Gestational Diabetes Mellitus Is Associated with Age-Specific Alterations in Markers of Adiposity in Offspring: A Narrative Review.

Maternal hyperglycemia alters an offspring's metabolic health outcomes, as demonstrated by the increased risk for obesity, impaired glucose handling and diabetes from early childhood onwards. Infant growth patterns are associated with childhood adiposity and metabolic health outcomes and, as such, can be used as potential markers to detect suboptimal metabolic development at an early age. Hence, we aimed to assess whether gestational diabetes mellitus (GDM) has an impact on offspring growth trajectories. Outcomes included weight gain (WG), body mass index (BMI), and skin fold thickness (SFT) measured at least at two time points from birth to later childhood. In addition, we explored the role of early life pre- and post-natal nutritional modifiable factors on longitudinal growth in infants of mother with GDM (GDM-F1). Despite the large heterogeneity of the studies, we can still conclude that GDM seems to be associated with altered growth outcomes in the offspring. More specifically, these alterations in growth outcomes seem to be rather time-specific. Increased SFT were reported particularly at birth, with limited information on reporting SFT between 2-5 y, and increased adiposity, measured via SFT and BMI, appeared mainly in later childhood (5-10 y). Studies evaluating longitudinal growth outcomes suggested a potential role of early life nutritional modifiable factors including maternal nutrition and breastfeeding. These may impact the cycle of adverse metabolic health by attenuating growth outcome alterations among GDM-F1. Conclusions: Timely diagnoses of growth deviations in infancy are crucial for early identification of GDM-F1 who are at risk for childhood overweight and metabolic disease development.

Macronutrient Composition and Food Form Affect Glucose and Insulin Responses in Humans.

Glycaemic index (GI) is used as an indicator to guide consumers in making healthier food choices. We compared the GI, insulin index (II), and the area under the curve for blood glucose and insulin as glucose (GR) and insulin responses (IR) of a newly developed liquid nutritional formula with one commercially available liquid product with different types of carbohydrates. We then evaluated the glucose and insulin responses of two test foods with comparable energy density and protein percentage but presented in different food forms (liquid vs. solid). Fourteen healthy women participated in the study. GI, II, GR, and IR were assessed after (independent) consumption of two liquid products and a solid breakfast meal. The two liquid foods showed comparable GI, whilst the liquid form appeared to produce lower median GI (25 vs. 54), and II (52 vs. 98) values compared to the solid breakfast (p < 0.02). The median GR and IR for solid breakfast were respectively 44% and 45% higher compared to the liquid product (p < 0.02). Liquid formulas with different carbohydrate qualities produced comparable glucose responses, while foods with comparable energy density and protein percentage but different food form elicited differential effects on GI, II, GR, and IR. Nutrient quality and food form need to be taken into consideration when developing low GI products to manage glycaemic responses.

A cross-sectional study on food patterns and adiposity among individuals with abnormal glucose homeostasis.

BACKGROUND: Dietary habits play an important role in the prevention of chronic disease; however, few studies have assessed the major dietary patterns in Middle Eastern countries. This study identifies major dietary patterns among Iranian people with abnormal glucose homeostasis. METHODS: This cross-sectional study was conducted at the Diabetes Research Center, Isfahan, Iran among 425 subjects with abnormal glucose homeostasis. Patients were of ages 35 - 55 years and had family histories of diabetes. We assessed dietary intake by the use of a food frequency questionnaire (FFQ) that contained 39 food items. General obesity was defined as a BMI ≥ 30 kg/m2 and central obesity was defined as waist circumference (WC) ≥ 88 in women and WC ≥ 102 in men. RESULTS: Five major dietary patterns were revealed by factor analysis: 'western', 'healthy', 'vegetarian', 'high-fat dairy', and 'chicken and plants'. Those in the top tertile of the 'western pattern' had greater odds for general (OR = 1.73; 95% CI = 1.07 - 2.78) and central obesity (OR = 2, 95% CI = 1.24 - 3.22), however these associations were not significant after adjustment for confounding variables. The 'high-fat dairy pattern' was associated with greater odds of general obesity only after adjusting for confounding variables (OR = 1.73; 95%CI = 1.01 - 2.96). CONCLUSION: The dietary pattern characterized by high intake of hydrogenated fat and sugar was shown to be positively associated with a risk of general and central obesity, however further prospective studies are required to confirm our findings.

The effect of consuming oxidized oil supplemented with fiber on lipid profiles in rat model.

BACKGROUND: This study was conducted to evaluate the effects of consuming thermally oxidized oil supplemented with pectin on liver glutathione peroxidase activity, serum malondialdehyde and lipid profiles in male Sprague-Dawley rats. METHODS: Fifty growing male Sprague-Dawley rats were randomly divided into different groups. The diets differed only in their fat and pectin content. The diets had fresh sunflower oil or thermally oxidized sunflower oil. The diets were supplemented with pectin in the amount of 50 g/kg diet or not supplemented. Thus, there were four experimental groups: "fresh oil", "oxidized oil", "fresh oil + pectin", "oxidized oil + pectin". Study duration was 42 days. Non parametric, Kruskal-Wallis and Mann-Whitney tests were used to evaluate mean values of variables in groups. RESULTS: In oil consumption, peroxide, p- Anisidine, thiobarbituric acid, free fatty acid values and total polar compounds increased but iodine value was decreased. In the oxidized oil group compared to the fresh oil group, total cholesterol, high density lipoprotein cholesterol and malondialdehyde increased (p < 0.05). Serum malondialdehyde was decreased in the "oxidized oil + pectin" group compared to the oxidized oil alone (2.82 ± 0.51 vs. 3.61 ± 0.72 nmol/ml; p < 0.05). Total cholesterol decreased in both groups containing pectin compared to their respective diets without supplementation (70.10 ± 10.75 vs. 81.20 ± 13.10 mg/dl; p < 0.05). CONCLUSIONS: Pectin consumption could decrease serum malondialdehyde and cholesterol in the diet that contains oxidized oil. Pectin supplementation could decrease the detrimental effects of thermally oxidized oil.

Relationship between major dietary patterns and metabolic syndrome among individuals with impaired glucose tolerance.

OBJECTIVE: Dietary habits have been associated with the prevalence of the metabolic syndrome and limited data are available in this field for individuals with impaired glucose tolerance. This study focused on the association between major dietary patterns and prevalence of the metabolic syndrome in individuals with impaired glucose tolerance. METHODS: This cross-sectional study was done in 425 subjects 35 to 55 y of age. Dietary data were collected using a food-frequency questionnaire. Blood pressure, waist circumference, glucose, triacylglycerols, and high-density lipoprotein cholesterol were measured and metabolic syndrome was defined based on Adult Treatment Panel III guidelines. RESULTS: Five major dietary patterns were found: a western pattern (high in sweets, butter, soda, mayonnaise, sugar, cookies, tail of a lamb, hydrogenated fat, and eggs), a prudent pattern (high in fish, peas, honey, nuts, juice, dry fruits, vegetable oil, liver and organic meat, and coconuts and low in hydrogenated fat and non-leafy vegetables), a vegetarian pattern (high in potatoes, legumes, fruits rich in vitamin C, rice, green leafy vegetables, and fruits rich in vitamin A), a high-fat dairy pattern (high in high-fat yogurt and high-fat milk and low in low-fat yogurt, peas, and bread), and a chicken and plant pattern (high in chicken, fruits rich in vitamin A, green leafy vegetables, and mayonnaise and low in beef, liver, and organic meat). After adjusting for confounding variables, the western pattern was associated with greater odds of having increased triacylglycerol (odds ratio 1.76, 95% confidence interval 1.01-3.07) and blood pressure (odds ratio 2.62, 95% confidence interval 1.32-5.23). The prudent pattern was positively associated with a prevalence of low high-density lipoprotein cholesterol levels (odds ratio 0.55, 95% confidence interval 0.31-0.96). The vegetarian dietary pattern was inversely associated with a risk of an abnormal fasting blood glucose level (odds ratio 2.26, 95% confidence interval 1.25-4.06). CONCLUSION: Major dietary patterns were significantly associated with the risk of metabolic syndrome.