highly variable. In this review we provide an overview of the important issues in the field of GDM, including diagnostic criteria, different treatment regimens available, and the long-term consequences of GDM in the offspring.
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Affiliation(s)
- Sarah H Koning
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands.
| | - Klaas Hoogenberg
- Department of Internal Medicine, Martini Hospital, Groningen, The Netherlands
| | - Helen L Lutgers
- Department of Endocrinology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Paul P van den Berg
- Department of Gynecology and Obstetrics, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Bruce H R Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
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Chavarro JE, Rich-Edwards JW, Gaskins AJ, Farland LV, Terry KL, Zhang C, Missmer SA. Contributions of the Nurses' Health Studies to Reproductive Health Research. Am J Public Health 2016; 106:1669-76. [PMID: 27459445 DOI: 10.2105/ajph.2016.303350] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To review the Nurses' Health Study's (NHS's) contribution to identifying risk factors and long-term health consequences of reproductive events. METHODS We performed a narrative review of the NHS I, NHS II, NHS3, and Growing Up Today Study (GUTS) publications between 1976 and 2016. RESULTS Collection of detailed reproductive history to identify breast cancer risk factors allowed the NHS to document an association between menstrual irregularities, a proxy for polycystic ovary syndrome (PCOS), and increased risk of diabetes and cardiovascular disease. The NHS II found that infertility associated with ovulation problems and gestational diabetes are largely preventable through diet and lifestyle modification. It also identified developmental and nutritional risk factors for pregnancy loss, endometriosis, and uterine leiomyomata. As women in NHS II age, it has become possible to address questions regarding long-term health consequences of pregnancy complications and benign gynecologic conditions on chronic disease risk. Furthermore, the NHS3 and GUTS are allowing new lines of research into human fertility, PCOS, and transgenerational effects of environmental exposures. CONCLUSIONS The multigenerational resources of the NHSs and GUTS, including linkages of related individuals across cohorts, can improve women's health from preconception through late adulthood and onto the next generation.
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Affiliation(s)
- Jorge E Chavarro
- Jorge E. Chavarro, Janet W. Rich-Edwards, Audrey J. Gaskins, Leslie V. Farland, Kathryn L. Terry, and Stacey A. Missmer are with the Harvard T. H. Chan School of Public Health, and Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Cuilin Zhang is with the Epidemiology Branch, Division of Intramural Population Health Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Janet W Rich-Edwards
- Jorge E. Chavarro, Janet W. Rich-Edwards, Audrey J. Gaskins, Leslie V. Farland, Kathryn L. Terry, and Stacey A. Missmer are with the Harvard T. H. Chan School of Public Health, and Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Cuilin Zhang is with the Epidemiology Branch, Division of Intramural Population Health Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Audrey J Gaskins
- Jorge E. Chavarro, Janet W. Rich-Edwards, Audrey J. Gaskins, Leslie V. Farland, Kathryn L. Terry, and Stacey A. Missmer are with the Harvard T. H. Chan School of Public Health, and Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Cuilin Zhang is with the Epidemiology Branch, Division of Intramural Population Health Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Leslie V Farland
- Jorge E. Chavarro, Janet W. Rich-Edwards, Audrey J. Gaskins, Leslie V. Farland, Kathryn L. Terry, and Stacey A. Missmer are with the Harvard T. H. Chan School of Public Health, and Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Cuilin Zhang is with the Epidemiology Branch, Division of Intramural Population Health Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Kathryn L Terry
- Jorge E. Chavarro, Janet W. Rich-Edwards, Audrey J. Gaskins, Leslie V. Farland, Kathryn L. Terry, and Stacey A. Missmer are with the Harvard T. H. Chan School of Public Health, and Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Cuilin Zhang is with the Epidemiology Branch, Division of Intramural Population Health Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Cuilin Zhang
- Jorge E. Chavarro, Janet W. Rich-Edwards, Audrey J. Gaskins, Leslie V. Farland, Kathryn L. Terry, and Stacey A. Missmer are with the Harvard T. H. Chan School of Public Health, and Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Cuilin Zhang is with the Epidemiology Branch, Division of Intramural Population Health Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Stacey A Missmer
- Jorge E. Chavarro, Janet W. Rich-Edwards, Audrey J. Gaskins, Leslie V. Farland, Kathryn L. Terry, and Stacey A. Missmer are with the Harvard T. H. Chan School of Public Health, and Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Cuilin Zhang is with the Epidemiology Branch, Division of Intramural Population Health Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
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Moses RG, Cefalu WT. Considerations in the Management of Gestational Diabetes Mellitus: "You Are What Your Mother Ate!". Diabetes Care 2016; 39:13-5. [PMID: 26696656 PMCID: PMC4822404 DOI: 10.2337/dci15-0030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Robert G Moses
- Diabetes Services, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - William T Cefalu
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
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