A prospective study of prepregnancy dietary fat intake and risk of gestational diabetes. Am J Clin Nutr

Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 01/2012; 95(2):446-53. DOI: 10.3945/ajcn.111.026294
Source: PubMed


Fatty acids play a vital role in glucose homeostasis; however, studies on habitual dietary fat intakes and gestational diabetes mellitus (GDM) risk are limited and provide conflicting findings.
We determined whether the total amount and the type and source of prepregnancy dietary fats are related to risk of GDM.
A prospective study was conducted in 13,475 women who reported a singleton pregnancy between 1991 and 2001 in the Nurses' Health Study II. In these women, 860 incident GDM cases were reported. The adjusted RR of GDM was estimated for quintiles of total fat, specific fat, and the source of fat intakes by pooled logistic regression.
Higher animal fat and cholesterol intakes were significantly associated with increased GDM risk. Across increasing quintiles of animal fat, RRs (95% CIs) for GDM were 1.00 (reference), 1.55 (1.20, 1.98), 1.43 (1.09, 1.88), 1.40 (1.04, 1.89), and 1.88 (1.36, 2.60) (P-trend = 0.05). Corresponding RRs (95% CIs) for dietary cholesterol were 1.00 (reference), 1.08 (0.84, 1.32), 1.02 (0.78, 1.29), 1.20 (0.93, 1.55), and 1.45 (1.11, 1.89) (P-trend = 0.04). The substitution of 5% of energy from animal fat for an equal percentage of energy from carbohydrates was associated with significantly increased risk of GDM [RR (95% CI): 1.13 (1.08, 1.18); P < 0.0001]. No significant associations were observed between dietary polyunsaturated fat, monounsaturated fat, or trans fat intakes and GDM risk.
Higher prepregnancy intakes of animal fat and cholesterol were associated with elevated GDM risk.

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    • "Recently, several dietary and lifestyle factors have been associated with GDM risk, although precise underlying mechanisms have yet to be established (5). Macronutrients including carbohydrates (6) and fats (7) have previously been evaluated for their association with GDM risk. The association with protein, however, remains unclear. "
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    ABSTRACT: OBJECTIVE Dietary protein is an important modulator of glucose metabolism. However, studies regarding the association between dietary protein intake and gestational diabetes mellitus (GDM) risk are sparse. This study was to examine the association.RESEARCH DESIGN AND METHODS Our study included 21,457 singleton pregnancies reported among 15,294 participants of the Nurses' Health Study II cohort between 1991 and 2001. Included pregnancies were free of chronic diseases before pregnancy or previous GDM. Generalized estimating equations were used to estimate the relative risks (RRs) and 95% CIs.RESULTSAfter adjustment for age, parity, nondietary and dietary factors, and BMI, multivariable RRs (95% CIs) comparing the highest with lowest quintiles were 1.49 (1.03-2.17) for animal protein intake and 0.69 (0.50-0.97) for vegetable protein intake. The substitution of 5% energy from vegetable protein for animal protein was associated with a 51% lower risk of GDM (RR (95% CI), 0.49 (0.29-0.84)). For major dietary protein sources, multivariable RRs (95% CIs) comparing the highest with the lowest quintiles were 2.05 (1.55-2.73) for total red meat and 0.73 (0.56-0.95) for nuts, respectively. The substitution of red meat with poultry, fish, nuts, or legumes showed a significantly lower risk of GDM.CONCLUSIONS Higher intake of animal protein, in particular red meat, was significantly associated with a greater risk of GDM. By contrast, higher intake of vegetable protein, specifically nuts, was associated with a significantly lower risk. Substitution of vegetable protein for animal protein, as well as substitution of some healthy protein sources for red meat, was associated with a lower risk of GDM.
    Diabetes care 02/2013; 36(7). DOI:10.2337/dc12-2018 · 8.42 Impact Factor
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    ABSTRACT: Despite women’s low inclusion in disease studies and acceptance of men’s results as universal, gender dichoto my shown in puberty/adolescence with girls’ fat accumulation vs. boys’ fat reduction suggests major metabolic differences and potentially related risk factors and diseases. Women’s evolution for reproduction and fetal/infant nourishment, with a historical advantage vs. scarcity, is now increasingly counteracted by the obesogenic environment. This corroborates recent decline in their healthy life expectancy (LE) and the female-male LE gap. Their higher lifelong body fat% compared to men’s, even with the same BMI, suggest it is metabolically more relevant than BMI; lower abdominal (high risk) fat utilization during weight loss diets; and higher sedentary risks vs. exercise benefits, suggest they need differential strategies against obesity. Premenopausal estrogen protection against abdominal obesity and related metabolic diseases, such as MetS, diabetes, CVD, inflammation, and cancer – that are delayed until menopause but accelerated with later suggests a differential time perspective for intervention. Women’s higher sensitivity to Western trends, including a sedentary lifestyle and obesogenic and high glycemic diet, further emphasizes the urgent need for a gender-specific nutritional approach to women’s care, particularly during critical lifecycle periods. This chapter presents some characteristics of women’s differential risk factors that could support gender nutrition within the PPPM approach.
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    ABSTRACT: In recent years, there has been a surge of interest in exploring the effect of trans-fatty acids (TFAs) on biological membrane properties. The research studies are motivated by an increasing body of evidence suggesting that the consumption of TFAs increases the risk of developing negative health effects such as coronary heart disease and cancer. The ultimate goal of studying the lipid-fatty acid interactions at the molecular level is to predict the biological role of fatty acids in cells. In this regard, it is interesting to elucidate the effect of loading TFAs and their counterpart cis-fatty acids (CFAs) on the physical properties of lipid model membranes. Here, the present study focuses on discussing the following: (1) the effect of mixing monoelaidin (ME, TFA-containing lipid) with its counterpart monoolein (MO, CFA-containing lipid) on modulating the fully hydrated self-assembled structure, and (2) the influence of solubilizing oleic acid (OA) and its trans counterpart elaidic acid (EA) on the fully hydrated ME system. The ME model membrane was selected due to its sensitivity to variations in lipid composition and temperature. Synchrotron small-angle X-ray scattering (SAXS) was applied for studying the temperature-dependent structural behavior of the fully hydrated ME/MO-based system prepared with an equal ME/MO weight ratio and also for characterizing the fully hydrated OA- and EA-loaded ME systems. Wide-angle X-ray (WAXS) experiments were also performed for characterizing the formed crystalline lamellar phases at ambient temperatures. The results demonstrate the significant influence of the partial replacement of ME by MO on the phase behavior. The addition of MO induces the lamellar-nonlamellar phase transitions at ambient temperatures and promotes the formation of the inverted type hexagonal (H(2)) phase above 72 °C. The fully hydrated ME/EA and ME/OA systems with their rich polymorphism exhibit an interesting temperature-dependent complex behavior. The experimental findings show that the temperature-induced phase transitions are dictated by the solubilized fatty acid concentration and its configuration. Both EA and OA have a significant impact on the fully hydrated ME system. Similar to previous published studies, OA induces a significantly stronger mean negative membrane curvature as compared to EA. The two phase diagrams are discussed in terms of water-lipid and lipid-fatty acid interactions, membrane bending, and lipid packing concepts. A newly observed interesting epitaxial relationship for the lamellar-hexagonal phase transition in the EA-loaded ME system is illustrated and discussed in detail.
    Langmuir 06/2012; 28(26):10105-19. DOI:10.1021/la3019716 · 4.46 Impact Factor
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