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Cao Y, Sheng J, Zhang D, Chen L, Jiang Y, Cheng D, Su Y, Yu Y, Jia H, He P, Wang L, Xu X. The role of dietary fiber on preventing gestational diabetes mellitus in an at-risk group of high triglyceride-glucose index women: a randomized controlled trial. Endocrine 2023; 82:542-549. [PMID: 37737931 DOI: 10.1007/s12020-023-03478-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/01/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Pregnant women with a high triglyceride-glucose (TyG) index during early pregnancy may increase the risk of gestational diabetes mellitus (GDM), and dietary fiber could play an important role in glucose and lipid metabolism. However, no trials have tested the effects of dietary fiber on preventing GDM in women with a high TyG index. This study aims to investigate whether GDM can be prevented by dietary fiber supplementation in women with a TyG index ≥8.5 during early pregnancy (<20 weeks). METHODS A randomized clinical trial was performed among 295 women with a TyG index ≥8.5 before 20 weeks of gestation, divided into a fiber group (24 g dietary fiber powder/day) or a control group (usual care). The intervention was conducted from 20 to 24+6 gestational weeks, and both groups received guidance on exercise and diet. The primary outcomes were the incidence of GDM diagnosed by a 75 g oral glucose tolerance test at 25-28 gestational weeks, and levels of maternal blood glucose, lipids. Secondary outcomes include gestational hypertension, postpartum hemorrhage, preterm birth, and other maternal and neonatal complications. RESULTS GDM occurred at 11.2% (10 of 89) in the fiber group, which was significantly lower than 23.7 (44 of 186) in the control group (P = 0.015). The mean gestational weeks increased dramatically in the fiber group compared with the control group (39.07 ± 1.08 vs. 38.58 ± 1.44 weeks, P = 0.006). The incidence of preterm birth was 2.3% (2 of 86) of women randomized to the fiber group compared with 9.4% (17 of 181) in the control group (P = 0.032). The concentrations of 2 h postprandial blood glucose showed statistically higher in the control group compared with the intervention group (6.69 ± 1.65 vs. 6.45 ± 1.25 mmol/L, P = 0.026). There were no other significant differences between groups in lipid profile values, or other secondary outcomes. CONCLUSION An intervention with dietary fiber supplementation during pregnancy may prevent GDM and preterm birth in women with a TyG index ≥8.5 before 20 weeks of gestation.
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Affiliation(s)
- Yannan Cao
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Jing Sheng
- Department of Radiology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Dongyao Zhang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
- Department of Obstetrics and Gynecology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Li Chen
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Ying Jiang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
- Nursing Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Decui Cheng
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Yao Su
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Yuexin Yu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Haoyi Jia
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Pengyuan He
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Li Wang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Xianming Xu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China.
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Ding Y, Shi X, Li G, Liang Q, Yang Z, Peng Y, Deng H, Wang Z. Effects of dynamic zero COVID-19 policy on anxiety status and lifestyle changes of pregnant women in rural South China: a survey-based analysis by propensity score matching method. Front Public Health 2023; 11:1182619. [PMID: 37427259 PMCID: PMC10323362 DOI: 10.3389/fpubh.2023.1182619] [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: 03/28/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic triggered a global public health crisis and has brought an unprecedented impact on pregnant women. The problems faced by pregnant women in the rural areas of China during the epidemic are different from those in urban areas. Although the epidemic situation in China has gradually improved, studying the impact of the previous dynamic zero COVID-19 policy on the anxiety status and lifestyle of pregnant women in rural areas of China, is still necessary. Methods A cross-sectional survey of pregnant women in rural South China was conducted from September 2021 to June 2022.Using questionnaires, sociodemographic characteristics, anxiety status, physical activity, sleep quality, and dietary status of the population were collected. Using the propensity score matching method, the effect of the dynamic zero COVID-19 strategy on the anxiety status and lifestyle of pregnant women was analyzed. Results Among the pregnant women in the policy group (n = 136) and the control group (n = 680), 25.7 and 22.4% had anxiety disorders, 83.1 and 84.7% had low or medium levels of physical activity, and 28.7 and 29.1% had sleep disorders, respectively. However, no significant difference (p > 0.05) was observed between the two groups. Compared with control group, the intake of fruit in the policy group increased significantly (p = 0.019), whereas that of aquatic products and eggs decreased significantly (p = 0.027). Both groups exhibited an unreasonable dietary structure and poor compliance with the Chinese dietary guidelines for pregnant women (p > 0.05). The proportion of pregnant women in the policy group, whose intake of stable food (p = 0.002), soybean, and nuts (p = 0.004) was less than the recommended amount, was significantly higher than that in the control group. Discussion The dynamic zero COVID-19 strategy had little impact on the anxiety status, physical activity, and sleep disorders of pregnant women in the rural areas of South China. However, it affected their intake of certain food groups. Improving corresponding food supply and organized nutritional support should be addressed as a strategic approach to improve the health of pregnant women in rural South China during the pandemic.
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Affiliation(s)
- Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xi Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Genyuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qingfen Liang
- Lingshan Maternal and Child Health Hospital, Qinzhou, China
| | - Ziqi Yang
- Tianyang Maternal and Child Health Hospital, Baise, China
| | - Yanxia Peng
- Zijin Maternal and Child Health Hospital, Heyuan, China
| | - Huiqin Deng
- Longchuan Maternal and Child Health Hospital, Heyuan, China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Oh K, Park S, Park S, Yun S, Choi H, Jeong EK. Changes in food and nutrient intakes in Korean adults before and during the COVID-19 pandemic: data from the 2011-2020 Korea National Health and Nutrition Examination Survey. Epidemiol Health 2023; 45:e2023015. [PMID: 36731472 PMCID: PMC10581887 DOI: 10.4178/epih.e2023015] [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: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES This study was to examine the changes in dietary habits and food and nutrient intakes between before (2019) and during (2020) the coronavirus disease 2019 (COVID-19) pandemic from the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS A total of 54,995 participants aged ≥19 years who participated in the 2011-2020 KNHANES were included. The 10-year trend (2011-2020) and differences between 2019 and 2020 for dietary habits and food and nutrient intakes were estimated using SAS. RESULTS In the past 10 years (2011-2020), the dietary habits (increase in skipping meals and eating out), food intake (increase in meats and decrease in fruits and vegetables), and nutrient intake (increase in fat and decrease in sodium) in adults have changed. When comparing between 2019 and 2020, there were 4.6%p decrease in the eating out more than once a day. On the other hand, there were no significant differences in the intakes of food, energy and most of nutrients between 2019 and 2020, except for the proportion of energy intake from fat (1.0%p increase) and carbohydrate (1.0%p decrease). CONCLUSIONS Although a change in dietary habits from before to during the COVID-19 pandemic was observed, food and nutrient intakes have not deteriorated markedly and appear similar to the trends in the past 10 years. Throughout the COVID-19 pandemic, it is necessary to monitor the effects of changes in dietary habits on health as well as food and nutrient intakes.
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Affiliation(s)
- Kyungwon Oh
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Suyeon Park
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sihyun Park
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sungha Yun
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Hongseok Choi
- Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Eun Kyeong Jeong
- Public Health Care Headquarters, Seoul National University Bundang Hospital, Seongnam, Korea
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Park S, Marcotte RT, Staudenmayer JW, Strath SJ, Freedson PS, Chasan-Taber L. The impact of the COVID-19 pandemic on physical activity and sedentary behavior during pregnancy: a prospective study. BMC Pregnancy Childbirth 2022; 22:899. [PMID: 36463119 PMCID: PMC9719639 DOI: 10.1186/s12884-022-05236-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/24/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Prior studies evaluating the impact of the COVID-19 pandemic on pregnancy physical activity (PA) have largely been limited to internet-based surveys not validated for use in pregnancy. METHODS This study used data from the Pregnancy PA Questionnaire Validation study conducted from 2019-2021. A prospective cohort of 50 pregnant women completed the Pregnancy PA Questionnaire (PPAQ), validated for use in pregnancy, in early, mid, and late pregnancy and wore an ActiGraph GT3X-BT for seven days. COVID-19 impact was defined using a fixed date of onset (March 13, 2020) and a self-reported date. Multivariable linear mixed effects regression models adjusted for age, early pregnancy BMI, gestational age, and parity. RESULTS Higher sedentary behavior (14.2 MET-hrs/wk, 95% CI: 2.3, 26.0) and household/caregiving PA (34.4 MET-hrs/wk, 95% CI: 8.5, 60.3 and 25.9 MET-hrs/wk, 95% CI: 0.9, 50.9) and lower locomotion (-8.0 h/wk, 95% CI: -15.7, -0.3) and occupational PA (-34.5 MET-hrs/wk, 95% CI: -61.9, -7.0 and -30.6 MET-hrs/wk, 95% CI: -51.4, -9.8) was observed in middle and late pregnancy, respectively, after COVID-19 vs. before. There was no impact on steps/day or meeting American College of Obstetricians and Gynecologists guidelines. CONCLUSIONS Proactive approaches for the promotion of pregnancy PA during pandemic-related restrictions are critically needed.
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Affiliation(s)
- Susan Park
- grid.266683.f0000 0001 2166 5835Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, 715 North Pleasant Street, Amherst, MA 01003-9304 USA
| | - Robert T. Marcotte
- grid.266683.f0000 0001 2166 5835Department of Kinesiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA USA
| | - John W. Staudenmayer
- grid.266683.f0000 0001 2166 5835Department of Mathematics and Statistics, College of Natural Sciences, University of Massachusetts, Amherst, MA USA
| | - Scott J. Strath
- grid.267468.90000 0001 0695 7223Department of Kinesiology, University of Wisconsin Milwaukee, Milwaukee, WI USA
| | - Patty S. Freedson
- grid.266683.f0000 0001 2166 5835Department of Kinesiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA USA
| | - Lisa Chasan-Taber
- grid.266683.f0000 0001 2166 5835Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, 715 North Pleasant Street, Amherst, MA 01003-9304 USA
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Tayyem R, Al-Bayyari N, Al-Awwad N, Abuhijleh H, Hoteit R, Qasrawi R, Badran E, Basha A, Allehdan S, Boukari K, Arrish J, Seir RA, Hoteit M. Dietary intake and lifestyle practices of eastern mediterranean postpartum women before and during COVID-19 pandemic: An internet-based cross-sectional survey. Front Nutr 2022; 9:932418. [PMID: 36034906 PMCID: PMC9400898 DOI: 10.3389/fnut.2022.932418] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background During the lockdown period, a substantial group of these women reported lifestyle changes. Aim The aim of the study is to characterize the dietary patterns, intake and the adherence to the United States Department of Agriculture (USDA) pregnancy guidelines before and during the COVID-19 pandemic in Eastern Mediterranean postartum women. Methods An internet-based cross-sectional survey was used to collect the data. The survey was carried out among 1,939 postpartum women from five countries from the Eastern Mediterranean region. Change in dietary intake from the five food groups and the adherence to USDA's daily recommendations were assessed. Findings There was a significant increase in the mean (SD) consumption of all the food groups, including bread, rice, and other cereals, fruits, vegetables, milk and milk products, white and red meat, and nuts during the pandemic. Around 84% of participants reported no/low adherence (0–2) to USDA guidelines, whereas only 15% reported moderate or high adherence (3–5) to the guidelines before the pandemic. However, there was an increase in the proportion of subjects reporting moderate/high adherence (22%) during the pandemic. Discussion and conclusions A substantial proportion of our study participants reported a lower dietary intake than the recommended amounts, and low adherence to the five food groups. Reasonable and applicable actions should be taken to protect postpartum women and their children from the effects of low dietary intake, particularly during pandemics and lockdowns. More researches are needed to identify the modifiable factors which could improve the nutritional status of the postpartum women during the pandemic.
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Affiliation(s)
- Reema Tayyem
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar.,School of Agriculture, The University of Jordan, Amman, Jordan
| | - Nahla Al-Bayyari
- Department of Nutrition and Food Technology, Faculty of Al-Huson University College, Al-Balqa Applied University, Al-Salt, Jordan
| | - Narmeen Al-Awwad
- Department of Clinical Nutrition and Dietetics, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Haya Abuhijleh
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Reem Hoteit
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Radwan Qasrawi
- Department of Computer Science, Al-Quds University, Jerusalem, Palestine.,Department of Computer Engineering, Istinye University, Istanbul, Turkey
| | - Eman Badran
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Asma Basha
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Sabika Allehdan
- Department of Biology, College of Science, University of Bahrain, Bahrain
| | - Khlood Boukari
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia.,National Nutrition Committee (NNC), Saudi Food and Drug Authority (Saudi FDA), Riyadh, Saudi Arabia
| | - Jamila Arrish
- National Nutrition Committee (NNC), Saudi Food and Drug Authority (Saudi FDA), Riyadh, Saudi Arabia
| | - Rania Abu Seir
- Department of Biomedical Technology, Al-Quds University, Jerusalem, Palestine
| | - Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut, Lebanon.,PHENOL Research Group (Public Health Nutrition program-Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
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Pregnancy Activity Levels and Impediments in the Era of COVID-19 Based on the Health Belief Model: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063283. [PMID: 35328974 PMCID: PMC8954454 DOI: 10.3390/ijerph19063283] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023]
Abstract
Physical activity (PA) and exercise benefit both the mother and the fetus. Many pregnant women avoid or severely limit PA, leading to complications before and after delivery. This study elucidated the precise effect of each moderator variable on prenatal physical activity (PPA) by examining demographic factors, the PPA-related health belief level (HBL), and the current PPA level. The health belief model (HBM) in conjunction with the international prenatal physical activity questionnaire was used. The HBL in pregnant parous women (PPW) (3.42) was significantly higher than that in nonpregnant nulliparous women (NNW) (3.06). The PPA level in pregnant nulliparous women (PNW) (5.67 metabolic equivalent-hours per week (MET-h/week)) was lower than in the PPW (6.01 MET-h/week). All HBM dimensions (except for perceived barriers) were positively correlated with exercise expenditure in both PNW and PPW. According to the regression tree, participants in PNW aged ≤ 23 years with annual household incomes > CNY 100,001−150,000 had the highest energy expenditure (10.75 MET-h/week), whereas participants in PPW with a perceived benefit score of >4 had the highest energy expenditure (10 MET-h/week). The results demonstrated that the HBL in all groups was acceptable, whereas the PPA level was lower than the recommended PA level. In both PPW and PNW, the HBL was most strongly correlated with exercise expenditure. There is an urgent need to organize public-interest courses to alleviate household expenditure, raise the HBL about PPA in pregnant and NNW, and ensure personal health in the context of COVID-19.
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Kołomańska-Bogucka D, Micek A, Mazur-Bialy AI. The COVID-19 Pandemic and Levels of Physical Activity in the Last Trimester, Life Satisfaction and Perceived Stress in Late Pregnancy and in the Early Puerperium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053066. [PMID: 35270759 PMCID: PMC8910231 DOI: 10.3390/ijerph19053066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 12/16/2022]
Abstract
Background: The aim of this study was to determine the impact of the COVID-19 pandemic on the levels of physical activity during the third trimester of pregnancy, life satisfaction and stress in women in late pregnancy and early postpartum. Methods: The study was conducted among 740 patients of maternity wards in Cracow hospitals on days 1−8 postpartum. Patients who were surveyed before the pandemic (December 2019−March 2020) were included in the prepandemic group (PPan: n = 252). The second group of women (COVID 1 group, Cov1: n = 262) was examined in the early stages of the pandemic (May−September 2020). In turn, participants who were surveyed during the population vaccination campaign (June−September 2021) were qualified to the COVID 2 group (Cov2: n = 226). The research tools used were the original questionnaire in addition to standardized questionnaires assessing physical activity in the last trimester of pregnancy (the Pregnancy Physical Activity Questionnaire); previous life satisfaction (the Satisfaction with Life Scale); and stress levels during the last month (the Perceived Stress Scale). Results: During the pandemic, women reduced the level of energy spent on total physical activity; nevertheless, statistically significant differences were found only between the PPan and Cov2 groups (p = 0.001). At the early stages of the pandemic, patients significantly reduced mobility activities (Cov1 vs. PPan: p < 0.001; Cov1 vs. Cov2: p = 0.007), while late in the pandemic they spent less energy on household activities (Cov2 vs. PPan: p = 0.002, Cov2 vs. Cov1: p = 0.002). There were no differences in the levels of stress and life satisfaction. Conclusions: The COVID-19 pandemic impacted the level of physical activity; however, it did not change levels of perceived stress and life satisfaction in women in late-stage pregnancy and in the early puerperium.
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Affiliation(s)
- Daria Kołomańska-Bogucka
- Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland;
| | - Agnieszka Micek
- Faculty of Health Science, Institute of Nursing and Midwifery, Jagiellonian University Medical College, Kopernika 25, 31-501 Krakow, Poland;
| | - Agnieszka I. Mazur-Bialy
- Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland;
- Correspondence: ; Tel.: +48-012-421-9351
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