Dietary fat and gestational hyperglycaemia

Abstract

Gestational diabetes mellitus (GDM) has an incidence of 2±6 % and is associated with maternal morbidity, adverse perinatal outcomes and many other conditions [1±4]. Unmodifiable known risk factors associated with GDM are ethnicity, age, number of previous pregnancies, and a family history of diabetes. Recently, a short stature has been identified as an independent variable associated with gestational diabetes [5±7]. A modifiable known risk factor is obesity [4]. However, women without conventional risk factors for gestational diabetes also develop the disease [8]. Discovering additional risk factors would help identify those women who need to be tested for gestational diabetes.Additional modifiable risk factors could be a lack of exercise and dietary fat as well as life-style habits that adversely influence insulin-resistance, such as smoking and certain drugs [4]. Diabetologia (2001) Abstract Aims/hypothesis. The purpose of this study was to investigate the relation between life-style habits and glucose abnormalities in Caucasian women with and without conventional risk factors for gestational diabetes. Methods. A total of 126 pregnant women with gestational diabetes, 84 with impaired glucose tolerance and 294 with normal glucose tolerance, identified by sequential screening, were interviewed to determine their usual weekly food pattern, amount of exercise, smoking habits and alcohol intake. Results. Patients with glucose abnormalities were older and shorter in height and had significantly higher BMI before pregnancy, percentage of diabetic firstdegree relatives and higher intake of saturated fat. Patients without known risk factors for gestational diabetes (i. e. younger than 35 years of age, BMI < 25 kg/m 2 , no first-degree diabetic relatives) included 40 with impaired glucose tolerance or gestational diabetes. In a multiple logistic regression model age, short stature, familial diabetes, BMI and percentages of saturated fat were associated with impaired glucose tolerance or gestational diabetes in all patients, after adjustment for gestational age. In patients without conventional risk factors only percentages of saturated fat (OR = 2.0; 95 %-CI = 1.2±3.2) and polyunsaturated fat (OR = 0.85; 95 %-CI = 0.77±0.92) were associated with gestational hyperglycaemia, after adjustment for age, gestational age and BMI. Conclusion/interpretation. Saturated fat has an independent role in the development of gestational glucose abnormalities. This role is more important in the absence of conventional risk factors suggesting that glucose abnormalities could be prevented during pregnancy, at least in some groups of women. [Diabetologia (2001) 44: 972±978]

Adverse effect of obesity on red cell membrane arachidonic and docosahexaenoic acids in gestational diabetes

“…Moreover, there was no biochemical indication of dietary linoleic (18:2n-6) and alpha-linolenic (18:3n-3) acids or DHA deficiency measured by Mead acid (20:3n-9) [25], the Mead acid/AA ratio [26,27], and docosapentaenoic acid (22:5n-6) in the plasma and red cell CPG. In contrast, others [28,29,30] have shown that GDM have a different fat intake (more saturated fat and less polyunsaturated fat) compared with control subjects. Although we did not have pre-diagnosis dietary information for these women, the fact that the plasma CPG and triglycerides (data not shown) were similar in the two groups suggests that dietary fat played a minor role in determining membrane fatty acids in the GDM.…”

The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies

“…Third, studies used different diagnostic criteria for GDM, with no clear pattern emerging regarding whether a significant association could be detected using less or more strict criteria. Some studies showed a gradient in dietary intake (e.g., increasing dietary fat intake) from normal glucose tolerance to abnormal glucose tolerance and GDM (39)(40)(41), whereas other studies found an association or no association consistent with both outcomes (16,20,42). Finally, the observed associations may be explained by residual confounding from unmeasured factors in the individual studies.…”

Fatty Acids as Biocompounds: Their Role in Human Metabolism, Health and Disease - A Review. Part 2: Fatty Acid Physiological Roles and Applications in Human Health and Disease

“…Excess intake of total fat during pregnancy, mainly trans and saturated fat, can lead to gestational hyperglycemia and gestational diabetes mellitus, whereas PUFA intake is linked with a lower risk 86 . Similarly, increased intake of LC n-3 PUFA may be protective against preeclampsia 87 .…”