Vol 89, No 12 (2018)
Research paper
Published online: 2018-12-28

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Dietary macronutrients and fluid intakes in a sample of pregnant women with either gestational diabetes or type 1 diabetes mellitus, assessed in comparison with Polish nutritional guidelines

Aleksandra Kozlowska1, Anna Maja Jagielska1, Katarzyna Malgorzata Okreglicka1, Filip Dabrowski1, Krzysztof Kanecki1, Aneta Nitsch-Osuch1, Mirosław Wielgos2, Dorota Bomba-Opon2
Pubmed: 30618032
Ginekol Pol 2018;89(12):659-666.

Abstract

Objectives: Pregnancy is a critical period during which environmental factors such as nutrition can affect development. Maintaining proper nutrition becomes even more significant when pregnant women have diabetes. The aim of this study was to measure changes in energy and macronutrient intakes among pregnant women and patients diagnosed either with gestational diabetes mellitus (GDM) during pregnancy, or, type 1 diabetes mellitus (T1DM) before pregnancy, and to assess the pregnant women’s dietary intakes in comparison with Polish Institute of Food and Nutrition nutritional guidelines.
Material and methods: The analysis was conducted among 83 pregnant women (29 GDM patients, 26 T1DM patients and 28 normal pregnancy patients — the control group) from whom we gathered nutritional data during the second part of their pregnancies. Data on each woman’s diet during pregnancy was collected is self-completed dietary records during seven consecutive 24-hour periods.
Results: The mean macronutrient intake of the GDM patients was 32.1% fat, 19.5% protein, and 48.3% carbohydrates; in the T1DM group the results were 34.2%, 19.4% and 46.4% respectively; and in control group they were 31.8%, 17.6% and 50.5% respectively. This study showed that many of the pregnant women did not reach the recommended level of energy intake during pregnancy. Moreover, most of the women exceeded their fat requirements, and fat intake as a proportion of energy intakes also exceeded the guidelines in more than 60% of the women across all groups.
Conclusions: The implications and possible causes of excessive fat intake during pregnancy and pregnancies complicated by diabetes are underestimated and undertreated by obstetricians and warrant further investigation, especially in association with gestational weight gain, maternal and fetal perinatal complications, and post-gestational diabetes.

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References

  1. Guéant JL, Namour F, Guéant-Rodriguez RM, et al. Folate and fetal programming: a play in epigenomics? Trends Endocrinol Metab. 2013; 24(6): 279–289.
  2. Kwon E, Kim Y. What is fetal programming?: a lifetime health is under the control of in utero health. Obstetrics & Gynecology Science. 2017; 60(6): 506.
  3. Jarosz M. Nutritional norms for the Polish population. 2nd ed PIoFa. ; 2017.
  4. Damm P, Houshmand-Oeregaard A, Kelstrup L, et al. Gestational diabetes mellitus and long-term consequences for mother and offspring: a view from Denmark. Diabetologia. 2016; 59(7): 1396–1399.
  5. Ruchat SM, Mottola M. The important role of physical activity in the prevention and management of gestational diabetes mellitus. Diabetes/Metabolism Research and Reviews. 2013; 29(5): 334–346.
  6. Colagiuri S, Falavigna M, Agarwal M, et al. Strategies for implementing the WHO diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. Diabetes Research and Clinical Practice. 2014; 103(3): 364–372.
  7. Cho N. Gestational diabetes mellitus—Challenges in research and management. Diabetes Research and Clinical Practice. 2013; 99(2): 237–239.
  8. Maahs D, West N, Lawrence J, et al. Epidemiology of Type 1 Diabetes. Endocrinology and Metabolism Clinics of North America. 2010; 39(3): 481–497.
  9. Mack L, Tomich P. Gestational Diabetes. Obstetrics and Gynecology Clinics of North America. 2017; 44(2): 207–217.
  10. Gumprecht J. Guidelines on the management of diabetic patients. Recommendation of Polish Daibetes Society. Via Medica. ; 2017(3): 1–92.
  11. Mennitti LV, Oliveira JL, Morais CA, et al. Type of fatty acids in maternal diets during pregnancy and/or lactation and metabolic consequences of the offspring. J Nutr Biochem. 2015; 26(2): 99–111.
  12. Ortega-Senovilla H, Alvino G, Taricco E, et al. Gestational Diabetes Mellitus Upsets the Proportion of Fatty Acids in Umbilical Arterial but Not Venous Plasma. Diabetes Care. 2008; 32(1): 120–122.
  13. Wadhwani N, Patil V, Joshi S. Maternal long chain polyunsaturated fatty acid status and pregnancy complications. Prostaglandins, Leukotrienes and Essential Fatty Acids. 2018; 136: 143–152.
  14. Kunachowicz H, Przygoda B, Iwanow K. Tabele składu i wartosci odzywczej zywnosci. Wydawnictwo Lekarskie PZWL, Warszawa. 2005.
  15. 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.
  16. 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.
  17. Jebeile H, Mijatovic J, Louie J, et al. A systematic review and metaanalysis of energy intake and weight gain in pregnancy. American Journal of Obstetrics and Gynecology. 2016; 214(4): 465–483.
  18. Abeysekera M, Morris J, Davis G, et al. Alterations in energy homeostasis to favour adipose tissue gain: A longitudinal study in healthy pregnant women. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2015; 56(1): 42–48.
  19. Yuruk AA, Nergiz-Unal R. Maternal dietary free or bound fructose diversely influence developmental programming of lipogenesis. Lipids Health Dis. 2017; 16(1): 226.
  20. Saad A, Dickerson J, Kechichian T, et al. High-fructose diet in pregnancy leads to fetal programming of hypertension, insulin resistance, and obesity in adult offspring. American Journal of Obstetrics and Gynecology. 2016; 215(3): 378.e1–378.e6.
  21. 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.
  22. Dietary fats and oils in human nutrition. Report of an Expert Consultation jointly organized by the Food and Agriculture Organization of the United Nations and the World Health Organization held in Rome, 21-30 September 1977. FAO Food Nutr Ser. 1980; 91(20): i–xv, 1.
  23. Taschereau-Charron A, Da Silva MS, Bilodeau JF, et al. Alterations of fatty acid profiles in gestational diabetes and influence of the diet. Maturitas. 2017; 99: 98–104.
  24. Dyson PA. Saturated fat and Type 2 diabetes: where do we stand? Diabet Med. 2016; 33(10): 1312–1314.
  25. Gómez Candela C, Bermejo López LM, Loria Kohen V. Importance of a balanced omega 6/omega 3 ratio for the maintenance of health: nutritional recommendations. Nutr Hosp. 2011; 26(2): 323–329.
  26. Meher A, Joshi A, Joshi S. Maternal micronutrients, omega-3 fatty acids, and placental PPARγ expression. Applied Physiology, Nutrition, and Metabolism. 2014; 39(7): 793–800.
  27. Polish Gynecological Society, Polish Gynecological Society. Recommendations of the Polish Gynecological Society concerning docosahexaenoic acid supplementation in the prevention of preterm birth. Ginekol Pol. 2014; 85(4): 318–320.
  28. Harton A, Choroszewska A, Gajewska D, et al. Spożycie wielonienasyconych kwasów tłuszczowych przez kobiety ciężarne. Probl Hig i Epidemiol. 2013; 94: 605–609.
  29. Jahan-Mihan A, Rodriguez J, Christie C, et al. The Role of Maternal Dietary Proteins in Development of Metabolic Syndrome in Offspring. Nutrients. 2015; 7(11): 9185–9217.
  30. Metges C, Görs S, Lang I, et al. Low and High Dietary Protein:Carbohydrate Ratios during Pregnancy Affect Materno-Fetal Glucose Metabolism in Pigs. The Journal of Nutrition. 2013; 144(2): 155–163.
  31. Mulyani EY, Briawan D, Santoso BI. Hydration status of pregnant women in West Jakarta. Asia Pac J Clin Nutr. 2017; 26(Suppl 1): S26–S30.
  32. Bardosono S, Prasmusinto D, Hadiati D, et al. Fluid Intake of Pregnant and Breastfeeding Women in Indonesia: A Cross-Sectional Survey with a Seven-Day Fluid Specific Record. Nutrients. 2016; 8(11): 651.