Carbohydrate Intake Quality and Gestational Diabetes Mellitus, and the Modifying Effect of Air Pollution

Overview

Journal Front Nutr

Specialty Nutritional Sciences

Date 2023 Jan 23

PMID 36687724

Authors

Hehua Zhang

Yang Xia

Xiangsu Zhang

Qing Chang

Yuhong Zhao

Affiliations

Soon will be listed here.

Abstract

Background: Nutritional 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.

Methods: Carbohydrate 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.

Results: A 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, = 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 ( < 0.01), particulate matter with an aerodynamic diameter of < 10 μm ( < 0.01), and sulfur dioxide ( = 0.02) during pregnancy decreased the beneficial effect of high pre-pregnancy CQI on GDM.

Conclusion: CQI 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.

Citing Articles

Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project.

Fabios E, Martinez-Gonzalez M, Garcia-Blanco L, de la O V, Santiago S, Zazpe I Children (Basel). 2023; 10(10).

PMID: 37892374 PMC: 10605036. DOI: 10.3390/children10101711.

References

Guxens M, Aguilera I, Ballester F, Estarlich M, Fernandez-Somoano A, Lertxundi A . Prenatal exposure to residential air pollution and infant mental development: modulation by antioxidants and detoxification factors. Environ Health Perspect. 2011; 120(1):144-9. PMC: 3261939. DOI: 10.1289/ehp.1103469. View

Hernandez T, Van Pelt R, Anderson M, Daniels L, West N, Donahoo W . A higher-complex carbohydrate diet in gestational diabetes mellitus achieves glucose targets and lowers postprandial lipids: a randomized crossover study. Diabetes Care. 2014; 37(5):1254-62. PMC: 3994935. DOI: 10.2337/dc13-2411. View

Lappas M, Hiden U, Desoye G, Froehlich J, Hauguel-De Mouzon S, Jawerbaum A . The role of oxidative stress in the pathophysiology of gestational diabetes mellitus. Antioxid Redox Signal. 2011; 15(12):3061-100. DOI: 10.1089/ars.2010.3765. View

Buchanan T, Xiang A, Page K . Gestational diabetes mellitus: risks and management during and after pregnancy. Nat Rev Endocrinol. 2012; 8(11):639-49. PMC: 4404707. DOI: 10.1038/nrendo.2012.96. View

Mustad V, Huynh D, Lopez-Pedrosa J, Campoy C, Rueda R . The Role of Dietary Carbohydrates in Gestational Diabetes. Nutrients. 2020; 12(2). PMC: 7071246. DOI: 10.3390/nu12020385. View

Lim C, Hayes R, Ahn J, Shao Y, Silverman D, Jones R . Mediterranean Diet and the Association Between Air Pollution and Cardiovascular Disease Mortality Risk. Circulation. 2019; 139(15):1766-1775. PMC: 6453737. DOI: 10.1161/CIRCULATIONAHA.118.035742. View

Chatzakis C, Sotiriadis A, Tsakmaki E, Papagianni M, Paltoglou G, Dinas K . The Effect of Dietary Supplements on Oxidative Stress in Pregnant Women with Gestational Diabetes Mellitus: A Network Meta-Analysis. Nutrients. 2021; 13(7). PMC: 8308478. DOI: 10.3390/nu13072284. View

Venter Z, Aunan K, Chowdhury S, Lelieveld J . Air pollution declines during COVID-19 lockdowns mitigate the global health burden. Environ Res. 2020; 192:110403. PMC: 7605823. DOI: 10.1016/j.envres.2020.110403. View

Trumbo P, Schlicker S, Yates A, Poos M . Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J Am Diet Assoc. 2002; 102(11):1621-30. DOI: 10.1016/s0002-8223(02)90346-9. View

10.

Chen X, Scholl T . Oxidative stress: changes in pregnancy and with gestational diabetes mellitus. Curr Diab Rep. 2005; 5(4):282-8. DOI: 10.1007/s11892-005-0024-1. View

11.

Liu S, Yin X, Hou C, Liu X, Ma H, Zhang X . As a Staple Food Substitute, Oat and Buckwheat Compound Has Health-Promoting Effects for Diabetic Rats. Front Nutr. 2022; 8:762277. PMC: 8740054. DOI: 10.3389/fnut.2021.762277. View

12.

Cui Y, Liao M, Xu A, Chen G, Liu J, Yu X . Association of maternal pre-pregnancy dietary intake with adverse maternal and neonatal outcomes: A systematic review and meta-analysis of prospective studies. Crit Rev Food Sci Nutr. 2021; 63(19):3430-3451. DOI: 10.1080/10408398.2021.1989658. View

13.

Zhang H, Zhao Y . Land use regression for spatial distribution of urban particulate matter (PM) and sulfur dioxide (SO) in a heavily polluted city in Northeast China. Environ Monit Assess. 2019; 191(12):712. DOI: 10.1007/s10661-019-7905-2. View

14.

Cui M, Li X, Yang C, Wang L, Lu L, Zhao S . Effect of Carbohydrate-Restricted Dietary Pattern on Insulin Treatment Rate, Lipid Metabolism and Nutritional Status in Pregnant Women with Gestational Diabetes in Beijing, China. Nutrients. 2022; 14(2). PMC: 8778860. DOI: 10.3390/nu14020359. View

15.

Farabi S, Hernandez T . Low-Carbohydrate Diets for Gestational Diabetes. Nutrients. 2019; 11(8). PMC: 6723585. DOI: 10.3390/nu11081737. View

16.

Hu Q, Wang D, Yue D, Xu C, Hu B, Cheng P . Association of ambient particle pollution with gestational diabetes mellitus and fasting blood glucose levels in pregnant women from two Chinese birth cohorts. Sci Total Environ. 2020; 762:143176. DOI: 10.1016/j.scitotenv.2020.143176. View

17.

Looman M, Schoenaker D, Soedamah-Muthu S, Geelen A, Feskens E, Mishra G . Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing gestational diabetes: the Australian Longitudinal Study on Women's Health. Br J Nutr. 2018; 120(4):435-444. DOI: 10.1017/S0007114518001277. View

18.

Lin Z, Chen R, Jiang Y, Xia Y, Niu Y, Wang C . Cardiovascular Benefits of Fish-Oil Supplementation Against Fine Particulate Air Pollution in China. J Am Coll Cardiol. 2019; 73(16):2076-2085. DOI: 10.1016/j.jacc.2018.12.093. View

19.

Munoz-Cabrejas A, Laclaustra M, Guallar-Castillon P, Casasnovas J, Jarauta E, Sandoval-Insausti H . High-quality intake of carbohydrates is associated with lower prevalence of subclinical atherosclerosis in femoral arteries: The AWHS study. Clin Nutr. 2021; 40(6):3883-3889. DOI: 10.1016/j.clnu.2021.04.049. View

20.

Rahnemaei F, Pakzad R, Amirian A, Pakzad I, Abdi F . Effect of gestational diabetes mellitus on lipid profile: A systematic review and meta-analysis. Open Med (Wars). 2022; 17(1):70-86. PMC: 8678474. DOI: 10.1515/med-2021-0408. View