Effect of low-glycemic index diet advice on pregnant outcomes in women with elevated risk of gestational diabetes mellitus: A meta-analysis of randomized controlled trails.

BACKGROUND AND AIMS: The beneficial effect of low-glycemic index (GI) diet on gestational diabetes mellitus (GDM) has been suggested in many observational studies; however, results from intervention trials remain inconsistent. This study aims to estimate the effect of interventions with low-GI dietary advice on pregnant outcomes in women with elevated risk of GDM. DESIGN: PubMed, Web of Science, Embase, and Cochrane Library databases were searched for randomized clinical trials (RCTs) through March 2022. Studies reporting the effect of low-GI diet advice intervention on maternal and fetal outcomes in pregnant women with increased risks of GDM were included. Random or fixed effects model was used to calculate combined treatment effects. Publication bias was assessed via Begg's and Egger's tests and funnel plot inspection. RESULTS: Nine RCTs recruiting 3416 participants were included. Low-GI diet advice did not modulate the risk of GDM. Compared with control diets, low-GI diet advice significantly reduced gestational weight gain (GWG) (weighted mean differences, WMD = -0.93 kg, 95% CI: -1.31, -0.55; p < 0.001; n = 7) and the risk of premature birth (RR = 0.55, 95% CI: 0.35, 0.88; p = 0.012; n = 5). In subgroup analyses, the effect of low-GI diet interventions on premature birth was significant only in women with BMI higher than 30 kg/m2 (RR = 0.28, 95% CI: 0.10, 0.77, p = 0.014; n = 3); the significant effect on GWG was not altered by stratification of BMI and the type of GDM risk factors. No significant changes in other maternal and newborn outcomes were found. CONCLUSIONS: Low-GI diet advice interventions during pregnancy decreased GWG and the risk of premature birth in women with elevated GDM risk; however, the interventions did not significantly prevent GDM development in these women.

[Association between the diet balance index-based dietary quality and cognitive function among Zhejiang population aged 40 years and older].

OBJECTIVE: To evaluation the dietary quality of Zhejiang population aged 40 years and older using the Dietary Balance Index(DBI) and to analyze the association between dietary quality and cognitive function. METHODS: The dietary information was collected with the help of questionnaire survey, a 3-day dietary recall and household condiment weighing method from Zhejiang participants of the 2018 wave of the China Health and Nutrition Survey aged 40 years and older, and the food and energy intakes were calculated. The cognitive function was assessed by the Mini Mental Status Examination. Dietary quality was evaluated using the DBI method. A multivariate Logistic regression model was used to examine the association between dietary quality and the risk of cognitive impairment. RESULTS: Among 640 participants aged 40 years and older, 14.2% had cognitive impairment. Univariate analysis showed that those with cognitive impairment had higher cereal(P=0.001), particularly, higher rice and products intake(P<0.001), as well as higher egg intake(P=0.008) than those with normal cognitive function; while the intake of soybean and its product(P=0.025) was lower. Those with cognitive impairment had higher DBI score of cereal(P=0.006) and high bound score(HBS)(P=0.028)than those with normal cognitive function. After adjustment for possible confounding factors, Logistic regression showed that moderated and severe over-consumption was positively associated with cognitive impairment(OR=2.486, 95% CI 1.130-5.470, P=0.024). CONCLUSION: Over-consumption may increase the risk of cognitive impairment among aged Zhejiang population, and should be used to prevent or reduce cognitive decline by improving the quality of the diet through a reasonable dietary mix.