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Tan NA, Davidson ZE, Grieger JA, Bonham MP. Time of day and glycaemic response in pregnant women: A gap in current guidelines? Clin Nutr ESPEN 2024; 61:219-223. [PMID: 38777436 DOI: 10.1016/j.clnesp.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND & AIMS Advice to monitor and distribute carbohydrate intake is a key recommendation for treatment of gestational diabetes, but fails to consider circadian regulation of glucose homeostasis. In the non-pregnant state, glucose responses to a meal at night-time are significantly higher than during the day and are associated with an increased risk of developing type 2 diabetes. However, the impact of night time eating on postprandial glucose in pregnancy is uncertain. Using a systematic approach we explored postprandial glucose responses to dietary intake at night compared to during the day in pregnant women. METHODS Searches were conducted in four databases (Ovid MEDLINE, Ovid Embase, CINAHL plus and Scopus), in September 2022 (updated, June 2023). Eligible studies reported on postprandial glucose at a minimum of two times a day, after identical meals or an oral glucose tolerance test, in pregnant women with or without gestational diabetes. Publication bias was assessed using the ROBINS-I tool. RESULTS Four eligible studies were retrieved. Two studies reported within group comparison of two timepoints, and observed reduced glucose tolerance in the afternoon compared to the morning in pregnant women, irrespective of diabetes status. The other two studies meeting inclusion criteria did not report time of day comparisons. CONCLUSION It is unclear as to whether the higher (and extended) postprandial glucose levels observed at night in non-pregnant populations are observed in pregnancy. Clinical studies are needed to explore the impact of circadian rhythmicity on glucose metabolism during pregnancy, and the implications of current dietary advice on when and what to eat for management of gestational diabetes.
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Affiliation(s)
- Nicole A Tan
- Department of Nutrition, Dietetics and Food, School of Clinical Science at Monash Health, Monash University, Melbourne, Australia.
| | - Zoe E Davidson
- Department of Nutrition, Dietetics and Food, School of Clinical Science at Monash Health, Monash University, Melbourne, Australia.
| | - Jessica A Grieger
- Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia; Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, School of Clinical Science at Monash Health, Monash University, Melbourne, Australia.
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Shivam V, Gillies CL, Goff LM, Zaccardi F, Khunti K. Taste perception genomics in gestational diabetes mellitus: A systematic review. Diabetes Obes Metab 2024; 26:1544-1547. [PMID: 38192264 DOI: 10.1111/dom.15449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024]
Affiliation(s)
- Vishnu Shivam
- Research and Development, Vedanadhi, Salem, India
- Intern, Coimbatore Medical College and Hospital, Coimbatore, India
| | - Clare L Gillies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Louise M Goff
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | | | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Zhou L, Liu J, Zhou M. A comprehensive meta-analysis on the association between vitamin C intake and gestational diabetes mellitus: Insights and novel perspectives. Medicine (Baltimore) 2023; 102:e34740. [PMID: 37565861 PMCID: PMC10419659 DOI: 10.1097/md.0000000000034740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Gestational Diabetes Mellitus (GDM) is a significant health concern in pregnant women and their offspring. Although Vitamin C is known to play a role in maintaining normal physiological processes, its relationship with GDM has not been fully elucidated. METHODS We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, analyzing data from 15 studies selected from PubMed, Embase, Web of Science, and the Cochrane Library up to May 16, 2023. These studies were selected based on inclusion criteria such as study design, outcome of interest, exposure factor, and data extractability. Quality assessment was performed using the Newcastle-Ottawa Scale. We assessed the heterogeneity between studies and conducted a sensitivity analysis. RESULTS Data from 10,131 subjects, including 1304 diagnosed GDM cases, were analyzed. The meta-analysis showed that women in the low Vitamin C exposure group had higher odds of developing GDM (odds ratio 2.72, 95% CI:1.24-4.19). There was a greater likelihood of increased GDM risk with lower Vitamin C exposure (standardized mean difference: -0.71, 95% CI [-1.07 -0.36]). Subgroup analysis revealed that both internal and external Vitamin C exposure, along with exposure during the second or third trimester of pregnancy, was associated with higher GDM incidence rates under low Vitamin C exposure. Sensitivity analysis confirmed the robustness of the results, and no significant publication bias was detected. CONCLUSION Low Vitamin C exposure during pregnancy may increase the risk of GDM. Given these findings, it could be beneficial for pregnant women to increase their intake of Vitamin C-rich foods and to ensure adequate blood Vitamin C levels as a preventive measure against GDM.
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Affiliation(s)
- Lili Zhou
- Department of Gynecology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Junbo Liu
- Department of Gynecology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Min Zhou
- Department of Gynecology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
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Balieiro LCT, Gontijo CA, Marot LP, Teixeira GP, Fahmy WM, Maia YCDP, Crispim CA. Is chronotype associated with dietary intake and weight gain during pregnancy? A prospective and longitudinal study. Nutrition 2021; 94:111530. [PMID: 34891106 DOI: 10.1016/j.nut.2021.111530] [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: 05/11/2021] [Revised: 10/06/2021] [Accepted: 10/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The effects of chronotype on dietary intake and weight gain during pregnancy have not been addressed in the literature. The aim of this study was to analyze the effect of chronotype on eating patterns, energy, and macronutrient intake and distribution, as well as weight gain during pregnancy. METHODS This was a prospective cohort study carried out with 100 pregnant women in the first, second, and third gestational trimesters. Dietary intake was assessed by three 24-h dietary recalls in each trimester, totaling nine recalls. Energy and macronutrient intake and distribution were evaluated at meals throughout the day. Chronotype was derived from midsleep time on free days, and the scores obtained were categorized into tertiles. Recommendations from the Institute of Medicine were used to assess the adequacy of weight gain. Generalized estimating equation models were used to determine the effects of chronotype and gestational trimester on eating patterns, daily energy, macronutrient distribution, and weight gain. RESULTS Pregnant women with values for midsleep time on free days indicative of eveningness have breakfast later and also have higher energy and carbohydrate intake at dinner than "morning" women. Pregnant "morning" women showed better diet quality in terms of milk and dairy and saturated fat. Also, despite the tendency for all tertiles to gain excess weight during pregnancy, we found that pregnant women with a tendency to eveningness had worse adequacy of gestational weight gain in the third trimester than "morning" women (2.24 ± 0.25 versus 1.22 ± 0.14, P < 0.001). CONCLUSION Pregnant women with a tendency to eveningness consume breakfast later in the day and exhibit greater consumption of energy and carbohydrates in the evening, as well as a worse standard of gestational weight gain in the third trimester. Our results emphasize the importance of considering chrononutrition variables in prenatal nutritional guidelines to promote maternal and fetal health.
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Affiliation(s)
| | | | | | | | - Walid Makin Fahmy
- Hospital and Municipal Maternity of Uberlândia, Department of Obstetrics, Uberlândia, Brazil
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Chrononutrition during Pregnancy: A Review on Maternal Night-Time Eating. Nutrients 2020; 12:nu12092783. [PMID: 32932985 PMCID: PMC7551833 DOI: 10.3390/nu12092783] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 01/20/2023] Open
Abstract
Evidence from women working night shifts during pregnancy indicates that circadian rhythm disruption has the potential to adversely influence pregnancy outcomes. In the general population, chronodisruption with the potential to affect pregnancy outcomes may also be seen in those with high energy intakes in the evening or at night. However, maternal night eating during pregnancy remains understudied. This narrative review provides an overview of the prevalence, contributing factors, nutritional aspects and health implications of night eating during pregnancy. We derived evidence based on cross-sectional studies and longitudinal cohorts. Overall, night eating is common during pregnancy, with the estimated prevalence in different populations ranging from 15% to 45%. The modern lifestyle and the presence of pregnancy symptoms contribute to night eating during pregnancy, which is likely to coexist and may interact with multiple undesirable lifestyle behaviors. Unfavorable nutritional characteristics associated with night eating have the potential to induce aberrant circadian rhythms in pregnant women, resulting in adverse metabolic and pregnancy outcomes. More research, particularly intervention studies, are needed to provide more definite information on the implications of night eating for mother-offspring health.
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Loy SL, Cheung YB, Chong M, Müller-Riemenschneider F, Lek N, Lee YS, Tan KH, Chern B, Yap F, Chan J. Maternal night-eating pattern and glucose tolerance during pregnancy: study protocol for a longitudinal study. BMJ Open 2019; 9:e030036. [PMID: 31601588 PMCID: PMC6797284 DOI: 10.1136/bmjopen-2019-030036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Coordinating eating schedules with day-night cycles has been shown to improve glucose regulation in adults, but its association with gestational glycaemia is less clear. A better understanding on how eating time can influence glucose levels in pregnancy may improve strategies for gestational glycaemic control. This study aims to examine the association of maternal night-eating pattern with glucose tolerance in the second trimester of pregnancy, and to investigate how lifestyle factors may be related to night-eating pattern. METHODS AND ANALYSIS This is an observational longitudinal study that targets to recruit 200 pregnant women at 18-24 weeks' gestation from the KK Women's and Children's Hospital in Singapore. Data collection includes sociodemographics, lifestyle habits and obstetric information. Maternal dietary intake is collected using the 4-day food diary and food frequency questionnaire; while 24-hour physical activity, sedentary behaviour, sleep and light exposure are captured using the accelerometer at 18-24 weeks' gestation. Continuous glucose monitoring at 18-24 weeks' gestation, oral glucose tolerance test and insulin test at 24-28 weeks' gestation are performed to assess glycaemic outcomes. Multivariable generalised linear models will be used to analyse the association of maternal night-eating pattern (consumption of meal and snack during 1900-0659 hours) with glycaemic measures, and the associated factors of night-eating pattern, controlling for potential confounders. Recruitment began in March 2019 and is estimated to end in November 2020. ETHICS AND DISSEMINATION Ethical approval has been granted by the Centralised Institutional Review Board of SingHealth, Singapore (reference 2018/2529). The results will be presented at conferences and disseminated in journal articles. TRIAL REGISTRATION NUMBER NCT03803345.
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Affiliation(s)
- See Ling Loy
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Yin Bun Cheung
- Programme in Health Services & Systems Research and Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Center for Child Health Research, Tampere University, Tampere, Finland
| | - Mary Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre Berlin, Berlin, Germany
| | - Ngee Lek
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Y S Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
- Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Bernard Chern
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Department of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Jerry Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, Singapore
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Loy SL, Wee PH, Colega MT, Cheung YB, Aris IM, Chan JKY, Godfrey KM, Gluckman PD, Tan KH, Shek LPC, Chong YS, Natarajan P, Müller-Riemenschneider F, Lek N, Rajadurai VS, Tint MT, Lee YS, Chong MFF, Yap F. Maternal Night-Fasting Interval during Pregnancy Is Directly Associated with Neonatal Head Circumference and Adiposity in Girls but Not Boys. J Nutr 2017; 147:1384-1391. [PMID: 28592516 DOI: 10.3945/jn.117.250639] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/18/2017] [Accepted: 05/10/2017] [Indexed: 01/08/2023] Open
Abstract
Background: Synchrony between daily feeding-fasting signals and circadian rhythms has been shown to improve metabolic health in animals and adult humans, but the potential programming effect on fetal growth is unknown.Objective: We examined the associations of the maternal night-fasting interval during pregnancy with offspring birth size and adiposity.Methods: This was a cross-sectional study of mother-offspring dyads within the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. For 384 mothers aged 30.8 ± 4.8 y (mean ± SD), the night-fasting interval at 26-28 wk of gestation was determined from a 3-d food diary based on the average of the fasting duration at night (1900-0659). Offspring birth weight, length, and head circumference were measured and converted to weight-for-gestational age (GA), length-for-GA, and head circumference-for-GA z scores, respectively, by using local customized percentile charts. The percentage of neonatal total body fat (TBF) was derived by using a validated prediction equation. Multivariable general linear models, stratified by child sex, were performed.Results: The mean ± SD maternal night-fasting interval was 9.9 ± 1.3 h. In infant girls, each 1-h increase in the maternal night-fasting interval was associated with a 0.22-SD (95% CI: 0.05-, 0.40-SD; P = 0.013) increase in birth head circumference-for-GA and a 0.84% (95% CI: 0.19%, 1.49%; P = 0.012) increase in TBF at birth, after adjustment for confounders. In infant boys, no associations were observed between the maternal night-fasting interval and birth size or TBF.Conclusions: An increased maternal night-fasting interval in the late second trimester of pregnancy is associated with increased birth head circumference and TBF in girls but not boys. Our findings are in accordance with previous observations that suggest that there are sex-specific responses in fetal brain growth and adiposity, and raise the possibility of the maternal night-fasting interval as an underlying influence. This trial was registered at clinicaltrials.gov as NCT01174875.
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Affiliation(s)
- See Ling Loy
- Departments of Reproductive Medicine.,Duke-NUS Medical School, Singapore
| | | | - Marjorelee T Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Yin Bun Cheung
- Center for Quantitative Medicine.,Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Jerry Kok Yen Chan
- Departments of Reproductive Medicine.,Duke-NUS Medical School, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | - Lynette Pei-Chi Shek
- Departments of Paediatrics and.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Obstetrics and Gynaecology, Yong Loo Lin School of Medicine and
| | | | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre, Berlin, Germany; and
| | - Ngee Lek
- Paediatrics.,Duke-NUS Medical School, Singapore
| | | | - Mya-Thway Tint
- Departments of Paediatrics and.,Obstetrics and Gynaecology, Yong Loo Lin School of Medicine and
| | - Yung Seng Lee
- Brenner Centre for Molecular Medicine and.,Departments of Paediatrics and.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| | - Mary Foong-Fong Chong
- Clinical Nutrition Research Centre.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Fabian Yap
- Paediatrics, .,Duke-NUS Medical School, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Bartáková V, Kuricová K, Zlámal F, Bělobrádková J, Kaňková K. Differences in food intake and genetic variability in taste receptors between Czech pregnant women with and without gestational diabetes mellitus. Eur J Nutr 2016; 57:513-521. [PMID: 27757593 DOI: 10.1007/s00394-016-1334-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/12/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE Gestational diabetes mellitus (GDM) represents the most frequent metabolic disorder in pregnancy. Since dietary intake plays an important role in obesity and type 2 diabetes development, it is likely to be for the susceptibility to GDM too. Food preferences, driving partly the diet composition, are changing during pregnancy. Taste and genetic variability in taste receptors is an important factor in determining food preferences. Aims of our study were (1) to characterize dietary habits of pregnant women and to find possible differences in food preferences between healthy pregnant women and those with GDM and (2) to ascertain possible association of several single nucleotide polymorphisms (SNPs) in taste receptor (TR) genes with GDM. METHODS A total of 363 pregnant women (293 with GDM and 70 with physiologic pregnancy) were included in the study. Dietary pattern spanning the period of approx. 6 months preceding the time of GDM screening was assessed using a semi-quantitative food frequency questionnaire. A total of five SNPs in TR genes were selected for genotyping based on their functionality or previous associations. RESULTS Women with GDM exhibited significantly more frequent meat consumption (esp. poultry, pork and smoked meat), dairy products and sweet beverages consumption. The legumes consumption was found to be inversely correlated with fasting glycaemia (P = 0.007, Spearman). CC genotype in TAS2R9 gene (SNP rs3741845) was significantly associated with GDM (P = 0.0087, Chi-square test). CONCLUSIONS Our study showed differences in dietary intake of selected food items between healthy pregnant women and those with GDM and genetic association of bitter taste receptor allele with GDM.
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Affiliation(s)
- Vendula Bartáková
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, Brno, 625 00, Czech Republic.
| | - Katarína Kuricová
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, Brno, 625 00, Czech Republic
| | - Filip Zlámal
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, Brno, 625 00, Czech Republic
| | - Jana Bělobrádková
- Diabetes Centre, Department of Internal Medicine, University Hospital, Brno, Brno, Czech Republic
| | - Katetřina Kaňková
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Kamenice 5, Brno, 625 00, Czech Republic
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Shin MK, Kim YS, Kim JH, Kim SH, Kim Y. Dietary Patterns and Their Associations with the Diet Quality Index-International (DQI-I) in Korean Women with Gestational Diabetes Mellitus. Clin Nutr Res 2015; 4:216-24. [PMID: 26566516 PMCID: PMC4641983 DOI: 10.7762/cnr.2015.4.4.216] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/06/2015] [Accepted: 09/25/2015] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to examine dietary pattern, nutritional intake, and diet quality of Korean pregnant women with gestational diabetes mellitus (GDM). Between October 2008 and May 2012, 166 pregnant women diagnosed with GDM completed a questionnaire and dietary intake was assessed using a 3-day food record. Blood pressure, fasting plasma glucose, and glycated hemoglobin (HbA1c) concentrations were measured and oral glucose tolerance test (OGTT) was performed. Two major dietary patterns ("carbohydrate and vegetable" and "western" patterns) were identified through factor analysis. Dietary pattern scores for each dietary pattern were categorized into tertiles. The dietary quality index-international (DQI-I) was used to measure overall diet quality. Subjects with higher carbohydrate and vegetable pattern scores reported less physical activity (p < 0.05) and have higher diastolic blood pressure levels (p = 0.05). After adjusting for age and energy intake, higher carbohydrate and vegetable pattern scores were associated with higher sodium intakes (p = 0.02), but lower intakes of fat (p = 0.002) and other micronutrients. On the other hand, higher western pattern scores were associated with higher fat intake (p = 0.0001), but lower intakes of sodium (p = 0.01) and other micronutrients. Higher scores for both dietary patterns were associated with lower scores in the moderation category of the DQI-I (p < 0.0001). HbA1c and fasting plasma glucose levels were significantly lower among participants with high DQI-I than those with low DQI-I (p < 0.05). The study findings suggest that many Korean women with GDM do not consume nutritionally adequate or balanced diets, regardless of dietary pattern.
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Affiliation(s)
- Moon-Kyung Shin
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Yoo-Sun Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Jung-Hyun Kim
- Department of Physical Education, Chung-Ang University, Seoul 06974, Korea
| | - Sung-Hoon Kim
- Department of Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul 04619, Korea
| | - Yuri Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
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Calcium plus vitamin D supplementation affects pregnancy outcomes in gestational diabetes: randomized, double-blind, placebo-controlled trial. Public Health Nutr 2015; 19:156-63. [PMID: 25790761 DOI: 10.1017/s1368980015000609] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The present study was designed to assess the effects of Ca+vitamin D supplementation on pregnancy outcomes in women with gestational diabetes mellitus (GDM). DESIGN A randomized, double-blind, placebo-controlled trial was conducted among sixty women with GDM. Participants were divided into two groups to receive Ca+vitamin D supplements or placebo. Individuals in the Ca+vitamin D group (n 30) received 1000 mg Ca/d and two pearls containing 1250 µg (50 000 IU) of cholecalciferol (vitamin D(3)) during the intervention (one at study baseline and another at day 21 of the intervention); those in the placebo group (n 30) received two placebos of vitamin D at the mentioned times and placebos of Ca every day for 6 weeks. Pregnancy outcomes were determined. SETTING A urban community setting in Arak, Iran. SUBJECTS Sixty women with GDM and their newborns, living in Arak, Iran were enrolled. RESULTS Women treated with Ca+vitamin D had a significant decrease in caesarean section rate (23·3 % v. 63·3 %, P=0·002) and maternal hospitalization (0 v. 13·3 %, P=0·03) compared with those receiving placebo. In addition, newborns of GDM women randomized to Ca+vitamin D had no case of macrosomia, while the prevalence of macrosomia among those randomized to placebo was 13·3 % (P=0·03). Lower rates of hyperbilirubinaemia (20·0 % v. 56·7 %, P=0·03) and hospitalization (20·0 % v. 56·7 %, P=0·03) were also seen in the supplemented group of newborns than in the placebo group. CONCLUSIONS Ca+vitamin D supplementation for 6 weeks among pregnant women with GDM led to decreased caesarean section rate and maternal hospitalization, and decreased macrosomia, hyperbilirubinaemia and hospitalization in newborns.
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Asemi Z, Karamali M, Esmaillzadeh A. Effects of calcium-vitamin D co-supplementation on glycaemic control, inflammation and oxidative stress in gestational diabetes: a randomised placebo-controlled trial. Diabetologia 2014; 57:1798-806. [PMID: 24962666 DOI: 10.1007/s00125-014-3293-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/19/2014] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS This study was designed to assess the effects of calcium and vitamin D supplementation on the metabolic status of pregnant women with gestational diabetes mellitus (GDM). METHODS This randomised placebo-controlled trial was performed at maternity clinics affiliated to Kashan University of Medical Sciences, Kashan, Iran. Participants were 56 women with GDM at 24-28 weeks' gestation (18 to 40 years of age). Subjects were randomly assigned to receive calcium plus vitamin D supplements or placebo. All study participants were blinded to group assignment. Individuals in the calcium-vitamin D group (n = 28) received 1,000 mg calcium per day and a 50,000 U vitamin D3 pearl twice during the study (at study baseline and on day 21 of the intervention), and those in the placebo group (n = 28) received two placebos at the mentioned times. Fasting blood samples were taken at study baseline and after 6 weeks of intervention. RESULTS The study was completed by 51 participants (calcium-vitamin D n = 25, placebo n = 26). However, as the analysis was based on an intention-to-treat approach, all 56 women with GDM (28 in each group) were included in the final analysis. After the administration of calcium plus vitamin D supplements, we observed a significant reduction in fasting plasma glucose (-0.89 ± 0.69 vs +0.26 ± 0.92 mmol/l, p < 0.001), serum insulin levels (-13.55 ± 35.25 vs +9.17 ± 38.50 pmol/l, p = 0.02) and HOMA-IR (-0.91 ± 1.18 vs +0.63 ± 2.01, p = 0.001) and a significant increase in QUICKI (+0.02 ± 0.03 vs -0.002 ± 0.02, p = 0.003) compared with placebo. In addition, a significant reduction in serum LDL-cholesterol (-0.23 ± 0.79 vs +0.26 ± 0.74 mmol/l, p = 0.02) and total cholesterol: HDL-cholesterol ratio (-0.49 ± 1.09 vs +0.18 ± 0.37, p = 0.003) and a significant elevation in HDL-cholesterol levels (+0.15 ± 0.25 vs -0.02 ± 0.24 mmol/l, p = 0.01) was seen after intervention in the calcium-vitamin D group compared with placebo. In addition, calcium plus vitamin D supplementation resulted in a significant increase in GSH (+51.14 ± 131.64 vs -47.27 ± 203.63 μmol/l, p = 0.03) and prevented a rise in MDA levels (+0.06 ± 0.66 vs +0.93 ± 2.00 μmol/l, p = 0.03) compared with placebo. CONCLUSIONS/INTERPRETATION Calcium plus vitamin D supplementation in women with GDM had beneficial effects on their metabolic profile. TRIAL REGISTRATION www.irct.ir IRCT201311205623N11. FUNDING The study was supported by a grant (no. 92110) from Kashan University of Medical Sciences.
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Affiliation(s)
- Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R., Iran
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