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The role of diet in the prevention of diabetes among women with prior gestational diabetes: A systematic review of intervention and observational studies

The role of diet in the prevention of diabetes among women with prior gestational diabetes: A systematic review of intervention and observational studies
The role of diet in the prevention of diabetes among women with prior gestational diabetes: A systematic review of intervention and observational studies

BACKGROUND: Women with prior gestational diabetes (GDM) have an increased lifetime risk of developing type 2 diabetes mellitus (T2DM). There are no up-to-date systematic reviews analyzing the relationship of diet with risk of developing T2DM following GDM.

OBJECTIVE: To systematically review the evidence from intervention and observational studies on effects of dietary interventions and associations of dietary intake with T2DM outcomes in women with a GDM history.

METHODS: Six electronic databases were searched (Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, Cochrane Central, Proquest, and Scopus) for articles published until May 2019. This review includes intervention and observational studies among women of any age with a history of GDM that reported on the effects of dietary interventions or association of dietary intake (energy, nutrients, foods, dietary patterns) with T2DM, impaired glucose tolerance, impaired fasting glucose, or prediabetes.

RESULTS: The systematic review identified five articles reporting results from four intervention studies, and seven articles reporting results from four observational studies. Findings from intervention studies indicated trends toward beneficial effects of a low-glycemic index diet, a low-carbohydrate diet, and a diet in line with general population dietary guidelines, but studies had unclear or high risk of bias. Findings from two cross-sectional and one prospective study indicated poorer diabetes outcomes for women with higher intakes of branched-chain amino acids, total and heme iron, and a diet relatively low in carbohydrates and high in animal fat and protein, and better outcomes among those consuming diets rich in fruit, vegetables, nuts, fish, and legumes, and low in red and processed meats and sugar-sweetened beverages, after adjustment for confounders, including body mass index.

CONCLUSIONS: Findings from observational studies support current dietary guidelines for the prevention of T2DM. Further dietary intervention studies are needed to confirm whether or not dietary modification following a GDM pregnancy reduces women's risk of developing T2DM.

Diabetes, Intervention, Nutrition, Pregnancy, Systematic review
2212-2672
69-85.e7
D'Arcy, Ellie
55b19f4b-c73c-4e0d-9be9-a53c43bbae7a
Rayner, Jessica
c3180f1d-9172-4884-826f-761674331097
Hodge, Allison
94d87cc7-a4a9-47a5-a41d-0e4f13ecb0d1
Ross, Lynda J
6f5fbe13-0fe8-43ae-9306-868ce2022fc5
Schoenaker, Danielle A J M
84b96b87-4070-45a5-9777-5a1e4e45e818
D'Arcy, Ellie
55b19f4b-c73c-4e0d-9be9-a53c43bbae7a
Rayner, Jessica
c3180f1d-9172-4884-826f-761674331097
Hodge, Allison
94d87cc7-a4a9-47a5-a41d-0e4f13ecb0d1
Ross, Lynda J
6f5fbe13-0fe8-43ae-9306-868ce2022fc5
Schoenaker, Danielle A J M
84b96b87-4070-45a5-9777-5a1e4e45e818

D'Arcy, Ellie, Rayner, Jessica, Hodge, Allison, Ross, Lynda J and Schoenaker, Danielle A J M (2020) The role of diet in the prevention of diabetes among women with prior gestational diabetes: A systematic review of intervention and observational studies. Journal of the Academy of Nutrition and Dietetics, 120 (1), 69-85.e7. (doi:10.1016/j.jand.2019.07.021).

Record type: Article

Abstract

BACKGROUND: Women with prior gestational diabetes (GDM) have an increased lifetime risk of developing type 2 diabetes mellitus (T2DM). There are no up-to-date systematic reviews analyzing the relationship of diet with risk of developing T2DM following GDM.

OBJECTIVE: To systematically review the evidence from intervention and observational studies on effects of dietary interventions and associations of dietary intake with T2DM outcomes in women with a GDM history.

METHODS: Six electronic databases were searched (Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, Cochrane Central, Proquest, and Scopus) for articles published until May 2019. This review includes intervention and observational studies among women of any age with a history of GDM that reported on the effects of dietary interventions or association of dietary intake (energy, nutrients, foods, dietary patterns) with T2DM, impaired glucose tolerance, impaired fasting glucose, or prediabetes.

RESULTS: The systematic review identified five articles reporting results from four intervention studies, and seven articles reporting results from four observational studies. Findings from intervention studies indicated trends toward beneficial effects of a low-glycemic index diet, a low-carbohydrate diet, and a diet in line with general population dietary guidelines, but studies had unclear or high risk of bias. Findings from two cross-sectional and one prospective study indicated poorer diabetes outcomes for women with higher intakes of branched-chain amino acids, total and heme iron, and a diet relatively low in carbohydrates and high in animal fat and protein, and better outcomes among those consuming diets rich in fruit, vegetables, nuts, fish, and legumes, and low in red and processed meats and sugar-sweetened beverages, after adjustment for confounders, including body mass index.

CONCLUSIONS: Findings from observational studies support current dietary guidelines for the prevention of T2DM. Further dietary intervention studies are needed to confirm whether or not dietary modification following a GDM pregnancy reduces women's risk of developing T2DM.

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More information

Accepted/In Press date: 26 July 2019
e-pub ahead of print date: 31 October 2019
Published date: January 2020
Keywords: Diabetes, Intervention, Nutrition, Pregnancy, Systematic review

Identifiers

Local EPrints ID: 441284
URI: http://eprints.soton.ac.uk/id/eprint/441284
ISSN: 2212-2672
PURE UUID: 330684e2-3946-4da7-a5e5-fd536663e51f
ORCID for Danielle A J M Schoenaker: ORCID iD orcid.org/0000-0002-7652-990X

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Date deposited: 08 Jun 2020 16:32
Last modified: 09 Jan 2022 04:10

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Contributors

Author: Ellie D'Arcy
Author: Jessica Rayner
Author: Allison Hodge
Author: Lynda J Ross

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