Lifestyle patterns in early pregnancy linked to gestational diabetes mellitus diagnoses when using IADPSG criteria. The St Carlos gestational study

Ruiz-Gracia, Teresa; Durán, Alejandra; Fuentes, Manuel; Rubio, Miguel A.; Rünkle, Isabelle; Carrera, Evelyn F.; Torrejón, María José; Bordiú, Elena; Valle, Laura del; Torre, Nuria García de la; Bedia, Ana R.; Montañez, Carmen; Familiar, Cristina; Calle-Pascual, Alfonso

doi:10.1016/j.clnu.2015.04.017

Cited by 27 publications

(14 citation statements)

References 26 publications

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“…First, there are no defining genetic factors that can be exemplified as the hallmark of GDM; thus, lifestyle factors in early pregnancy, including nutritional factors, are moving to the forefront as key forces that drive the pathogenesis of GDM 29 , 30 . Indeed, among the strongest risk factors is prepregnancy obesity (defined as body mass index [BMI] >30 kg/m 2 ) 28 , 31 .…”

Section: Risk Factors For Gestational Diabetesmentioning

confidence: 99%

Maternal nutrition: opportunities in the prevention of gestational diabetes

2017

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Gestational diabetes mellitus (GDM) is currently defined as glucose intolerance that is of variable severity with onset or first recognition during pregnancy. The Hyperglycemia and Adverse Pregnancy Outcome Study, including 25 000 nondiabetic pregnant women in 15 centers across the world, reported that an average of 17.8% of pregnancies are affected by GDM and its frequency can be as high as 25.5% in some countries, based on the International Association of Diabetes and Pregnancy Study Groups criteria. Nevertheless, true global prevalence estimates of GDM are currently lacking due to the high level of heterogeneity in screening approaches, diagnostic criteria, and differences in the characteristics of the populations that were studied. The presence of systemic high blood glucose levels in pregnancy results in an adverse intrauterine environment, which has been shown to have a negative impact on short- and long-term health outcomes for both the mother and her offspring, including increased risks for the infant to develop obesity and for both mother and child to develop type 2 diabetes mellitus later in life. Epigenetic mechanisms that are directly influenced by environmental factors, including nutrition, may play a key role in shaping these future health risks and may be part of this vicious cycle. This article reviews the burden of GDM and the current evidence that supports maternal nutritional interventions as a promising strategy to break the cycle by addressing risk factors associated with GDM.

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Section: Risk Factors For Gestational Diabetesmentioning

confidence: 99%

Maternal nutrition: opportunities in the prevention of gestational diabetes

2017

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“…Moreover, MedDiet was retrospectively associated with a decreased risk for GDM [ 12 ]. Furthermore, adoption during the first gestational trimester of certain dietary patterns, clearly divergent from MedDiet principles, has been associated with a higher risk [ 13 ]. We have previously described an association of GDM treatment with a reduction in obesity-induced adverse pregnancy and neonatal events [ 14 ].To date, no randomized clinical trials have assessed the effect of an early nutritional intervention with MedDiet on the incidence of GDM in unselected pregnant women.…”

Section: Introductionmentioning

confidence: 99%

A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM): A randomized controlled trial: The St. Carlos GDM prevention study

et al. 2017

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BackgroundGestational diabetes mellitus (GDM) prevalence is increasing and becoming a major public health concern. Whether a Mediterranean diet can help prevent GDM in unselected pregnant women has yet to be studied.MethodsWe conducted a prospective, randomized controlled trial to evaluate the incidence of GDM with two different dietary models. All consecutive normoglycemic (<92 mg/dL) pregnant women at 8–12 gestational weeks (GW) were assigned to Intervention Group (IG, n = 500): MedDiet supplemented with extra virgin olive oil (EVOO) and pistachios; or Control Group (CG, n = 500): standard diet with limited fat intake. Primary outcome was to assess the effect of the intervention on GDM incidence at 24–28 GW. Gestational weight gain (GWG), pregnancy-induced hypertension, caesarean section (CS), preterm delivery, perineal trauma, small and large for gestational age (SGA and LGA) and admissions to neonatal intensive care unit were also assessed. Analysis was by intention-to-treat.ResultsA total of 874 women completed the study (440/434, CG/IG). According to nutritional questionnaires and biomarker analysis, women in the IG had a good adherence to the intervention. 177/874 women were diagnosed with GDM, 103/440 (23.4%) in CG and 74/434(17.1%) in IG, p = 0.012. The crude relative risk (RR) for GDM was 0.73 (95% CI: 0.56–0.95; p = 0.020) IG vs CG and persisted after adjusted multivariable analysis, 0.75(95% CI: 0.57–0.98; p = 0.039). IG had also significantly reduced rates of insulin-treated GDM, prematurity, GWG at 24–28 and 36–38 GW, emergency CS, perineal trauma, and SGA and LGA newborns (all p<0.05).ConclusionsAn early nutritional intervention with a supplemented MedDiet reduces the incidence of GDM and improves several maternal and neonatal outcomes.

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“…Previously our group identified four early-pregnancy dietary patterns that are associated with a reduced risk of developing GDM, diagnosed according to the International Association of Diabetes and the Pregnancy Study Groups criteria (IADPSGc) [11]. A recent randomized controlled trial analyzed by the intention-to-treat approach, found that the adherence to a Mediterranean Diet (MedDiet), supplemented with extra virgin olive oil (EVOO) and pistachios, was associated with a 30% reduction in the incidence of GDM [12].…”

Section: Introductionmentioning

confidence: 99%

A High Adherence to Six Food Targets of the Mediterranean Diet in the Late First Trimester is Associated with a Reduction in the Risk of Materno-Foetal Outcomes: The St. Carlos Gestational Diabetes Mellitus Prevention Study

et al. 2018

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A prenatal diet affects materno-foetal outcomes. This is a post hoc analysis of the St. Carlos gestational diabetes mellitus (GDM) Prevention Study. It aims to evaluate the effect of a late first-trimester (>12 gestational weeks) degree of adherence to a MedDiet pattern—based on six food targets—on a composite of materno-foetal outcomes (CMFCs). The CMFCs were defined as having emergency C-section, perineal trauma, pregnancy-induced hypertension and preeclampsia, prematurity, large-for-gestational-age, and/or small-for-gestational-age. A total of 874 women were stratified into three groups according to late first-trimester compliance with six food targets: >12 servings/week of vegetables, >12 servings/week of fruits, <2 servings/week of juice, >3 servings/week of nuts, >6 days/week consumption of extra virgin olive oil (EVOO), and ≥40 mL/day of EVOO. High adherence was defined as complying with 5–6 targets; moderate adherence 2–4 targets; low adherence 0–1 targets. There was a linear association between high, moderate, and low adherence, and a lower risk of GDM, CMFCs, urinary tract infections (UTI), prematurity, and small-for-gestational-age (SGA) newborns (all p < 0.05). The odds ratios (95% CI) for GDM and CMFCs in women with a high adherence were 0.35((0.18–0.67), p = 0.002) and 0.23((0.11–0.48), p < 0.001), respectively. Late first-trimester high adherence to the predefined six food targets is associated with a reduction in the risk of GDM, CMFCs, UTI, prematurity, and SGA new-borns.

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Lifestyle patterns in early pregnancy linked to gestational diabetes mellitus diagnoses when using IADPSG criteria. The St Carlos gestational study

Cited by 27 publications

References 26 publications

Maternal nutrition: opportunities in the prevention of gestational diabetes

Maternal nutrition: opportunities in the prevention of gestational diabetes

A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM): A randomized controlled trial: The St. Carlos GDM prevention study

A High Adherence to Six Food Targets of the Mediterranean Diet in the Late First Trimester is Associated with a Reduction in the Risk of Materno-Foetal Outcomes: The St. Carlos Gestational Diabetes Mellitus Prevention Study

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