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Miller C, Boushey C, Benny P, Ma S, Huang J, Lim E, Lee MJ. Diet quality predicts hypertensive disorders of pregnancy in Asian and Pacific Islander Cohort. Nutr Health 2024; 30:243-252. [PMID: 35754336 DOI: 10.1177/02601060221109668] [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] [Indexed: 11/16/2022]
Abstract
Background: There is limited data on diet quality during pregnancy and its impact on hypertensive disorders of pregnancy (HDP). Aim: Examine the association with diet quality and development of HDP in an Asian and Pacific Islander Cohort Methods: Pregnant women from the 4 largest ethnic groups in Hawai'i were recruited for participation. Participants completed a food frequency questionnaire during each trimester. Adherence to three diet quality indices (DQIs) were scored-The Healthy Eating Index (HEI), The Alternate Mediterranean Diet score (aMED), and the Dietary approaches to Stop Hypertension (DASH) score. Mean scores were compared among those who did and did not develop HDP. Logistic Regression models were used to examine the association between diet quality and HDP accounting for confounders (age, parity, obesity, ethnicity, gestational weight gain). Results: Among 55 participants with complete follow-up, there was a high incidence of HDP (23%). There was no significant change of DQIs over time. Non-Hispanic White participants had higher DQIs than Filipinas, Japanese, or Native Hawaiians (not statistically significant). Across gestation, participants who did not have HDP had better diet quality than those who did. Logistic regression showed that HEI and DASH indices are predictive of HDP development, with the high DASH diet score having the greatest reduced odds. Every point higher of DASH diet score portended approximately 30% reduced odds of developing HDP. Conclusions: The DASH diet had the strongest association with reduced odds of HDP, but better diet quality in any of the indices was also predictive.
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Affiliation(s)
- Corrie Miller
- Department of Obstetrics, Gynecology and Women's Health, John A Burns School of Medicine, University of Hawai'i, Manoa, Honolulu, HI, USA
| | - Carol Boushey
- Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Paula Benny
- Department of Obstetrics, Gynecology and Women's Health, John A Burns School of Medicine, University of Hawai'i, Manoa, Honolulu, HI, USA
| | - Shani Ma
- Department of Obstetrics, Gynecology and Women's Health, John A Burns School of Medicine, University of Hawai'i, Manoa, Honolulu, HI, USA
| | - Joyce Huang
- Department of Obstetrics, Gynecology and Women's Health, John A Burns School of Medicine, University of Hawai'i, Manoa, Honolulu, HI, USA
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A Burns School of Medicine, University of Hawai'i, Manoa, Honolulu, HI, USA
| | - Men-Jean Lee
- Department of Obstetrics, Gynecology and Women's Health, John A Burns School of Medicine, University of Hawai'i, Manoa, Honolulu, HI, USA
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Londoño-Osorio S, Leon-Carreño L, Cala MP, Sierra-Zapata L. The gut metabolome in a cohort of pregnant and lactating women from Antioquia-Colombia. Front Mol Biosci 2024; 11:1250413. [PMID: 38803424 PMCID: PMC11128665 DOI: 10.3389/fmolb.2024.1250413] [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: 06/30/2023] [Accepted: 02/20/2024] [Indexed: 05/29/2024] Open
Abstract
Nutrition during the perinatal period is an essential component of health and one that can severely impact the correct development of a human being and its overall condition, in all the subsequent stages of life. The availability of several compounds, mainly macronutrients and micronutrients, plays a key role in the balanced nutrition of both mother and baby and is a process with direct relation to the gut microbiome. Thus, we hereby refer to the set of small molecules derived from gut microbiome metabolism as the gut metabolome. These continuous processes occurring in the gut of a gestating or lactating mother related to microbial communities and nutrients, can be revealed by metabolomics. In this study, we explore for the first time the gut metabolome of pregnant and lactating women, from our region of Antioquia-Colombia, applying untargeted metabolomics by LC-QTOF-MS, and molecular networking. Regarding the gut metabolome composition of the cohort, we found, key metabolites that can be used as biomarkers of microbiome function, overall metabolic health, dietary intake, pharmacology, and lifestyle. In our cohort, pregnant women evidenced a significantly higher abundance of prostaglandins, alkaloids, corticosteroids, organosilicons, and natural toxins, while in lactating women, lipids stand out. Our results suggest that unveiling the metabolic phenotype of the gut microbiome of an individual, by untargeted metabolomics, allows a broad visualization of the chemical space present in this important niche and enables the recognition of influential indicators of the host's health status and habits, especially of women during this significant perinatal period. This study constitutes the first evidence of the use of untargeted LC-QTOF-MS coupled with molecular networking analysis, of the gut microbiome in a Colombian cohort and establishes a methodology for finding relative abundances of key metabolites, with potential use in nutritional and physiological state assessments, for future personalized health and nutrition practices.
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Affiliation(s)
- Sara Londoño-Osorio
- CIBIOP Research Group, School of Applied Sciences and Engineering, Universidad EAFIT, Medellín, Colombia
| | - Lizeth Leon-Carreño
- MetCore–Metabolomics Core Facility, Vice-Presidency for Research, Universidad de Los Andes, Bogotá, Colombia
| | - Mónica P. Cala
- MetCore–Metabolomics Core Facility, Vice-Presidency for Research, Universidad de Los Andes, Bogotá, Colombia
| | - Laura Sierra-Zapata
- CIBIOP Research Group, School of Applied Sciences and Engineering, Universidad EAFIT, Medellín, Colombia
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Tugume P, Mustafa AS, Walusansa A, Ojelel S, Nyachwo EB, Muhumuza E, Nampeera M, Kabbale F, Ssenku JE. Unravelling taboos and cultural beliefs associated with hidden hunger among pregnant and breast-feeding women in Buyende district Eastern Uganda. JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE 2024; 20:46. [PMID: 38693532 PMCID: PMC11064283 DOI: 10.1186/s13002-024-00682-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/29/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Food taboos and cultural beliefs among pregnant and breast-feeding women influence their food consumption patterns and hence the health of women and unborn children. Cognizant of their neglect in programs aimed to ameliorate hidden hunger among pregnant and breast-feeding women in Buyende and other resource-poor communities in sub-Saharan Africa, we opted for a study to unravel them to inform program design. METHODS We documented food taboos and beliefs amongst pregnant and breast-feeding women from six sub-counties of Buyende district in Eastern Uganda. A mixed-methods approach was used, which was comprised of questionnaire interviews with 462 women, eight focus group discussions with 6-10 participants in each and a total of 15 key informant interviews. RESULTS The present study revealed that 129 (27.9%) of the respondents practice food taboos and adhere to cultural beliefs related to their dietary habits during pregnancy and breast-feeding that are fuelling the prevalence of hidden hunger. The most tabooed foods during pregnancy were sugarcane (17.8%), fishes which included lung fish, catfish and the Lake Victoria sardine (Rastrineobola argentea) (15.2%), oranges (6.6%), pineapples (5.9%), eggs (3.3%), chicken (3.3%) and cassava, mangoes and Cleome gynandra (each at 3%). Most foods were avoided for reasons associated with pregnancy and labour complications and undesirable effects on the baby. Most women learnt of the taboos and beliefs from the elders, their own mother, grandparents or mother-in-law, but there was also knowledge transmission in social groups within the community. CONCLUSIONS The taboos and cultural beliefs in the study area render pregnant and breast-feeding women prone to micronutrient deficiency since they are denied consumption of a diversity of nutritious foods. There is a need to educate such women about consumption of nutrient-rich foods like fish, eggs, fruits and vegetables in order to improve their health, that of the unborn and children being breast fed. Additionally, culturally appropriate nutrition education may be a good strategy to eliminate inappropriate food taboos and beliefs with negative impact on the health of pregnant and breast-feeding women.
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Affiliation(s)
- Patience Tugume
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Abubakar Sadik Mustafa
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Abdul Walusansa
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
- Department of Medical Microbiology, Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda, P. O. Box 7689, Kampala, Uganda
| | - Samuel Ojelel
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Evelyne B Nyachwo
- Department of Health Policy Planning and Management, School of Public Health, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Emmanuel Muhumuza
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Maria Nampeera
- Department of Health Nutrition, Buyende District Local Government, P. O. Box 87, Kamuli, Uganda
| | - Fredrick Kabbale
- Directorate of Research and Quality Assurance, Busoga University, P. O. Box 154, Iganga, Uganda
- Department of Production, Buyende District Local Government, P. O. Box 87, Kamuli, Uganda
| | - Jamilu E Ssenku
- Department of Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
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Przybysz P, Kruszewski A, Kacperczyk-Bartnik J, Romejko-Wolniewicz E. The Impact of Maternal Plant-Based Diet on Obstetric and Neonatal Outcomes-A Cross-Sectional Study. Nutrients 2023; 15:4717. [PMID: 38004112 PMCID: PMC10675710 DOI: 10.3390/nu15224717] [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: 09/22/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND In the last decades, plant-based diets have gained popularity. Pregnancy is not a contraindication to follow a meat-free diet. This study aimed to compare maternal and neonatal outcomes between women who followed a plant-based diet with those on an omnivore diet. Our second purpose was to investigate the association between physical activity level in combination with diet type and the occurrence of GDM and gestational hypertension. METHODS A questionnaire was distributed electronically via social media. The survey was conducted on a population of Polish women. RESULTS The final research group included 1015 women. The results showed that a maternal plant-based diet 6 months before pregnancy and during pregnancy does not change the incidence of GDM, anemia, and gestational hypertension. Moreover, no association was found between a diet type before conception and a delivery method or newborn birth weight. Among women who followed an omnivore diet, the risk of GDM was lower in a group with adequate physical activity during 6 months before conception (p = 0.0166). However, the combination of a plant-based diet with adequate activity during the preconception period did not influence GDM incidence. CONCLUSIONS Our study indicates that a plant-based diet during the preconception period is not worse than an omnivore diet.
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Affiliation(s)
- Paulina Przybysz
- Students’ Scientific Group Affiliated to 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, 00-315 Warsaw, Poland;
| | - Adrian Kruszewski
- Students’ Scientific Group Affiliated to 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, 00-315 Warsaw, Poland;
| | - Joanna Kacperczyk-Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, 00-315 Warsaw, Poland; (J.K.-B.); (E.R.-W.)
| | - Ewa Romejko-Wolniewicz
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, 00-315 Warsaw, Poland; (J.K.-B.); (E.R.-W.)
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Palma O, Jallah JK, Mahakalkar MG, Mendhe DM. The Effects of Vegan Diet on Fetus and Maternal Health: A Review. Cureus 2023; 15:e47971. [PMID: 38034264 PMCID: PMC10685994 DOI: 10.7759/cureus.47971] [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: 09/26/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Veganism, a way of eating that forbids goods produced from animals, is rising in acceptance around the globe. This thorough analysis investigates how a vegan diet affects fetal growth during pregnancy, highlighting the need to maintain ideal maternal nutrition. The idea of "early life programming" emphasizes how a pregnant woman's lifestyle impacts her unborn child's health. Nutrient consumption during pregnancy makes it essential to have a healthy eating routine. While a carefully thought-out vegan diet may contain all the essential nutrients, some micronutrients need special attention, which may call for supplementation. The study delves into significant findings concerning nutritional adequacy and challenges in the discussion section, highlighting nutrients like calcium, iron, omega-3 fatty acids, vitamin D, and protein. It emphasizes medical professionals' need to monitor and assist vegan expectant mothers in meeting their nutritional needs. The analysis also examines the intricate connection between a mother's health and the outcomes of vegan pregnancies, such as decreased rates of gestational diabetes and hypertension. Examining fetal growth and development further highlights the complexity of this process, as do the contradicting data on birth weights. Furthermore, early data suggest that infants born to vegan moms may benefit cognitively, but further studies are required to prove a causal relationship. In addressing ethical and environmental issues in the review's conclusion, it is acknowledged that these aspects impact pregnant women's food decisions. Given the rising popularity of veganism, it is crucial to offer trustworthy advice to expectant women who are thinking about or already following a vegan diet.
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Affiliation(s)
- Ogiza Palma
- Biochemistry, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | | | - Manjusha G Mahakalkar
- Obstetrics and Gynecology, Shrimati Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Deeplata M Mendhe
- Medicine, Community Health Nursing, Datta Meghe Institute of Medical Sciences, Wardha, IND
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林 咏, 周 雅, 赵 润, 许 雅, 刘 燕. [Analysis on the iron status and associated factors during the first trimester of pregnancy]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:600-605. [PMID: 37534638 PMCID: PMC10398780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Indexed: 08/04/2023]
Abstract
OBJECTIVE To investigate the impact of dietary and underlying factors on the iron status of women in early pregnancy and to provide evidence for preventing iron deficiency and iron deficiency anemia, thereby reducing the incidence of associated adverse outcomes. METHODS From November to December 2018, women in the first trimester of pregnancy (< 12 weeks gestation) who established prenatal records at the Shunyi District Maternal and Child Health Hospital, Beijing, were enrolled in this study, in which 388 participants were accessed for data including demographic characteristics, anthropometric measurements, parity, biomarkers reflecting iron status, and food-frequency questionnaire. SPSS 26.0 were used for statistical analysis. Dietary patterns were extracted using principal component analysis, and factor scores of each dietary pattern were calculated. Two-sided Fisher exact probability test and one-way ANOVA were conducted to access differences in iron status among the groups, and the differences were significant if P < 0.05. Iron deficiency was defined as serum ferritin(SF) < 30 μg/L. To analyze the potential role of dietary factors on iron deficiency during the first trimester, the collected data listed above were adopted as independent factors for the cross-sectional Logistic regression. We used Logistic regression to analyze the potential effects of baseline characteristics and dietary factors on iron status. RESULTS Among the 388 participants included in the analysis, 121 (32.2%) were iron deficient, in which 107 (27.6%) were iron depletion (ID), 8 (2.1%) were iron deficiency erythropoiesis (IDA), 6(1.5%) were iron deficiency anemia. The mean SF concentration was (50.4±35.3) μg/L. Multiparity(OR=3.9, 95%CI: 1.81-8.42, P=0.001)was a risk factor for iron deficiency during early pregnancy. No significant iron status differences were found among the participants with different educational levels and anthropometric measurements. In contrast, age (OR =0.96, 95%CI: 0.94-0.97, P < 0.001) was a protective factor. For multiparas, taking iron-containing supplements might have a protective effect for iron deficiency (OR=0.27, 95%CI: 0.09-0.83, P=0.022). The balance-diet pattern (OR=0.81, 95%CI: 0.66-1.00, P=0.054) only showed a marginally significant effect. CONCLUSION Increasing attention should be paid to the iron status of pregnant multiparas and young pregnant women. For those women of reproductive age with the risk factors listed above, especially for multiparas, iron-containing supplements should be recommended to prevent gestational iron deficiency. The effect of the "balance" dietary pattern on iron status in the first trimester and following requires further research and discussion.
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Affiliation(s)
- 咏惟 林
- 北京大学公共卫生学院营养与食品卫生学系,北京 100191Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - 雅琳 周
- 北京大学公共卫生学院营养与食品卫生学系,北京 100191Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - 润茏 赵
- 北京大学公共卫生学院营养与食品卫生学系,北京 100191Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - 雅君 许
- 北京大学公共卫生学院营养与食品卫生学系,北京 100191Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
- 食品安全毒理学研究与评价北京市重点实验室,北京 100191Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China
| | - 燕萍 刘
- 中国医学科学院北京协和医院临床营养科,北京 100730Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing 100730, China
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Liberal Â, Almeida D, Fernandes Â, Pereira C, Ferreira ICFR, Vivar-Quintana AM, Barros L. Nutritional, chemical and antioxidant evaluation of Armuña lentil (Lens culinaris spp): Influence of season and soil. Food Chem 2023; 411:135491. [PMID: 36724608 DOI: 10.1016/j.foodchem.2023.135491] [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: 09/17/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/20/2023]
Abstract
Lentils (Lens culinaris spp.) are a type of edible pulse consumed and produced worldwide; they are known for their valuable nutritional assets. The nutritional and chemical profiles of 34 Armuña lentil samples were assessed together with their antioxidant capacity. In addition, the influence of both the climatic conditions during the growing season and the soil type in which they grow (Luvisol and Cambisol) on nutritional and chemical profiles was also evaluated. Our results showed large amounts of valuable nutrients, such as carbohydrates, of which approximately 47.06 % and 29.11 % consist of fibers and starch respectively and significant amounts of proteins (20.47 to 25.56 g/100 g fw) and ashes. Sucrose stood out as the main free sugar in this variety, and oxalic and γ-tocopherol as the main organic acid and tocopherol isoform respectively. Fatty acid assessment showed the prevalence of PUFAs (45.3 to 63.7 %). A high antioxidant capacity (TBARS and OxHLIA) was also observed. Our results indicate that the growing season has a significant impact on the major nutrients in lentils such as the concentration of fat, ashes, fibers, and fructose and to a lesser extent proteins and sucrose. In addition, the two different soil types in this study do not seem to affect any of the parameters analyzed.
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Affiliation(s)
- Ângela Liberal
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; Food Technology Area, Escuela Politécnica Superior de Zamora, Universidad de Salamanca, Avenida Requejo, 33. 49022 Zamora, Spain.
| | - Daiana Almeida
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Ângela Fernandes
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal.
| | - Carla Pereira
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Isabel C F R Ferreira
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Ana María Vivar-Quintana
- Food Technology Area, Escuela Politécnica Superior de Zamora, Universidad de Salamanca, Avenida Requejo, 33. 49022 Zamora, Spain.
| | - Lillian Barros
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
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Ustick J, Chakos K, Jia H, Hanneke R, DiPiazza B, Koenig MD, Ma J, Man B, Tussing-Humphreys L, Burton TCJ. Associations between plant-based diets, plant foods and botanical supplements with gestational diabetes mellitus: a systematic review protocol. BMJ Open 2023; 13:e068829. [PMID: 36944462 PMCID: PMC10032412 DOI: 10.1136/bmjopen-2022-068829] [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] [Indexed: 03/23/2023] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is one of the most common health complications during pregnancy. Medical nutrition therapy is the mainstay of treatment for GDM, however, there is no current consensus on optimal dietary approaches to prevent or control hyperglycaemia in pregnancy. The aim of this systematic review is to assess the relationships between plant-based dietary patterns, plant foods and botanical dietary supplements with GDM and maternal glycaemic biomarkers. METHODS AND ANALYSIS A predefined search strategy was used on 16 June 2021, to search PubMed, Embase and CINAHL Plus with Full Text (EBSCOhost), as well as ClinicalTrials.gov, for studies published as original articles in English. Articles will be included if they are human observational studies or clinical trials and will be excluded if they are review articles or conference abstracts. We will use Cochrane's risk of bias tools for interventions that are parallel arm (Risk of Bias tool for randomised trials version 2 (RoB 2)) and single arm, non-randomised intervention studies (Risk of Bias In Non-randomised Studies-of Interventions (ROBINS-I)). For observational, case-control and cross-sectional studies, we will use the National Heart, Lung and Blood Institute's quality assessment tools. Data will be synthesised in a narrative format describing significant results as well as presenting the results of the quality assessment of studies. ETHICS AND DISSEMINATION This systematic review does not require ethical approval as primary data will not be collected. The review will be published in a peer-reviewed journal and disseminated electronically and in print. PROSPERO REGISTRATION NUMBER CRD42022306915.
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Affiliation(s)
- Jessica Ustick
- Kinesiology and Nutrition, University of Illinois Chicago, Chicago, Illinois, USA
| | - Kaitlin Chakos
- Kinesiology and Nutrition, University of Illinois Chicago, Chicago, Illinois, USA
| | - Hejingzi Jia
- Kinesiology and Nutrition, University of Illinois Chicago, Chicago, Illinois, USA
| | - Rosie Hanneke
- University Library, University of Illinois Chicago, Chicago, Illinois, USA
| | - Brittany DiPiazza
- Kinesiology and Nutrition, University of Illinois Chicago, Chicago, Illinois, USA
| | - Mary Dawn Koenig
- Human Development Nursing Science, University of Illinois Chicago, Chicago, Illinois, USA
| | - Jun Ma
- Medicine, University of Illinois Chicago, Chicago, Illinois, USA
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, Illinois, USA
| | - Bernice Man
- Medicine, University of Illinois Chicago, Chicago, Illinois, USA
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Jayedi A, Zeraattalab-Motlagh S, Moosavi H, Mirmohammadkhani M, Emadi A, Shab-Bidar S. Association of plant-based dietary patterns in first trimester of pregnancy with gestational weight gain: results from a prospective birth cohort. Eur J Clin Nutr 2023:10.1038/s41430-023-01275-x. [PMID: 36788355 DOI: 10.1038/s41430-023-01275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND/OBJECTIVES Plant-based dietary patterns are becoming more popular worldwide. We aimed to examine the relationship between plant-based dietary patterns and the risk of inadequate or excessive gestational weight gain (GWG) in Iranian pregnant women. METHODS We prospectively followed 657 pregnant women in Iran. Adherence to the plant-based diet, represented by plant-based (PDI), healthy (hPDI) and unhealthy plant-based (uPDI) dietary indexes was evaluated by applying a 90-item food frequency questionnaire during the first trimester of pregnancy. Multivariable-adjusted Cox proportional-hazards regression model was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) across quartiles of plant-based diet scores. RESULTS Over 25,562 person-weeks of follow-up, we documented 106 and 294 participants with inadequate and excessive GWG, respectively. We found a strong inverse association between adherence to the PDI and inadequate GWG after adjustment for demographic and confounding variables. Women in the highest quartile of the PDI had 50% lower risk of inadequate GWG than those in the lowest quartile (adjusted HR: 0.50; 95%CI 0.29, 0.89; P = 0.02). No significant association was found between hPDI and uPDI and inadequate GWG. There was no association between PDI, hPDI, and uPDI and the risk of excessive GWG. CONCLUSIONS Greater adherence to a plant-based diet during the first trimester of pregnancy may be associated with a lower risk of inadequate GWG. This finding needs to be confirmed in larger cohort studies, considering other pregnancy outcomes such as birth weight and the potential changes across the trimester in terms of food types and quantity.
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Affiliation(s)
- Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.,Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sheida Zeraattalab-Motlagh
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh Moosavi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Alireza Emadi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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10
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Evsevieva M, Sergeeva O, Mazurakova A, Koklesova L, Prokhorenko-Kolomoytseva I, Shchetinin E, Birkenbihl C, Costigliola V, Kubatka P, Golubnitschaja O. Pre-pregnancy check-up of maternal vascular status and associated phenotype is crucial for the health of mother and offspring. EPMA J 2022; 13:351-366. [PMID: 36061831 PMCID: PMC9437153 DOI: 10.1007/s13167-022-00294-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/04/2022] [Indexed: 12/15/2022]
Abstract
Abstract Cardiovascular disease remains the leading cause of disease burden globally with far-reaching consequences including enormous socio-economic burden to healthcare and society at large. Cardiovascular health is decisive for reproductive function, healthy pregnancy and postpartum. During pregnancy, maternal cardiovascular system is exposed to highly increased haemodynamic stress that significantly impacts health status of the mother and offspring. Resulting from sub-optimal maternal health conditions overlooked in pre-pregnancy time, progressive abnormalities can be expected during pregnancy and postpartum. Contextually, there are two main concepts to follow in the framework of predictive, preventive and personalised medicine, namely to develop: 1. advanced screening of sub-optimal health conditions in young populations to predict and prevent individual health risks prior to planned pregnancies 2. in-depth companion diagnostics during pregnancy to predict and prevent long-lasting postpartum health risks of the mother and offspring. Data collected in the current study demonstrate group-specific complications to health of the mother and offspring and clinical relevance of the related phenotyping in pre-pregnant mothers. Diagnostic approach proposed in this study revealed its great clinical utility demonstrating important synergies between cardiovascular maladaptation and connective tissue dysfunction. Co-diagnosed pre-pregnancy low BMI of the mother, connective tissue dysfunction, increased stiffness of peripheral vessels and decreased blood pressure are considered a highly specific maternal phenotype useful for innovative screening programmes in young populations to predict and prevent severe risks to health of the mother and offspring. This crucial discovery brings together systemic effects characteristic, for example, for individuals with Flammer syndrome predisposed to the phenotype-specific primary vascular dysregulation, pregnancy-associated risks, normal tension glaucoma, ischemic stroke at young age, impaired wound healing and associated disorders. Proposed maternal phenotyping is crucial to predict and effectively protect both the mother and offspring against health-to-disease transition. Pre-pregnancy check-up focused on sub-optimal health and utilising here described phenotypes is pivotal for advanced health policy. Plain English abstract Cardiovascular health is decisive for reproductive function and healthy pregnancy. During pregnancy, maternal cardiovascular system may demonstrate health-to-disease transition relevant for the affected mother and offspring. Overlooked in pre-pregnancy time, progressive abnormalities can be expected during pregnancy and lifelong. Here we co-diagnosed maternal pre-pregnancy low bodyweight with systemic effects which may increase risks of pregnancy, eye and heart disorders and ischemic stroke at young age, amongst others. Innovative screening programmes focused on sub-optimal health in young populations to predict and to mitigate individual health risks prior to pregnancy is an essential innovation for health policy proposed.
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Affiliation(s)
- Maria Evsevieva
- Stavropol State Medical University, Stavropol, Russian Federation
| | - Oksana Sergeeva
- Stavropol State Medical University, Stavropol, Russian Federation
| | - Alena Mazurakova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Lenka Koklesova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | | | | | | | | | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
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11
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Maternal Consumption of Ultra-Processed Foods-Rich Diet and Perinatal Outcomes: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14153242. [PMID: 35956418 PMCID: PMC9370797 DOI: 10.3390/nu14153242] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
The consumption of ultra-processed food (UPF)-rich diets represents a potential threat to human health. Considering maternal diet adequacy during pregnancy is a major determinant for perinatal health outcomes, this study aimed to systematically review and meta-analyze studies investigating the association between maternal consumption of a UPF-rich diet and perinatal outcomes. Conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, five electronic databases and gray literature using Google Scholar and ProQuest Dissertations and Theses Global were searched up to 31 May 2022. No restrictions were applied on language and publication date. Two reviewers independently conducted the study selection and data extraction process. Meta-analysis was conducted according to the random-effects model. In total, 61 studies were included in the systematic review and the overall population comprised 698,803 women from all gestational trimesters. Meta-analysis of cohort studies showed that maternal consumption of UPF-rich diets was associated with an increased risk of gestational diabetes mellitus (odds ratio (OR): 1.48; 95% confidence interval (CI): 1.17, 1.87) and preeclampsia (OR: 1.28; 95% CI: 1.15, 1.42). Neonatal outcomes showed no association. The overall GRADE quality of the evidence for the associations was very low. The findings highlight the need to monitor and reduce UPF consumption, specifically during the gestational period, as a strategy to prevent adverse perinatal outcomes.
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12
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Adherence to Clinical Practice Guideline Recommendations in Women with Gestational Diabetes and Associations with Maternal and Infant Health—A Cohort Study. Nutrients 2022; 14:nu14061274. [PMID: 35334931 PMCID: PMC8949953 DOI: 10.3390/nu14061274] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 12/25/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is managed by dietary advice, but limited evidence exists about the impact of adherence on health. We assessed whether adherence to the New Zealand Ministry of Health dietary recommendations is associated with maternal and infant health in women with GDM. Data from 313 women with GDM were used. Adherence to food-related recommendations was scored from 0 (no adherence) to 10 (adhered to all recommendations) and analysed in tertile groups (high, moderate, low adherence). Adherence to visiting a dietitian and appropriate weight gain were assessed as yes or no. Chi-square, ANOVA, and odds ratios were used to compare groups. High dietary adherence compared to low adherence was associated with reduced oral hypoglycaemic and insulin use (OR = 0.55, CI = 0.30–1.00). Visiting a dietitian compared to not was associated with increased oral hypoglycaemic and insulin use (OR = 2.96, CI = 1.12–7.80), decreased odds of a large-for-gestational-age infant (OR = 0.32, CI = 0.14–0.73) and neonatal hyperbilirubinaemia (OR = 0.27, CI = 0.08–0.95). Greater than recommended compared with recommended weight gain was associated with increased oral hypoglycaemic and insulin use (OR = 2.51, CI = 1.26–5.01), while lower than recommended weight gain was associated with decreased postpartum haemorrhage (OR = 0.45, CI = 0.23–0.91) and increased breastfeeding (OR = 1.96, CI = 1.04–3.70). Adherence to dietary recommendations for women with GDM likely improves health outcomes.
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13
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Craig WJ, Mangels AR, Fresán U, Marsh K, Miles FL, Saunders AV, Haddad EH, Heskey CE, Johnston P, Larson-Meyer E, Orlich M. The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals. Nutrients 2021; 13:4144. [PMID: 34836399 PMCID: PMC8623061 DOI: 10.3390/nu13114144] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 12/13/2022] Open
Abstract
Plant-based diets, defined here as including both vegan and lacto-ovo-vegetarian diets, are growing in popularity throughout the Western world for various reasons, including concerns for human health and the health of the planet. Plant-based diets are more environmentally sustainable than meat-based diets and have a reduced environmental impact, including producing lower levels of greenhouse gas emissions. Dietary guidelines are normally formulated to enhance the health of society, reduce the risk of chronic diseases, and prevent nutritional deficiencies. We reviewed the scientific data on plant-based diets to summarize their preventative and therapeutic role in cardiovascular disease, cancer, diabetes, obesity, and osteoporosis. Consuming plant-based diets is safe and effective for all stages of the life cycle, from pregnancy and lactation, to childhood, to old age. Plant-based diets, which are high in fiber and polyphenolics, are also associated with a diverse gut microbiota, producing metabolites that have anti-inflammatory functions that may help manage disease processes. Concerns about the adequate intake of a number of nutrients, including vitamin B12, calcium, vitamin D, iron, zinc, and omega-3 fats, are discussed. The use of fortified foods and/or supplements as well as appropriate food choices are outlined for each nutrient. Finally, guidelines are suggested for health professionals working with clients consuming plant-based diets.
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Affiliation(s)
- Winston J. Craig
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | | | - Ujué Fresán
- eHealth Group, Instituto de Salud Global Barcelona (ISGlobal), 08036 Barcelona, Spain;
| | - Kate Marsh
- Private Practice, Chatswood, NSW 2067, Australia;
| | - Fayth L. Miles
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
- School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA;
| | - Angela V. Saunders
- Nutrition Insights, Sanitarium Health Food Company, Berkeley Vale, NSW 2261, Australia;
| | - Ella H. Haddad
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Celine E. Heskey
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Patricia Johnston
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Enette Larson-Meyer
- Human Nutrition, Foods, and Exercise Virginia Tech, Blacksburg, VA 24061, USA;
| | - Michael Orlich
- School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA;
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14
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Pinna C, Sala A. Citrus flavonoids effects on human umbilical vein. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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15
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Wang T, Grech A, Dissanayake HU, Boylan S, Skilton MR. Modeling the Effect of Environmentally Sustainable Food Swaps on Nutrient Intake in Pregnant Women. Nutrients 2021; 13:3355. [PMID: 34684355 PMCID: PMC8537316 DOI: 10.3390/nu13103355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
Food production greatly contributes to greenhouse gas emissions (GHG), but there remain concerns that consuming environmentally sustainable foods can increase the likelihood of nutritional deficiencies during pregnancy. We identified commonly consumed foods of pregnant women and determined the effect of their replacement with environmentally sustainable alternatives on nutrient intake and measures of environmental sustainability. Dietary intake data from 171 pregnant women was assessed and foods that contributed the most to energy and protein intake were identified. Of these, foods producing the highest GHG emissions were matched with proposed environmentally sustainable alternatives, and their impact on nutrient provision determined. Meats, grains, and dairy products were identified as important sources of energy and protein. With the highest GHG emissions, beef was selected as the reference food. Proposed alternatives included chicken, eggs, fish, tofu, legumes, and nuts. The most pronounced reductions in CO2 emissions were from replacing beef with tofu, legumes, and nuts. Replacing one serve per week of beef with an isocaloric serve of firm tofu during pregnancy could reduce GHG emissions by 372 kg CO2 eq and increase folate (+28.1 µg/serve) and fiber (+3.3 g/serve) intake without compromising iron (+1.1 mg/serve) intake. Small dietary substitutions with environmentally sustainable alternatives can substantially reduce environmental impact without compromising nutrient adequacy.
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Affiliation(s)
- Tian Wang
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, NSW 2006, Australia;
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
| | - Allison Grech
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
| | - Hasthi U. Dissanayake
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
| | - Sinead Boylan
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
- School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia
| | - Michael R. Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, NSW 2006, Australia;
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
- Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Camperdown, NSW 2050, Australia
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16
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McNelly AP, Eaves ER, Christine Gardner J, Wetzel WS, Sutliffe JT. A Qualitative Exploration of Pregnancy Experience With a Nutrient-Dense, Plant-Rich Dietary Pattern: A Pilot Study. Am J Lifestyle Med 2021; 16:390-398. [DOI: 10.1177/15598276211040454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: A nutrient-dense, plant-rich diet may be promising as a nutrition intervention for pregnant women for a number of factors. Factors include the possibility of a decreased risk for gestational diabetes, excess weight gain, and preeclampsia. Little is known about the experience of following this type of dietary pattern while pregnant and what barriers are present that should be addressed in a large-scale intervention. Methods: Qualitative interviews were used to understand the personal experience of women who aimed to eat a nutrient-dense plant-rich diet while pregnant. Semi-structured interviews were conducted from June to August 2020. Results: Three main themes regarding a nutrient-dense plant-rich diet emerged. First, family and social influence played an important role. Second, women who had a previous pregnancy felt they had fewer pregnancy symptoms on this diet. Last, the participants may have experienced a reduced milk supply on this dietary plan. Conclusion: Future research should consider family context as a factor in adherence to a nutrient-dense plant-rich dietary pattern, investigate the possible associations between nutrient-dense plant-rich dietary patterns and reduced nausea and vomiting in early pregnancy, and determine whether nutrient-dense, plant-rich dietary patterns contribute to a reduction in milk production for women who experience over-engorgement.
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Affiliation(s)
- Allison P. McNelly
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Emery R. Eaves
- Department of Anthropology, Northern Arizona University, Flagstaff, AZ, USA
| | | | - Wendy S. Wetzel
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Jay T. Sutliffe
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
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17
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Miedziaszczyk M, Ciabach P, Grześkowiak E, Szałek E. The Safety of a Vegan Diet During Pregnancy. POSTEP HIG MED DOSW 2021. [DOI: 10.5604/01.3001.0014.9343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
There is an increasing number of people who go vegetarian. Some young parents also switch
to this diet. The safety of vegetarian diets, especially vegan diets, is very important, especially
during pregnancy. Unfortunately, reference publications do not provide coherent data on the
safety of vegetarian diets during pregnancy. On the one hand, the vegan diet has advantages
because it reduces the risk of heart disease and gestational diabetes. On the other hand,
vegetarians/vegans should be aware of potential deficiencies of some nutrients (iron, zinc,
vitamin B12, vitamin D, omega-3 fatty acids, calcium, iodine) and the clinical consequences
for the fetus. For example, iron deficiency may affect cognitive abilities, behavior, intelligence
and increase the risk of preterm birth and low birth weight of infants. Plant food contains
non-haem iron with variable absorption. Therefore, the vegan diet should include nutrients
increasing the bioavailability of iron, e.g. ascorbic acid, carotene and retinol. Due to the fact
that animal food is the main source of vitamin B12, vegans are at a very high risk of vitamin
B12 deficiency, which will affect the infant’s weight at birth. Low level of vitamin D, which is
prevalent in animal food, is the most common deficiency among vegans and lacto-ovo vegetarians.
This vitamin prevents gestational diabetes, reduces insulin resistance and guarantees
normal function of the musculoskeletal system. Zinc deficiency during pregnancy may lead to
preterm birth, neural tube defects or even miscarriage. In view of the clinical consequences
of potential deficiencies of nutrients, the vegetarian/vegan diet should be well balanced.
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Affiliation(s)
- Miłosz Miedziaszczyk
- Student’s Scientific Circle of Clinical Pharmacy of Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Patrycja Ciabach
- Student’s Scientific Circle of Clinical Pharmacy of Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Edmund Grześkowiak
- Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Edyta Szałek
- Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, Poznan, Poland
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18
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Basu A, Feng D, Planinic P, Ebersole JL, Lyons TJ, Alexander JM. Dietary Blueberry and Soluble Fiber Supplementation Reduces Risk of Gestational Diabetes in Women with Obesity in a Randomized Controlled Trial. J Nutr 2021; 151:1128-1138. [PMID: 33693835 PMCID: PMC8112774 DOI: 10.1093/jn/nxaa435] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/09/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a growing public health concern and maternal obesity and poor dietary intakes could be implicated. Dietary polyphenols and fiber mitigate the risk of diabetes and its complications, but little is known about their efficacy in preventing GDM. OBJECTIVES We examined the effects of whole blueberry and soluble fiber supplementation on primary outcomes of cardiometabolic profiles in women at high risk of developing GDM. METHODS Women (n = 34; mean ± SD age: 27 ± 5 y; BMI: 35.5 ± 4.0 kg/m2; previous history of GDM ∼56%; Hispanic ∼79%) were recruited in early pregnancy (<20 weeks of gestation) and randomly assigned to 1 of the following 2 groups for 18 wk: intervention (280 g whole blueberries and 12 g soluble fiber per day) and standard prenatal care (control). Both groups received nutrition education and maintained 24-h food recalls throughout the study. Data on anthropometrics, blood pressure, and blood samples for biochemical analyses were collected at baseline (<20 weeks), midpoint (24-28 weeks), and end (32-36 weeks) of gestation. Diagnosis of GDM was based on a 2-step glucose challenge test (GCT). Data were analyzed using a mixed-model ANOVA. RESULTS Maternal weight gain was significantly lower in the dietary intervention than in the control group at the end of the trial (mean ± SD: 6.8 ± 3.2 kg compared with 12.0 ± 4.1 kg, P = 0.001). C-reactive protein was also lower in the intervention than in the control group (baseline: 6.1 ± 4.0 compared with 6.8 ± 7.2 mg/L; midpoint: 6.1 ± 3.7 compared with 7.5 ± 7.3 mg/L; end: 5.5 ± 2.2 compared with 9.5 ± 6.6 mg/L, respectively, P = 0.002). Blood glucose based on GCT was lower in the intervention than in the control (100 ± 33 mg/dL compared with 131 ± 40 mg/dL, P < 0.05). Conventional lipids (total, LDL, and HDL cholesterol and triglycerides) did not differ between groups over time. No differences were noted in infant birth weight. CONCLUSIONS Whole blueberry and soluble fiber supplementation may prevent excess gestational weight gain and improve glycemic control and inflammation in women with obesity.This trial was registered at clinicaltrials.gov as NCT03467503.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Du Feng
- School of Nursing, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Petar Planinic
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Jeffrey L Ebersole
- School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Timothy J Lyons
- Division of Endocrinology, Medical University of South Carolina, Charleston, SC, USA
| | - James M Alexander
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
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19
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Avnon T, Paz Dubinsky E, Lavie I, Ben-Mayor Bashi T, Anbar R, Yogev Y. The impact of a vegan diet on pregnancy outcomes. J Perinatol 2021; 41:1129-1133. [PMID: 32873905 DOI: 10.1038/s41372-020-00804-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/28/2020] [Accepted: 08/25/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the effect of a maternal vegan diet on pregnancy outcome. STUDY DESIGN This is a prospective observational study. Women with a singleton pregnancy who maintained the same diet prior to, and throughout current pregnancy were enrolled. Stratification was performed according to diet type: vegans, lacto-ovo-vegetarians, fish-eaters, and omnivores. RESULTS Overall, 273 women were enrolled, of them, 112 omnivores, 37 fish-eaters, 64 lacto-ovo-vegetarians, and 60 vegans. The vegan diet was significantly associated with an increased risk of small-for-gestational-age newborns compared only to an omnivore diet (RR = 5.9, 95% CI, 1.2-21.8). The incidence of preterm birth was similar in all groups. Vegans had lower birthweight compared to lacto-ovo-vegetarians (3015 ± 420 g vs. 3285 ± 482 g, P = 0.004), and to omnivores (3328 ± 495 g, P < 0.001), but not to fish-eaters. Vegans also had a lower mean gestational weight gain compared only to omnivores (11.6 ± 4.2 kg vs. 14.3 ± 4.6 kg, P = 0.001). CONCLUSION The vegan diet is associated with an increased risk for small-for-gestational-age newborns and lower birthweight.
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Affiliation(s)
- Tomer Avnon
- Department of Obstetrics & Gynecology, Lis Maternity & Women's Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. .,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Efrat Paz Dubinsky
- Nutrition and Dietetic Unit, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Inbar Lavie
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Tali Ben-Mayor Bashi
- Department of Obstetrics & Gynecology, Lis Maternity & Women's Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ronit Anbar
- Nutrition and Dietetic Unit, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,School of Nutritional Sciences, The Robert H Smith Faculty of Agriculture, Food and Environmental Quality Sciences, Hebrew University, Jerusalem, Israel
| | - Yariv Yogev
- Department of Obstetrics & Gynecology, Lis Maternity & Women's Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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20
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Schiattarella A, Lombardo M, Morlando M, Rizzo G. The Impact of a Plant-Based Diet on Gestational Diabetes: A Review. Antioxidants (Basel) 2021; 10:antiox10040557. [PMID: 33918528 PMCID: PMC8065523 DOI: 10.3390/antiox10040557] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/13/2022] Open
Abstract
Gestational diabetes mellitus (GDM) represents a challenging pregnancy complication in which women present a state of glucose intolerance. GDM has been associated with various obstetric complications, such as polyhydramnios, preterm delivery, and increased cesarean delivery rate. Moreover, the fetus could suffer from congenital malformation, macrosomia, neonatal respiratory distress syndrome, and intrauterine death. It has been speculated that inflammatory markers such as tumor necrosis factor-alpha (TNF-α), interleukin (IL) 6, and C-reactive protein (CRP) impact on endothelium dysfunction and insulin resistance and contribute to the pathogenesis of GDM. Nutritional patterns enriched with plant-derived foods, such as a low glycemic or Mediterranean diet, might favorably impact on the incidence of GDM. A high intake of vegetables, fibers, and fruits seems to decrease inflammation by enhancing antioxidant compounds. This aspect contributes to improving insulin efficacy and metabolic control and could provide maternal and neonatal health benefits. Our review aims to deepen the understanding of the impact of a plant-based diet on oxidative stress in GDM.
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Affiliation(s)
- Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.S.); (M.M.)
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.S.); (M.M.)
| | - Gianluca Rizzo
- Independent Researcher, Via Venezuela 66, 98121 Messina, Italy
- Correspondence: ; Tel.: +39-320-897-6687
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21
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Vasile FC, Preda A, Ștefan AG, Vladu MI, Forțofoiu MC, Clenciu D, Gheorghe IO, Forțofoiu M, Moța M. An Update of Medical Nutrition Therapy in Gestational Diabetes Mellitus. J Diabetes Res 2021; 2021:5266919. [PMID: 34840988 PMCID: PMC8616668 DOI: 10.1155/2021/5266919] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/25/2021] [Accepted: 11/09/2021] [Indexed: 12/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is a serious and frequent pregnancy complication that can lead to short and long-term risks for both mother and fetus. Different health organizations proposed different algorithms for the screening, diagnosis, and management of GDM. Medical Nutrition Therapy (MNT), together with physical exercise and frequent self-monitoring, represents the milestone for GDM treatment in order to reduce maternal and fetal complications. The pregnant woman should benefit from her family support and make changes in their lifestyles, changes that, in the end, will be beneficial for the whole family. The aim of this manuscript is to review the literature about the Medical Nutrition Therapy in GDM and its crucial role in GDM management.
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Affiliation(s)
| | - Agnesa Preda
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical County Emergency Hospital, Craiova, Dolj, Romania
| | - Adela Gabriela Ștefan
- Department of Diabetes Nutrition and Metabolic Diseases, Calafat Municipal Hospital, Calafat, Dolj, Romania
| | - Mihaela Ionela Vladu
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical Municipal Hospital “Philanthropy”, Craiova, Romania
| | - Mircea-Cătălin Forțofoiu
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical Municipal Hospital “Philanthropy”, Craiova, Romania
| | - Diana Clenciu
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical Municipal Hospital “Philanthropy”, Craiova, Romania
| | - Ioan Ovidiu Gheorghe
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Public Health Department Gorj, Romania
| | - Maria Forțofoiu
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
- Clinical Municipal Hospital “Philanthropy”, Craiova, Romania
| | - Maria Moța
- University of Medicine and Pharmacy of Craiova, Craiova, Dolj, Romania
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Garland MA, Reynolds K, Zhou CJ. Environmental mechanisms of orofacial clefts. Birth Defects Res 2020; 112:1660-1698. [PMID: 33125192 PMCID: PMC7902093 DOI: 10.1002/bdr2.1830] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
Orofacial clefts (OFCs) are among the most common birth defects and impart a significant burden on afflicted individuals and their families. It is increasingly understood that many nonsyndromic OFCs are a consequence of extrinsic factors, genetic susceptibilities, and interactions of the two. Therefore, understanding the environmental mechanisms of OFCs is important in the prevention of future cases. This review examines the molecular mechanisms associated with environmental factors that either protect against or increase the risk of OFCs. We focus on essential metabolic pathways, environmental signaling mechanisms, detoxification pathways, behavioral risk factors, and biological hazards that may disrupt orofacial development.
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Affiliation(s)
- Michael A. Garland
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, CA 95817
| | - Kurt Reynolds
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Biochemistry, Molecular, Cellular, and Developmental Biology (BMCDB) graduate group, University of California, Davis, CA 95616
| | - Chengji J. Zhou
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Biochemistry, Molecular, Cellular, and Developmental Biology (BMCDB) graduate group, University of California, Davis, CA 95616
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23
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Sun C, Liu Y, Zhan L, Rayat GR, Xiao J, Jiang H, Li X, Chen K. Anti-diabetic effects of natural antioxidants from fruits. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.07.024] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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24
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Aydar EF, Tutuncu S, Ozcelik B. Plant-based milk substitutes: Bioactive compounds, conventional and novel processes, bioavailability studies, and health effects. J Funct Foods 2020. [DOI: 10.1016/j.jff.2020.103975] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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25
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Avnon T, Anbar R, Lavie I, Ben-Mayor Bashi T, Paz Dubinsky E, Shaham S, Yogev Y. Does vegan diet influence umbilical cord vitamin B12, folate, and ferritin levels? Arch Gynecol Obstet 2020; 301:1417-1422. [PMID: 32347355 DOI: 10.1007/s00404-020-05561-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To determine the influence of maternal diets on maternal and umbilical cord blood levels of vitamin B12, folic acid, ferritin, and hemoglobin. METHODS A prospective observational study on women who maintained the same diet for at least 3 months prior to, and throughout current pregnancy. Women were divided according to their diet. Diet questionnaires were filled in during the 3rd trimester. Blood samples for complete blood counts and levels of ferritin, vitamin B12, folate, and albumin were taken from the women prior to delivery and from the umbilical cord immediately after delivery. RESULTS The 273 enrolled women included 112 omnivores, 37 pescatarians, 64 vegetarians, and 60 vegans. There were no significant differences in the maternal B12 levels between the study groups (P = 0.426). Vegans had lower maternal ferritin levels compared to pescatarians (27 ± 17 vs 60 ± 74 ng/ml, respectively, P = 0.034), but not compared to vegetarians (P = 0.597), or omnivores (P = 1.000). There were no significant differences in the umbilical cord B12, folate, ferritin, and hemoglobin levels between the study groups. A sub-analysis that compared women who consumed multivitamins, B12 and iron supplements during pregnancy to women who did not, revealed differences in the levels of umbilical-cord B12 (1002 ± 608 vs 442 ± 151 pg/ml, respectively, P = 0.000) and maternal blood B12 (388 ± 209 vs 219 ± 95 pg/ml, respectively, P = 0.030) only among vegans, but not among omnivores. CONCLUSION Vegan diet does not change the umbilical cord levels of B12, folic acid, ferritin, and hemoglobin. Vegans who do not take any vitamin supplementation are at greater risk for B12 deficiency than omnivores.
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Affiliation(s)
- Tomer Avnon
- Department of Obstetrics and Gynecology, Lis Maternity and Women's Hospital, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel-Aviv, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Ronit Anbar
- Nutrition and Dietetic Unit, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- The Robert H Smith Faculty of Agriculture, Food and Environmental Quality Sciences, School of Nutritional Sciences, Hebrew University, Jerusalem, Israel
| | - Inbar Lavie
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Tali Ben-Mayor Bashi
- Department of Obstetrics and Gynecology, Lis Maternity and Women's Hospital, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel-Aviv, Israel
| | - Efrat Paz Dubinsky
- Nutrition and Dietetic Unit, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Sivan Shaham
- Nutrition and Dietetic Unit, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yariv Yogev
- Department of Obstetrics and Gynecology, Lis Maternity and Women's Hospital, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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26
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Torreggiani M, Fois A, D’Alessandro C, Colucci M, Orozco Guillén AO, Cupisti A, Piccoli GB. Of Mice and Men: The Effect of Maternal Protein Restriction on Offspring's Kidney Health. Are Studies on Rodents Applicable to Chronic Kidney Disease Patients? A Narrative Review. Nutrients 2020; 12:E1614. [PMID: 32486266 PMCID: PMC7352514 DOI: 10.3390/nu12061614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 12/20/2022] Open
Abstract
In the almost 30 years that have passed since the postulation of the "Developmental Origins of Health and Disease" theory, it has been clearly demonstrated that a mother's dietary habits during pregnancy have potential consequences for her offspring that go far beyond in utero development. Protein malnutrition during pregnancy, for instance, can cause severe alterations ranging from intrauterine growth retardation to organ damage and increased susceptibility to hypertension, diabetes mellitus, cardiovascular diseases and chronic kidney disease (CKD) later in life both in experimental animals and humans. Conversely, a balanced mild protein restriction in patients affected by CKD has been shown to mitigate the biochemical derangements associated with kidney disease and even slow its progression. The first reports on the management of pregnant CKD women with a moderately protein-restricted plant-based diet appeared in the literature a few years ago. Today, this approach is still being debated, as is the optimal source of protein during gestation in CKD. The aim of this report is to critically review the available literature on the topic, focusing on the similarities and differences between animal and clinical studies.
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Affiliation(s)
- Massimo Torreggiani
- Nephrology and Dialysis, Centre Hospitalier Le Mans, Avenue Roubillard 194, 72000 Le Mans, France; (A.F.); (G.B.P.)
| | - Antioco Fois
- Nephrology and Dialysis, Centre Hospitalier Le Mans, Avenue Roubillard 194, 72000 Le Mans, France; (A.F.); (G.B.P.)
| | - Claudia D’Alessandro
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.D.); (A.C.)
| | - Marco Colucci
- Unit of Nephrology and Dialysis, ICS Maugeri S.p.A. SB, Via S. Maugeri 10, 27100 Pavia, Italy;
| | | | - Adamasco Cupisti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.D.); (A.C.)
| | - Giorgina Barbara Piccoli
- Nephrology and Dialysis, Centre Hospitalier Le Mans, Avenue Roubillard 194, 72000 Le Mans, France; (A.F.); (G.B.P.)
- Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, 10100 Torino, Italy
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27
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Zhang YY, Hughes J, Grafenauer S. Got Mylk? The Emerging Role of Australian Plant-Based Milk Alternatives as A Cow's Milk Substitute. Nutrients 2020; 12:E1254. [PMID: 32354190 PMCID: PMC7281999 DOI: 10.3390/nu12051254] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/22/2020] [Accepted: 04/26/2020] [Indexed: 12/12/2022] Open
Abstract
Growing ethical, environmental and health concerns have encouraged demand for novel plant-based milk alternatives, yet it remains nebulous whether these products are nutritionally adequate as cow's milk replacements. The aim of this study was to conduct a cross-sectional survey of plant-based milk alternatives available in major Australian supermarkets and selected niche food retailers from November 2019 to January 2020 and assess two dietary scenarios (adolescents and older women) where dairy serves were substituted for plant-based alternatives against Australian Estimated Average Requirements (EAR). We collected compositional data from nutrition panels in juxtaposition with derivatives from the Australian Food Composition database, with a total of 115 products, including tree nuts and seeds (n = 48), legumes (n = 27), coconut (n = 10), grains (n = 19) and mixed sources (n = 10). Just over 50% of products were fortified, but only 1/3 contained similar calcium content to cow's milk. Indiscriminate substitutions might reduce intakes of protein and micronutrients, particularly vitamin A, B2, B12, iodine and zinc, and lead to reductions >50% of the EARs for protein, zinc and calcium in the chosen dietary scenarios. To avoid unintended dietary outcomes, it is vital that consumers make pragmatic decisions regarding dietary replacements for cow's milk.
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Affiliation(s)
- Yianna Y. Zhang
- School of Agriculture and Food, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC 3052, Australia
- CSIRO Agriculture & Food, 671 Sneydes Road, Werribee, VIC 3030, Australia
| | - Jaimee Hughes
- Grains & Legumes Nutrition Council, Mount Street, North Sydney, NSW 2060, Australia
| | - Sara Grafenauer
- Grains & Legumes Nutrition Council, Mount Street, North Sydney, NSW 2060, Australia
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
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28
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Ganie MA, Sahar T, Rashid A, Wani IA, Nisar S, Sathyapalan T, Vishnubhatla S, Ramakrishnan L, Parvez T, Geer I. Comparative Evaluation of Biomarkers of Inflammation Among Indian Women With Polycystic Ovary Syndrome (PCOS) Consuming Vegetarian vs. Non-vegetarian Diet. Front Endocrinol (Lausanne) 2019; 10:699. [PMID: 31781027 PMCID: PMC6857098 DOI: 10.3389/fendo.2019.00699] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/26/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Sub-inflammation and insulin resistance characterize women with PCOS. Data on dietary modulation of inflammation among PCOS women is scant, particularly from Indian subcontinent. The present study aimed to assess the effect of plant based vs. animal origin diets on serum markers of inflammation (primary outcome measure). Methods: This observational case-control study compared age and BMI matched PCOS and apparently healthy women from two populations following different dietary practices. The vegetarian women from New-Delhi (n = 82 PCOS and n = 179 healthy) and non-vegetarian women from Srinagar (n = 62 PCOS and n = 141 healthy) formed the groups. Using a uniform methodology, detailed clinical, biochemical, hormonal, and inflammatory marker assessment was undertaken. Results: The mean age of the overall cohort was 26.23 ± 4.59 years with a mean BMI of 24.39 ± 3.72 kg/m2. Overall pro-inflammatory markers (TNF-α, IL-6, IL-1β, hs-CRP and serum resistin) were significantly higher (p ≤ 0.05) and anti-inflammatory markers (IL-10 and adiponectin) were lower among women with PCOS than healthy subjects. On comparing vegetarian women with non-vegetarians, higher daily calorie intake (1895.46 ± 258.19 vs. 1860.13 ± 323.96 Kcal) with a higher protein and fat and lower carbohydrate intake was recorded in the latter, although the percent energy derived from carbohydrates was higher among vegetarians. Clinical and biochemical parameters were comparable among the groups except mFG score, total serum testosterone and serum lipid levels which were higher among non-vegetarian women as compared to their vegetarian counterparts from both categories (PCOS and healthy). Interestingly, vegetarian women with PCOS and healthy women had higher serum pro-inflammatory and lower anti-inflammatory markers compared to their non-vegetarian counterparts. Conclusion: Women with PCOS consuming Indian vegetarian diet have higher pro-inflammatory and lower anti-inflammatory marker levels than their age and BMI matched healthy non-vegetarian counterparts. This interesting observation can be attributed to the dietary composition, among other factors and needs confirmation from well-designed randomized studies on a larger cohort. Clinical Trial Registration: The study was registered with CTRI database under registration number CTRI/2013/09/003996.
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Affiliation(s)
- Mohd Ashraf Ganie
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Tajali Sahar
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Aafia Rashid
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Ishfaq A. Wani
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Sobia Nisar
- Department of Medicine, Government Medical College, Srinagar, India
| | - Thozhukat Sathyapalan
- Department of Academic Endocrinology Diabetes and Metabolism, Hull York Medical School, University of Hull, Kingston upon Hull, United Kingdom
| | | | - Lakshmy Ramakrishnan
- Departments of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Tabasum Parvez
- Department of Obstetrics and Gynaecology, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | - Ishaq Geer
- Department of Pharmaceutical Sciences, University of Kashmir, Srinagar, India
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Nasiri M, Gheibi Z, Miri A, Rahmani J, Asadi M, Sadeghi O, Maleki V, Khodadost M. Effects of consuming date fruits (Phoenix dactylifera Linn) on gestation, labor, and delivery: An updated systematic review and meta-analysis of clinical trials. Complement Ther Med 2019; 45:71-84. [PMID: 31331586 DOI: 10.1016/j.ctim.2019.05.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/13/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Recent studies have shown that consumption of date fruits during pregnancy and also postpartum period might affect some pregnancy outcomes. We performed an updated systematic review and meta-analysis about the effects of consuming date fruits on gestation, labor, and delivery. METHODS Two researchers independently searched the online databases of PubMed, Scopus, Web of Science, Embase, Google Scholar, and EBSCO up to January 2019 for clinical trials examining the effects of date fruits consumption on any types of gestation, labor, and delivery outcomes. A fixed-effects model or random-effects models were applied to pool data, where appropriate. Quality assessment was done by Jadad scale. RESULTS In total, 11 and 8 studies were included in the systematic review and meta-analysis. Meta-analysis revealed that date fruit consumption significantly reduced gestation duration (pooled effect size: -0.30, 95% CI: -0.45, -0.15; P < 0.001), increased cervical dilation on admission (pooled effect size: 0.94, 95% CI: 0.88, 1.00; P < 0.001), and shorten duration of first stage of labor (pooled effect size: -50.09, 95% CI: -72.25, -27.93; P < 0.001). Also, it was revealed that date fruit consumption significantly reduced duration of second stage of labor in fixed-effects model (pooled effect size: -9.85, 95% CI: -14.00, -5.70; P < 0.001); however, this effect was not significant in random-effects analysis (pooled effect size: -11.27, 95% CI: -28.23, -5.68; P = 0.193). CONCLUSIONS Date fruits intake seems to reduce gestation duration and duration of the first stage of labor, and also increase cervical dilation on admission.
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Affiliation(s)
- Morteza Nasiri
- Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran; Student Research Committee, Department of Surgical Technology, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zeinab Gheibi
- Student Research Committee, Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Ali Miri
- Department of Nutrition, School of Health, Zabol University of Medical Sciences, Zabol, Iran.
| | - Jamal Rahmani
- Department of Clinical Nutrition and Dietetics, School of Nutritional and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Masoumeh Asadi
- Department of Nursing, Abadan School of Medical Sciences, Abadan, Iran.
| | - Omid Sadeghi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vahid Maleki
- Department of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahmoud Khodadost
- Larestan University of Medical Sciences, Larestan, Iran; Gerash University of Medical Sciences, Gerash, Iran.
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Elshani B, Kotori V, Daci A. Role of omega-3 polyunsaturated fatty acids in gestational diabetes, maternal and fetal insights: current use and future directions. J Matern Fetal Neonatal Med 2019; 34:124-136. [PMID: 30857450 DOI: 10.1080/14767058.2019.1593361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
ω-3-Polyunsaturated fatty acids (ω-3 PUFAs) are widely used during pregnancy and gestational diabetes mellitus (GDM). ω-3 PUFAs are beneficial in the regulation of maternal and fetal metabolic function, inflammation, immunity, macrosomia (MAC), oxidative stress, preeclampsia, intrauterine growth, preterm birth, offspring metabolic function, and neurodevelopment. Dietary counseling is vital for improving therapeutic outcomes in patients with GDM. In maternal circulation, ω-3 PUFAs are transported via transporters, synthesis enzymes, and intracellular proteins, which activate nuclear receptors and play central roles in the cellular metabolic processes of placental trophoblasts. In patients with GDM, this process is compromised due to abnormal functioning of the placenta, which disrupts the normal mother to fetus transport. This results in reduced fetal levels of ω-3 PUFAs, which contributes negatively to fetal growth, metabolic function, and development. Dietary counseling and nutritional assessment remain challenging in the prevention and alleviation of GDM. Therefore, personalized approaches, including measurement of the ω-3 index, pharmacogenetic implementation strategies, and appropriate supplementation with ω-3 PUFAs are used to achieve sufficient distribution in the maternal and fetal fluids during the entire pregnancy period. Developing new dosing guidelines and personalized approaches, determining the mechanisms of ω-3 PUFAs in the placenta, and examining the pharmacodynamic and pharmacokinetics interactions involving ω-3 PUFAs will lead to better management and increase the quality of life of patients with GDM and their offspring. Moreover, different strategies for supplementing with ω-3 PUFAs, improving their placental transport, and pharmacological exploration of the maternal-fetal interactions will help to further elucidate the role of ω-3 PUFAs in women with GDM. In this review, we summarize the current information on the potential therapeutic benefits and clinical applicability of ω-3 PUFAs in patients with GDM and their offspring, highlighting recent progress and future perspectives in this field. Studies investigating the mechanisms of ω-3 PUFA transport to targeted tissues have spurred an interest in personalized treatment strategies for patients with GDM and their offspring. To implement such therapies, we need to clarify the index/ratio of ω-3 PUFAs in maternal and fetal fluids, delineate the ω-3 PUFA transport pathways, and establish the guidelines for FA profiling prepregnancy and during pregnancy-associated weight gain. Such therapies also need to take into account the gender of the fetus, and whether the patient is obese.
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Affiliation(s)
- Brikene Elshani
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Vjosa Kotori
- Department of Endocrinology, Pediatric Clinic, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Armond Daci
- Department of Pharmacy, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
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The Effects of Vegetarian and Vegan Diet during Pregnancy on the Health of Mothers and Offspring. Nutrients 2019; 11:nu11030557. [PMID: 30845641 PMCID: PMC6470702 DOI: 10.3390/nu11030557] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/19/2019] [Accepted: 03/01/2019] [Indexed: 11/17/2022] Open
Abstract
Vegetarian and vegan diets have increased worldwide in the last decades, according to the knowledge that they might prevent coronary heart disease, cancer, and type 2 diabetes. Althought plant-based diets are at risk of nutritional deficiencies such as proteins, iron, vitamin D, calcium, iodine, omega-3, and vitamin B12, the available evidence shows that well planned vegetarian and vegan diets may be considered safe during pregnancy and lactation, but they require a strong awareness for a balanced intake of key nutrients. A review of the scientific literature in this field was performed, focusing specifically on observational studies in humans, in order to investigate protective effects elicited by maternal diets enriched in plant-derived foods and possible unfavorable outcomes related to micronutrients deficiencies and their impact on fetal development. A design of pregestational nutrition intervention is required in order to avoid maternal undernutrition and consequent impaired fetal growth.
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Attini R, Montersino B, Leone F, Minelli F, Fassio F, Rossetti MM, Colla L, Masturzo B, Barreca A, Menato G, Piccoli GB. Dialysis or a Plant-Based Diet in Advanced CKD in Pregnancy? A Case Report and Critical Appraisal of the Literature. J Clin Med 2019; 8:jcm8010123. [PMID: 30669543 PMCID: PMC6352283 DOI: 10.3390/jcm8010123] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 02/07/2023] Open
Abstract
Pregnancy is increasingly reported in chronic kidney disease (CKD), reflecting higher awareness, improvements in materno-foetal care, and a more flexible attitude towards “allowing” pregnancy in the advanced stages of CKD. Success is not devoid of problems and an important grey area regards the indications for starting dialysis (by urea level, clinical picture, and residual glomerular filtration rate) and for dietary management. The present case may highlight the role of plant-based diets in dietary management in pregnant CKD women, aimed at retarding dialysis needs. The case. A 28-year-old woman, affected by glomerulocystic disease and unilateral renal agenesis, in stage-4 CKD, was referred at the 6th week of amenorrhea: she weighed 40 kg (BMI 16.3), was normotensive, had no sign of oedema, her serum creatinine was 2.73 mg/dL, blood urea nitrogen (BUN) 35 mg/dL, and proteinuria 200 mg/24 h. She had been on a moderately protein-restricted diet (about 0.8 g/kg/real body weight, 0.6 per ideal body weight) since childhood. Low-dose acetylsalicylate was added, and a first attempt to switch to a protein-restricted supplemented plant-based diet was made and soon stopped, as she did not tolerate ketoacid and aminoacid supplementation. At 22 weeks of pregnancy, creatinine was increased (3.17 mg/dL, BUN 42 mg/dL), dietary management was re-discussed and a plant-based non-supplemented diet was started. The diet was associated with a rapid decrease in serum urea and creatinine; this favourable effect was maintained up to the 33rd gestational week when a new rise in urea and creatinine was observed, together with signs of cholestasis. After induction, at 33 weeks + 6 days, she delivered a healthy female baby, adequate for gestational age (39th centile). Urea levels decreased after delivery, but increased again when the mother resumed her usual mixed-protein diet. At the child’s most recent follow-up visit (age 4 months), development was normal, with normal weight and height (50th–75th centile). In summary, the present case confirms that a moderate protein-restricted diet can be prescribed in pregnancies in advanced CKD without negatively influencing foetal growth, supporting the importance of choosing a plant-based protein source, and suggests focusing on the diet’s effects on microcirculation to explain these favourable results.
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Affiliation(s)
- Rossella Attini
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Benedetta Montersino
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Filomena Leone
- Department of Surgery, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Fosca Minelli
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Federica Fassio
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Maura Maria Rossetti
- SCDU Nephrology, Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy.
| | - Loredana Colla
- SCDU Nephrology, Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy.
| | - Bianca Masturzo
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Antonella Barreca
- Department of Medical Sciences, University of Torino, 10100 Torino, Italy.
| | - Guido Menato
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Giorgina Barbara Piccoli
- Department of Biological and Clinical Sciences, University of Torino, 10100 Torino, Italy.
- Nephrology, Centre Hospitalier Le Mans, 72000 Le Mans, France.
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Tan C, Zhao Y, Wang S. Is a vegetarian diet safe to follow during pregnancy? A systematic review and meta-analysis of observational studies. Crit Rev Food Sci Nutr 2019; 59:2586-2596. [PMID: 29621406 DOI: 10.1080/10408398.2018.1461062] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Whether a vegetarian diet is appropriate for pregnancy remains unclear. Objective: This study aimed to determine the association between vegetarian diet during pregnancy and various maternal-fetal outcomes. Method: PubMed-Medline, EMBASE, and Cochrane Library databases were searched for relevant articles published by August 30, 2017. Quantitative data were analyzed by a random-effects model with pooled odds ratios or weighted mean difference (WMD) and 95% confidence interval as aggregate estimations. Results: A total of 19 observational studies were identified for each of meta-analysis and narrative review. The overall estimated relation between vegetarian pregnancy and low birth weight (LBW) was marginally significant (1.27 (0.98, 1.65), P = 0.07, I2=0%). Asian (India/Nepal) vegetarian mothers exhibited increased risks to deliver a baby with LBW (1.33 (1.01, 1.76), P = 0.04, I2=0%). However, the WMD of neonatal birth weight in five studies suggested no difference between vegetarians and omnivores. Given the high heterogeneity of the included studies, lack of high-quality evidence, and limited studies included for each category, we failed to reach conclusive results regarding the risks of hypospadias, intrauterine growth retardation, maternal anemia, and gestational diabetes mellitus. Conclusion: Asian vegetarian mothers presented increased risks to deliver babies with LBW than those of omnivores. Large-scale prospective studies focusing on pre- and/or early gestational nutrition will help clarify the correlation between vegetarian diet and various pregnancy outcomes.
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Affiliation(s)
- Chang Tan
- Department of Nutrition and Food Hygiene, School of Health Sciences , Wuhan University , Wuhan , China
| | - Yudi Zhao
- Department of Computer Science, Volgenau School of Engineering , George Mason University , Fairfax , Virginia , USA
| | - Suqing Wang
- Department of Nutrition and Food Hygiene, School of Health Sciences , Wuhan University , Wuhan , China.,Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Academy for Preventive Medicine , Wuhan , 430060 , China
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Vegan Nutrition for Mothers and Children: Practical Tools for Healthcare Providers. Nutrients 2018; 11:nu11010005. [PMID: 30577451 PMCID: PMC6356233 DOI: 10.3390/nu11010005] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/12/2018] [Accepted: 12/17/2018] [Indexed: 12/18/2022] Open
Abstract
As the number of subjects choosing vegan diets increases, healthcare providers must be prepared to give the best advice to vegan patients during all stages of life. A completely plant-based diet is suitable during pregnancy, lactation, infancy, and childhood, provided that it is well-planned. Balanced vegan diets meet energy requirements on a wide variety of plant foods and pay attention to some nutrients that may be critical, such as protein, fiber, omega-3 fatty acids, iron, zinc, iodine, calcium, vitamin D, and vitamin B12. This paper contains recommendations made by a panel of experts from the Scientific Society for Vegetarian Nutrition (SSNV) after examining the available literature concerning vegan diets during pregnancy, breastfeeding, infancy, and childhood. All healthcare professionals should follow an approach based on the available evidence in regard to the issue of vegan diets, as failing to do so may compromise the nutritional status of vegan patients in these delicate periods of life.
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Kibret KT, Chojenta C, Gresham E, Tegegne TK, Loxton D. Maternal dietary patterns and risk of adverse pregnancy (hypertensive disorders of pregnancy and gestational diabetes mellitus) and birth (preterm birth and low birth weight) outcomes: a systematic review and meta-analysis. Public Health Nutr 2018; 22:1-15. [PMID: 30319090 PMCID: PMC10260420 DOI: 10.1017/s1368980018002616] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 08/28/2018] [Accepted: 09/03/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Epidemiological studies have indicated that dietary patterns during pregnancy are associated with adverse pregnancy and birth outcomes such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), preterm birth (PTB) and low birth weight (LBW). However, the results of these studies are varied and inconsistent. The present study aimed to assess the association between dietary patterns and the risk of adverse pregnancy and birth outcomes. DESIGN Systematic review and meta-analysis. Seven databases were searched for articles. Two reviewers performed the study selection and data extraction. A random-effects model was used to estimate pooled effect sizes of eligible studies. SETTING Studies conducted all over the world were incorporated. SUBJECTS The review focused on pregnant women. RESULTS A total of twenty-one studies were identified. Adherence to a healthy dietary pattern (intake of vegetables, fruits, legumes, whole grains) was significantly associated with lower odds (OR; 95 % CI) of pre-eclampsia (0·78; 0·70, 0·86; I2=39·0 %, P=0·178), GDM (0·78; 0·56, 0·99; I2=68·6 %, P=0·013) and PTB (0·75; 0·57, 0·93; I2=89·6 %, P=0·0001). CONCLUSIONS Our review suggests that dietary patterns with a higher intake of fruits, vegetables, legumes, whole grains and fish are associated with a decreased likelihood of adverse pregnancy and birth outcomes. Further research should be conducted in low-income countries to understand the impact of limited resources on dietary intake and adverse pregnancy and birth outcomes.
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Affiliation(s)
- Kelemu Tilahun Kibret
- Health Intelligence Unit, Orange Health Service, Western NSW Health, Orange, New South Wales, Australia
| | - Catherine Chojenta
- Priority Research Centre for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW2308, Australia
| | - Ellie Gresham
- Health Intelligence Unit, Orange Health Service, Western NSW Health, Orange, New South Wales, Australia
| | - Teketo K Tegegne
- Priority Research Centre for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW2308, Australia
| | - Deborah Loxton
- Priority Research Centre for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW2308, Australia
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Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet 2017; 116:1970-1980. [PMID: 27886704 DOI: 10.1016/j.jand.2016.09.025] [Citation(s) in RCA: 551] [Impact Index Per Article: 78.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Indexed: 02/06/2023]
Abstract
It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes. Plant-based diets are more environmentally sustainable than diets rich in animal products because they use fewer natural resources and are associated with much less environmental damage. Vegetarians and vegans are at reduced risk of certain health conditions, including ischemic heart disease, type 2 diabetes, hypertension, certain types of cancer, and obesity. Low intake of saturated fat and high intakes of vegetables, fruits, whole grains, legumes, soy products, nuts, and seeds (all rich in fiber and phytochemicals) are characteristics of vegetarian and vegan diets that produce lower total and low-density lipoprotein cholesterol levels and better serum glucose control. These factors contribute to reduction of chronic disease. Vegans need reliable sources of vitamin B-12, such as fortified foods or supplements.
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Berry C, Atta MG. Hypertensive disorders in pregnancy. World J Nephrol 2016; 5:418-28. [PMID: 27648405 PMCID: PMC5011248 DOI: 10.5527/wjn.v5.i5.418] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 05/31/2016] [Accepted: 06/27/2016] [Indexed: 02/06/2023] Open
Abstract
Renal injury or failure may occur in the context of pregnancy requiring special considerations with regard to fetal and maternal health. The condition of pregnancy itself may be a major factor in such injuries. In addition, for many young women previously known to be healthy, pregnancy may be the first presentation for routine urine and blood testing which may yield previously subclinical renal disease. As such, pregnancy may add complexity to considerations in the management of renal disease presenting coincidentally requiring knowledge of the physiologic changes and potential renal disorders that may be encountered during pregnancy.
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