Dietary vitamin and mineral intakes in a sample of pregnant women with either gestational diabetes or type 1 diabetes mellitus, assessed in comparison with Polish nutritional guidelines
Abstract
Objectives: Maintaining proper nutrition during pregnancy is crucial for pregnant women and especially for who have
been diagnosed with type 1 diabetes mellitus (T1DM) or who develop gestational diabetes mellitus (GDM).
Material and methods: To measure differences in vitamin and mineral intakes among women with normal pregnancies,
pregnant women with GDM, and pregnant women with pre-gestational T1DM; and to assess the women’s dietary intakes in comparison with Polish nutritional guidelines. The analysis was conducted among 83 pregnant women (29 GDM patients, 26 T1DM patients and 28 normal pregnancy participants) from whom we collected seven-day 24-hour dietary records during the second part of their pregnancies.
Results: There were no statistically significant differences observed for most of the vitamin and mineral intakes across the three groups. However, we did observe a significant difference in the vitamin C and calcium intakes between groups. The mean vitamin C and calcium intakes were significantly higher in the control group than among the diabetic patients. Insufficient dietary calcium intakes were found among 52.3% of the GDM patients and 61.6% of the T1DM participants, while only 28.6% of the normal pregnancy patients experienced a calcium deficiency. The highest incidence of inadequate intake in each of the GDM, T1DM and control groups was observed for vitamin D (100%, 100%, 100%), folate (97.7%, 100%, 100%), iron (97.7%, 100%, 100%), and iodine (97.7%, 92.4%, 85.7%), respectively.
Conclusions: Diet alone may not be enough to provide adequate levels of vitamins and minerals for most micronutrients. Supplement use reduces the risk of inadequate intake for many micronutrients, but diet-related issues during pregnancy and pregnancy diagnosed with diabetes remain, and they deserve to be addressed during public health interventions.
Keywords: maternal dietGDMT1DMvitamins inatkesmienrals intakes
References
- Chango A, Pogribny I. Considering Maternal Dietary Modulators for Epigenetic Regulation and Programming of the Fetal Epigenome. Nutrients. 2015; 7(4): 2748–2770.
- Wu G, Imhoff-Kunsch B, Girard A. Biological Mechanisms for Nutritional Regulation of Maternal Health and Fetal Development. Paediatric and Perinatal Epidemiology. 2012; 26: 4–26.
- Wei S. Vitamin D and pregnancy outcomes. Current Opinion in Obstetrics and Gynecology. 2014; 26(6): 438–447.
- Jarosz M. Nutritional norms for the Polish population. 2nd ed PIoFa. ; 2017.
- Pietrobelli A, Agosti M. Nutrition in the First 1000 Days: Ten Practices to Minimize Obesity Emerging from Published Science. International Journal of Environmental Research and Public Health. 2017; 14(12): 1491.
- Madi S, Garcia R, Souza V, et al. Effect of Obesity on Gestational and Perinatal Outcomes. Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics. 2017; 39(07): 330–336.
- Gumprecht J. Guidelines on the management of diabetic patients. Recommendation of Polish Daibetes Society. . Via Medica. 2017; 3: 1–92.
- Kunachowicz H, Przygoda B, Iwanow K. Tabele składu i wartości odżywczej żywnosci. Wydawnictwo Lekarskie PZWL Warszawa. 2005.
- Percy L, Mansour D, Fraser I. Iron deficiency and iron deficiency anaemia in women. Best Pract Res Clin Obstet Gynaecol. 2017; 40: 55–67.
- Bhutta ZA, Khan I. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database of Systematic Reviews. 2004.
- Savard C, Lemieux S, Weisnagel S, et al. Trimester-Specific Dietary Intakes in a Sample of French-Canadian Pregnant Women in Comparison with National Nutritional Guidelines. Nutrients. 2018; 10(6): 768.
- Dubois L, Diasparra M, Bédard B, et al. Adequacy of nutritional intake from food and supplements in a cohort of pregnant women in Québec, Canada: the 3D Cohort Study (Design, Develop, Discover). The American Journal of Clinical Nutrition. 2017; 106(2): 541–548.
- Maimaitiming T, Wang X, Tuerxunjiang C, et al. [Follow-up study on diet, folic acid and iron status in 358 cases of Uighur pregnant women from Xinjiang Kashi]. Wei Sheng Yan Jiu. 2017; 46(4): 563–568.
- Lim SY, Yoo HJ, Kim AL, et al. Nutritional intake of pregnant women with gestational diabetes or type 2 diabetes mellitus. Clin Nutr Res. 2013; 2(2): 81–90.
- Sicińska E, Jeruszka-Bielak M, Roszkowski W, et al. How is the process of setting micronutrients recommendations reflected in nutrition policies in Poland? The case study of folate. Ann Agric Environ Med. 2018; 25(1): 82–86.
- Navarrete-Muñoz E, Valera-Gran D, Hera MG, et al. Use of high doses of folic acid supplements in pregnant women in Spain: an INMA cohort study. BMJ Open. 2015; 5(11): e009202.
- DELANGE F. Iodine deficiency as a cause of brain damage. Postgraduate Medical Journal. 2001; 77(906): 217–220.
- Boroje I, Koren G, Lamm S. Sea water desalination: A newly discovered cause of iodine deficiency. Birth Defects Research. 2018; 110(12): 971–972.
- Szybiński Z. [Iodine deficiency in pregnancy--a continuing public health problem]. Endokrynol Pol. 2005; 56(1): 65–71.
- Webster J, Land MA, Christoforou A, et al. Reducing dietary salt intake and preventing iodine deficiency: towards a common public health agenda. Med J Aust. 2014; 201(9): 507–508.
- Pasin G, Comerford K. Dairy Foods and Dairy Proteins in the Management of Type 2 Diabetes: A Systematic Review of the Clinical Evidence. Advances in Nutrition. 2015; 6(3): 245–259.
