Effect of Carbohydrate-Restricted Dietary Pattern on Insulin Treatment Rate, Lipid Metabolism and Nutritional Status in Pregnant Women with Gestational Diabetes in Beijing, China

Cui, Mingxuan; Li, Xuening; Yang, Chen; Wang, Linlin; Liu, Lulu; Zhao, Shilong; Guo, Qingping; Liu, Peng

doi:10.3390/nu14020359

Cited by 7 publications

(5 citation statements)

References 32 publications

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“…With the global rise of obesity and T2DM in humans, various dietary strategies that target the restriction of calorie intake have been used not only to promote weight loss but also to prevent and reduce the onset of T2DM ( 28 , 29 ). Over the past decade, a low-carbohydrate diet has been centered on weight loss in individuals with obesity and those who are overweight, as well as in patients with or at risk of T2DM ( 30 , 31 ). Even though the impact of a low-carbohydrate diet, especially the ketogenic diet, has been found to be very effective in the rapid induction of weight loss in both individuals with obesity and those who are overweight, the impact of such a diet remains to be well characterized in normal weight or lean counterparts.…”

Section: Discussionmentioning

confidence: 99%

Low carbohydrate intake correlates with trends of insulin resistance and metabolic acidosis in healthy lean individuals

Al-Reshed

Sindhu

Madhoun

et al. 2023

Front. Public Health

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IntroductionBoth obesity and a poor diet are considered major risk factors for triggering insulin resistance syndrome (IRS) and the development of type 2 diabetes mellitus (T2DM). Owing to the impact of low-carbohydrate diets, such as the keto diet and the Atkins diet, on weight loss in individuals with obesity, these diets have become an effective strategy for a healthy lifestyle. However, the impact of the ketogenic diet on IRS in healthy individuals of a normal weight has been less well researched. This study presents a cross-sectional observational study that aimed to investigate the effect of low carbohydrate intake in healthy individuals of a normal weight with regard to glucose homeostasis, inflammatory, and metabolic parameters.MethodsThe study included 120 participants who were healthy, had a normal weight (BMI 25 kg/m2), and had no history of a major medical condition. Self-reported dietary intake and objective physical activity measured by accelerometry were tracked for 7 days. The participants were divided into three groups according to their dietary intake of carbohydrates: the low-carbohydrate (LC) group (those consuming <45% of their daily energy intake from carbohydrates), the recommended range of carbohydrate (RC) group (those consuming 45–65% of their daily energy intake from carbohydrates), and the high-carbohydrate (HC) group (those consuming more than 65% of their daily energy intake from carbohydrates). Blood samples were collected for the analysis of metabolic markers. HOMA of insulin resistance (HOMA-IR) and HOMA of β-cell function (HOMA-β), as well as C-peptide levels, were used for the evaluation of glucose homeostasis.ResultsLow carbohydrate intake (<45% of total energy) was found to significantly correlate with dysregulated glucose homeostasis as measured by elevations in HOMA-IR, HOMA-β% assessment, and C-peptide levels. Low carbohydrate intake was also found to be coupled with lower serum bicarbonate and serum albumin levels, with an increased anion gap indicating metabolic acidosis. The elevation in C-peptide under low carbohydrate intake was found to be positively correlated with the secretion of IRS-related inflammatory markers, including FGF2, IP-10, IL-6, IL-17A, and MDC, but negatively correlated with IL-3.DiscussionOverall, the findings of the study showed that, for the first time, low-carbohydrate intake in healthy individuals of a normal weight might lead to dysfunctional glucose homeostasis, increased metabolic acidosis, and the possibility of triggering inflammation by C-peptide elevation in plasma.

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Section: Discussionmentioning

confidence: 99%

Low carbohydrate intake correlates with trends of insulin resistance and metabolic acidosis in healthy lean individuals

Al-Reshed

Sindhu

Madhoun

et al. 2023

Front. Public Health

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“…A clinical trial has reported that carbohydrate counting and adherence to the DASH diet decreases fasting blood glucose levels in GDM with metformin therapy ( 30 ). Most interventional studies have focused on dietary intake during pregnancy and GDM control ( 30 , 33 ). Only limited studies have explored components of carbohydrate intake and the risk of GDM development.…”

Section: Discussionmentioning

confidence: 99%

Carbohydrate intake quality and gestational diabetes mellitus, and the modifying effect of air pollution

et al. 2023

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BackgroundNutritional management is the cornerstone of gestational diabetes mellitus (GDM) prevention. High quality instead of low quantity of carbohydrate intake has been paying attention in controlling glycemia. Air pollution exposure can be interacted with dietary sourced nutrients, which may modify the associations with GDM. This study aims to explore the associations between overall quality of carbohydrate intake and GDM as well as the modifying effect of prenatal air pollution exposure.MethodsCarbohydrate quality index (CQI) was calculated was calculated by summing scores of the four components; Land use regression prediction models were used to assess the air pollution exposure levels. GDM definition was based on 75 g glucose tolerance test results. Associations between pre-pregnancy CQI, pre-natal air pollution as well as the modifying effect on GDM were explored based on a birth cohort in China.ResultsA total of 3,183 participants were included, of which 784 (24.63%) were diagnosed with GDM. Higher pre-pregnancy CQI was associated with a lower incidence of GDM [odds ratio (OR) = 0.75, 95% confidence interval (CI): 0.56–0.99, Pfor trend = 0.04], especially for higher fasting blood glucose related GDM (OR = 0.66, 95% CI: 0.47, 0.91). Higher air pollution exposure before and during pregnancy was associated with a greater risk of GDM. Higher exposure to particulate matter with an aerodynamic diameter of < 2.5 μm (Pfor interaction < 0.01), particulate matter with an aerodynamic diameter of < 10 μm (Pfor interaction < 0.01), and sulfur dioxide (Pfor interaction = 0.02) during pregnancy decreased the beneficial effect of high pre-pregnancy CQI on GDM.ConclusionCQI related dietary interventions pre-pregnancy to prevent GDM incidence should be considered. Women who are planning to be pregnant should avoid high exposure to air pollution during pregnancy.

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“…With the global rise of obesity and type 2 diabetes in humans, various dietary strategies that target restriction of calorie intake have been used widely as a common weight loss approach [12]. During the past decade, low carbohydrate diet has centered on weight loss in the obese and overweight individuals as well as in patients with or at risk for IRS, such as diabetes and atherosclerosis [13,14]. Even though, the impact of low carbohydrate diet, especially the ketogenic diet, is found to be very effective in rapid induction of weight loss in both obese and overweight individuals, the impact of such diet remains to be well characterized in the normal weight or lean counterparts.…”

Section: Discussionmentioning

confidence: 99%

“…C-peptide is a biologically active short polypeptide (31 amino acids) that serve as a diagnostic biomarker to distinguish between type 1 and type 2 diabetes and a strong indicator of insulin biosynthesis and insulin resistance syndrome (IRS) (13)(14)(15). During the past decade, several studies have demonstrated a biological effect of plasma circulating C-peptide on activating inflammatory signaling pathway (16,17).…”

Section: Association Of the C-peptide Levels With Circulatory Inflamm...mentioning

confidence: 99%

The Association between Self-Reported Daily Energy Intake from Carbohydrates with Insulin Resistance in Healthy Weight Nor-Mal-Weight Individuals

Al-Rashed¹,

Madhoun²,

Sindhu³

et al. 2022

Preprint

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Carbohydrates form the major source of energy in Asian diets. A lower carbohydrate diet became the recommended golden standard for healthy lifestyle. However, the effects of low-carbohydrates diet on health in apparently healthy individuals have been poorly studied, especially in relation to insulin resistance syndrome (IRS). A total of 120 healthy weight participants with no previous history of a major medical condition and an average BMI of ≤ 25kg/m2 were recruited. Self-reported dietary intake and objective physical activity by accelerometry were tracked for seven days. Participants were divided into three categories according to their dietary intake of carbohydrates. Blood samples were collected for metabolic markers analysis. HOMA of insulin resistance (HOMA-IR), β-cell function (HOMA-B) and C-peptide were used to evaluate glucose homeostasis. The consumption of low carbohydrates (less than 45% of total energy) significantly correlated with higher HOMA-IR, Lower HOMA-β % compared to moderate carbohydrate intake (between 45% to 65%). However, only the HOMA-β % was significantly influenced by carbohydrates intake. Moreover, low carbohydrates intake was significantly associated with elevated C-peptide secretion. The substitution of carbohydrates with other macronutrients, such as fat and proteins in the Atkins/ketogenic diet, resulted in a pronounced induction of IRS-related inflammatory markers; FGF2, IP-10, IL-6, IL-17A, MDC and reduction of IL-13. Overall, the presented data highlight, for the first time, that low carbohydrate intake results in significant glucose homeostasis imbalance that may be driven by a heightened state of inflammatory response.

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Effect of Carbohydrate-Restricted Dietary Pattern on Insulin Treatment Rate, Lipid Metabolism and Nutritional Status in Pregnant Women with Gestational Diabetes in Beijing, China

Cited by 7 publications

References 32 publications

Low carbohydrate intake correlates with trends of insulin resistance and metabolic acidosis in healthy lean individuals

Low carbohydrate intake correlates with trends of insulin resistance and metabolic acidosis in healthy lean individuals

Carbohydrate intake quality and gestational diabetes mellitus, and the modifying effect of air pollution

The Association between Self-Reported Daily Energy Intake from Carbohydrates with Insulin Resistance in Healthy Weight Nor-Mal-Weight Individuals

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