Tuesday, May 31, 2016
Gestational diabetes mellitus and the role of diet
Dietary factors have a significant association with the incidence of gestational diabetes mellitus (GDM). Various studies have demonstrated the influence of diet on GDM, but with conflicting evidence. This systematic review provides an insight into the role of energy, nutrients, foods, and dietary patterns in the development of GDM.
In a systematic review published in the journal Diabetes Care, Schoenaker et al. synthesised evidence from observational studies to investigate the association between dietary factors and GDM. The studies included were original, observational studies in women of the reproductive age group that investigated the association between dietary intake before or during pregnancy and the development of GDM.
The review included data from 21 studies across 34 articles, of which 10 were prospective cohort studies (83,189 women, 2,446 with GDM), 6 were cross-sectional studies (2452 women, 478 with GDM), and 5 were case-control studies (1657 women, 438 with GDM). The dietary intake was assessed using dietary recall, diet history, or the food frequency questionnaire in 14 of the 21 studies. Additional information on maternal dietary factors, such as energy, dietary patterns, nutrients, and food before or during pregnancy, was also assessed.
Prospective cohort studies indicated an independent association between nutrient intake and GDM. An increased risk of GDM was associated with replacing 1%-5% of energy source from carbohydrates with fat, and for high consumption of cholesterol (≥300 mg/day), haeme iron (≥1.1 mg/day), red and processed meat (increment of 1 serving/day) and eggs (≥7 per week). A diet rich in fruit, vegetables, whole grains, and fish; and low in processed meat, refined grains, and high-fat dairy was found to be beneficial.
However, this systematic review has significant limitations. None of the studies examined dietary intake before and during pregnancy to evaluate whether the timing of dietary habits affects the association of diet with GDM. The consistency and comparability of the findings across studies were limited, and a meta-analysis was not conducted based on the pooled data. Moreover, this systematic review only included studies published in English.
In conclusion, this systematic review indicates a link between dietary factors and the risk of developing GDM. The findings support current guidelines for reproductive-aged women to limit their intake of saturated fat and cholesterol.
News Source: Schoenaker DA, Mishra GD, Callaway LK, Soedamah-Muthu SS. The role of energy, nutrients, foods, and dietary patterns in the development of gestational diabetes mellitus: a systematic review of observational studies. Diabetes care. 2016 Jan 1;39(1):16-23.