Thursday, July 14, 2016
Can Gestational Diabetes be Prevented by a Nutritious Diet?
Gestational diabetes mellitus (GDM) is associated with increased risk of obstructive labour, and type 2 diabetes mellitus (T2DM) later in life. Furthermore, infants may be born with congenital malformations, foetal macrosomia, or neonatal hypoglycaemia. Research indicates that a maternal diet containing high-fibre foods, fruits, vegetables, poultry, and fish before or during pregnancy may reduce the risk of GDM. A low intake of saturated fat, red or processed meat, sweets, and refined products is also beneficial in lowering the risk of GDM.
A randomised controlled trial published in The Journal of Nutrition focused on the association between women’s dietary intake before and during pregnancy and the risk of GDM. The study included married women under 40 years of age and living in Mumbai’s slums. Snacks prepared from green leafy vegetables, full-fat milk powder, and dried fruits were given to the intervention group. Similar snacks prepared using low-micronutrient vegetables, such as potato and onion, were given to the control group. Pregnant women underwent an oral glucose tolerance test (OGTT) at 28–32 weeks of pregnancy.
Out of 6513 non-pregnant women selected for the study, 2291 became pregnant during the course of study, 2028 reached 28 weeks of pregnancy, and only 1008 had an OGTT. Eventually, 100 women were diagnosed with GDM. Women in the intervention group had lower weight, body mass index, and skinfold thickness compared to those from the control group. Women in the control group had a higher incidence of GDM compared to those in the intervention group. Overall, women who were diagnosed with GDM were older and had more adipose tissue; they also ate nonvegetarian foods more frequently than those who did not develop GDM. Most of them underwent emergency caesarean sections, and some women gave birth to premature infants, infants smaller than usual, or infants with congenital anomalies.
The findings suggest that the low energy and protein in the control snack increased the risk of GDM. Snacks given to the intervention group did not affect the glucose levels of normal women or those with GDM. However, the intervention had an effect on the women who were at risk for GDM. The intake of micronutrients may have a protective effect against GDM. Study limitations such as the small sample size (100 women) and unreliable information on the history of GDM in earlier pregnancies might have influenced the results.
News source - Sahariah SA, Potdar RD, Gandhi M, Kehoe SH, Brown N, Sane H, Coakley PJ, Marley-Zagar E, Chopra H, Shivshankaran D, Cox VA. A daily snack containing leafy green vegetables, fruit, and milk before and during pregnancy prevents gestational diabetes in a randomized, controlled trial in Mumbai, India. The Journal of Nutrition. 2016 Jun 8:jn223461.