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Coffee consumption and the risk of gestational diabetes mellitus
Acta Obstetricia et Gynecologica Scandinavica
Abstract
Coffee consumption has been associated with a decreased risk of type 2 diabetes mellitus. We examined the relationship between coffee consumption and the risk of gestational diabetes mellitus [GDM].
In this prospective study, 1744 non-diabetic pregnant women were questioned during early gestation about their coffee consumption. We studied the association of coffee consumption before and during pregnancy, and the subsequent risk of GDM. Generalised, linear models were fitted to estimate risk ratios and 95% confidence intervals.
Women who reported moderate pre-pregnancy caffeinated coffee intake had a significantly reduced risk of GDM (adjusted RR 0.50; 95% CI 0.29-0.85) compared with non-consumers. No risk reduction was associated with decaffeinated coffee intake.
Moderate pre-pregnancy caffeinated coffee consumption may have a protective association with GDM. Prospective studies, including a wider range of consumption habits, are necessary.
... In studies assessing the association between polyphenol consumption and the risk of GDM, women were recruited from hospitals [24,26,27,30,31] or national cohort studies [25,28,29]. In articles assessing the risk of PE, three studies were hospital or care practices based [20][21][22] and one was a national cohort study [23]. ...
... From the studies selected to evaluate the association of polyphenol-rich food consumption and GDM risk [24][25][26][27][28][29][30][31], the same population was evaluated in Dong et al. (2019), [28] and Dong et al. (2021) [29]. Therefore, two different metanalyses were performed including chocolate and soy isoflavone consumption, respectively (Figure 2A,B). ...
... In both cases, the analysis included a total of 162,443 individuals. All eight studies were cohort and corresponded to self-administrated questionnaires [24,26,28,29] or in-person/telephone interviews to apply questionnaires [25,27,30,31]. The majority of these studies were conducted in Asia [27][28][29][30][31], followed by Europe [25,26] and North America [24]. ...
Gestational Diabetes Mellitus (GDM) and preeclampsia (PE) affects 6–25% of pregnancies and are characterized by an imbalance in natural prooxidant/antioxidant mechanisms. Due to their antioxidant and anti-inflammatory properties, polyphenols consumption during the pregnancy might exert positive effects by preventing GDM and PE development. However, this association remains inconclusive. This systematic review and metanalysis is aimed to analyze the association between polyphenol-rich food consumption during pregnancy and the risk of GDM and PE. A systematic search in MEDLINE, EMBASE, and Web of Science (Clarivate Analytics, London, United Kingdom) for articles dated between 1 January 1980 and July 2022 was undertaken to identify randomized controlled trials and observational studies evaluating polyphenol-rich food consumption and the risk of GDM and PE. The Newcastle-Ottawa Scale was used to evaluate the quality of these included studies. Twelve studies were included, of which eight articles evaluated GDM and four studied PE. A total of 3785 women presented with GDM (2.33%). No association between polyphenol consumption and GDM was found (ES = 0.85, 95% CI 0.71–1.01). When total polyphenol intake was considered, a lower likelihood to develop GDM was noted (ES = 0.78, 95% CI 0.69–0.89). Furthermore, polyphenol consumption was not associated with PE development (ES = 0.90, 95% CI 0.57–1.41). In conclusion, for both outcomes, pooled analyses showed no association with polyphenol-rich food consumption during pregnancy. Therefore, association of polyphenol intake with a decreased risk of GDM and PE remains inconclusive.
... A double-blind, randomized crossover study indicated that acute caffeine ingestion impairs insulin sensitivity in women with GDM (17). Furthermore, some observational studies displayed no relationship between intake of coffee and GDM (18)(19)(20)(21), while two studies showed inverse associations (22,23). ...
... In this stage, 10 articles were omitted because of the following reasons: irrelevant articles (n = 9) and consideration of both tea and coffee as exposure (n = 1). Finally, seven epidemiologic studies possessed eligibility to this study (18)(19)(20)(21)(22)(23)30). ...
... The brief information of each selected study has been described in Table 1. Three cohort studies (18,19,30), two casecontrol studies (20,22), and two cross-sectional studies (21,23) were imported to meta-analysis. The studies were published between 2007 and 2021, and these were conducted in the US (18), Denmark (19), Indonesia (22), Oman (20), Spain (21), Malaysia (30), and Ethiopia (23). ...
Objective: The results from epidemiologic studies on the relationship between intake of coffee and the risk of gestational diabetes mellitus (GDM) remain inconclusive. A meta-analysis was performed to achieve a comprehensive finding regarding the association between intake of coffee and the risk of GDM.
Methods: PubMed, Scopus, ISI Web of Science, and Google Scholar were searched to find articles published up to August 2021. Observational studies that reported risk estimates [risk ratios (RRs), hazard ratios (HRs), and odds ratios (ORs)] for the association of consumption of coffee with the risk of GDM in pregnant women were included. Random effects model was applied to calculate summarized risk estimate and 95% CIs for the highest vs. lowest categories of intake of coffee.
Results: Seven observational studies (three cohort, two case-control, and two cross-sectional studies) with 75,607 participants and 1,625 women with GDM met the inclusion criteria. The meta-analysis of comparing the highest vs. lowest intake of coffee categories showed no significant association between intake of coffee and risk of GDM (summarized risk estimate: 0.89; 95% CI: 0.76, 1.05; I² = 63.4%). Subgroup analysis showed that consumption of coffee had an inverse relationship with GDM in studies conducted in non-Asia countries (summarized risk estimate: 0.75; 95% CI: 0.58, 0.97; I² = 6%).
Conclusion: This study has shown that high consumption of coffee did not decrease the risk of GDM. Furthermore, large-scale cohort studies are required to confirm our findings.
... Publication bias and meta-regression analyses were not possible due to a small number of included studies. All analyses were performed using Stata version 13.1 (StataCorp LP, College Station, TX). Figure 1 graphically describes the study selection process, indicating the initial number of studies found and the sequence of steps until the final number of studies included in the final review (n = 12) [10,[13][14][15][28][29][30][31][32][33][34][35]. These studies were conducted in the United States, Iceland, Denmark, Australia, China, Iran and ten Mediterranean countries (Algeria, France, Greece, Italy, Lebanon, Malta, Morocco, Serbia, Syria, Tunisia) during the period 2007-2017. ...
... These studies were conducted in the United States, Iceland, Denmark, Australia, China, Iran and ten Mediterranean countries (Algeria, France, Greece, Italy, Lebanon, Malta, Morocco, Serbia, Syria, Tunisia) during the period 2007-2017. They consisted of ten prospective cohort studies [10,13,15,[28][29][30][31][32][33][34], one case-control study [35] and another cross-sectional study [14], comprising 124,959 participants including 5786 women with GDM. Table 1 summarizes the characteristics of these studies. ...
... Of the 12 identified studies, eight assessed the association between individual food sources of polyphenol and GDM [10, 13-15, 28, 29, 32, 34], while the remaining four addressed the effect of Mediterranean diet-a rich source of polyphenols [30,31,33,35]. GDM was ascertained using self-report questionnaires in nearly half of these studies [13,29,30,33,34], blood glucose levels in 6 [10,14,15,28,31,35], and hospital databases in one study [32]. Two-thirds of the included studies were rated as good quality [10,13,15,[28][29][30][32][33][34], and the remaining onethird were considered fair [14,31,35]. ...
Animal studies have demonstrated anti-diabetic properties of several food-derived polyphenols, but data in humans remains unclear. This study aimed to review and meta-analyse evidence concerning the effect of the intake of several polyphenol-rich foods on gestational diabetes (GDM) risk. A systematic literature search was conducted in PubMed, Web of Science and Embase databases for observational studies on the association between dietary intake of foods/diets rich in polyphenols and GDM risk. Inclusion criteria were original research articles with full texts published in peer-reviewed English language journals, which investigated foods within the top 100 richest dietary sources of polyphenols and reported odds ratio/relative risk with their corresponding 95% confidence intervals. The quality of included studies was assessed using the Newcastle-Ottawa Scale. The intake of polyphenol-rich foods and dietary patterns in relation to GDM were pooled with fixed- and random-effects models. In total, 12 (10 cohort, 1 cross-sectional and 1 case-control) studies were included for the final systematic review, comprising 124,959 participants and including 5,786 women with GDM. Five studies found a significant, inverse association between the intake of polyphenol-rich foods or Mediterranean diet and GDM, whereas five studies reported no association and two exhibited a positive association. Meta-analyses further showed that the risk of GDM was about halved amongst women with the highest score of Mediterranean diet compared to those with the lowest score. The results suggest that dietary patterns rich in polyphenols may reduce the risk of GDM despite inconclusive evidence for polyphenol-rich food groups.
... Twenty-nine studies (72%) obtained a positive quality rating and 11 (28%) were rated neutral (Table S2). All the articles reported findings from prospective cohort studies of which there were multiple publications from four major studies including Nurses' Health Study II (n = 14) [24][25][26][27][28][29][30][31][32][33][34][35][36][37], Omega (n = 7) [38][39][40][41][42][43][44], Australian Longitudinal Study on Women's Health (n = 4) [45][46][47][48] and Project Viva (n = 2) [49,50]. The most common reasons for exclusion of publications were unavailability of full texts, no relevant data collected necessary for the present review and late recruitment of study participants, consequently capturing dietary and PA information that were not reflective of the pre-pregnancy or early pregnancy period. ...
... The studies provided information on women from multiple populations including 26 American 48,49,[51][52][53], five Australian [45][46][47][48]54], two Hispanic American [55,56] and one each for the following: Iranian [57], Danish [58], Canadian [59], Pakistani [60], Norwegian [61], Spanish [62], and multi-centre Mediterranean Study (Algeria, France, Greece, Italy, Lebanon, Malta, Morocco, Serbia, Syria and Tunisia) [63], The number of participants per study ranged from 97 to 71,239 and were published between 1997-2016, with an age range of 16-48 years as reported in 27 studies. Of 22 studies that reported retention rate, 14 had ≥80% [38,40,44,47,49,50,54,56,58,[60][61][62][63], 7 had 50-79% [41][42][43]48,51,55,59], and only one <50% [47]. ...
... The [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]44,45,[51][52][53]58,59]. Thirty-six studies reported on pre-pregnancy body mass index (BMI), of which 20 were within the normal range [24][25][26][27][28][29][30][33][34][35][36]39,[41][42][43]49,57,61,62], one overweight [51], one obese [54] and 14 were categorised into multiple groups [32,37,40,47,48,50,52,53,55,56,[58][59][60]63] rather than providing an overall average. ...
Rising rates of gestational diabetes mellitus (GDM) and related complications have prompted calls to identify potentially modifiable risk factors that are associated with gestational diabetes mellitus (GDM). We systematically reviewed the scientific literature for observational studies examining specific dietary and/or physical activity (PA) factors and risk of GDM. Our search included PubMed, Medline, CINAHL/EBSCO, Science Direct and EMBASE, and identified 1167 articles, of which 40 met our inclusion criteria (e.g., singleton pregnancy, reported diet or PA data during pre-pregnancy/early pregnancy and GDM as an outcome measure). Studies were assessed for quality using a modified Quality Criteria Checklist from American Dietetic Association. Of the final 40 studies, 72% obtained a positive quality rating and 28% were rated neutral. The final analysis incorporated data on 30,871 pregnant women. Dietary studies were categorised into either caffeine, carbohydrate, fat, protein, calcium, fast food and recognized dietary patterns. Diets such as Mediterranean Diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH) diet and Alternate Healthy Eating Index diet (AHEI) were associated with 15–38% reduced relative risk of GDM. In contrast, frequent consumption of potato, meat/processed meats, and protein (% energy) derived from animal sources was associated with an increased risk of GDM. Compared to no PA, any pre-pregnancy or early pregnancy PA was associated with 30% and 21% reduced odds of GDM, respectively. Engaging in >90 min/week of leisure time PA before pregnancy was associated with 46% decreased odds of GDM. We conclude that diets resembling MedDiet/DASH diet as well as higher PA levels before or in early pregnancy were associated with lower risks or odds of GDM respectively. The systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42016027795.
... Moderate coffee intake is typically a part of a prudent dietary pattern which has been associated with lower risk of GDM in one earlier study [31]. In observational studies, one reported reduced risk of GDM with moderate pre-pregnancy coffee intake [32], and another found a protective but non-significant association with higher coffee intake and development of GDM [33]. In a large longitudinal cohort study, moderate total caffeine intake during mid-pregnancy was associated with a lower risk of GDM and lower blood glucose concentrations [34]. ...
... Pregnant women are a special group as caffeine and coffee consumers, and it is still unclear whether moderate intake of coffee protects against GDM. Our findings that caffeine and coffee intakes were not associated with the risk of GDM differs from earlier studies showing reduced risk between moderate caffeine intake and GDM [34] and reduced risk between coffee consumption and GDM [32]. However, as one study earlier [33], we found protective, non-significant association between coffee consumption and GDM but only with moderate intake. ...
... A pregnant mother with a history of large gestational age in weeks [22,29,31,32], and 60.7% less likely was linked with the occurrence of GDM than small for gestational age. From other evidence, those mothers with increase gestational age have a higher risk of developing GDM [33]. ...
... Similar findings have been stated in studies conducted in Seattle, Tacoma, and Washington. Women who reported moderate prepregnancy caffeinated coffee intake had a significantly reduced risk of GDM (adjusted RR 0.50; 95% CI 0.29, 0.85) compared with nonconsumers [32]. Researchers at Harvard tracked over found that people who increased their coffee intake by over one cup per day had an 11% lower risk of developing GDM. ...
... Previous studies on caffeine (or coffee) and gestational diabetes (GDM), 12,13 gestational hypertension, 14 and preeclampsia 15 were null except for an inverse association between moderate intakes and preeclampsia. 14 These studies were limited by lack of multiple assessments across pregnancy, 12,13,15 objective measures, [12][13][14] and limited lifestyle measures to reduce confounding. 13,15 This study aimed to examine prospective associations between caffeine exposure in early-and mid-pregnancy and maternal cardiometabolic health, including GDM, preeclampsia, and gestational hypertension as well as cardiometabolic biomarkers and blood pressure. ...
... Previous studies on caffeine (or coffee) and gestational diabetes (GDM), 12,13 gestational hypertension, 14 and preeclampsia 15 were null except for an inverse association between moderate intakes and preeclampsia. 14 These studies were limited by lack of multiple assessments across pregnancy, 12,13,15 objective measures, [12][13][14] and limited lifestyle measures to reduce confounding. 13,15 This study aimed to examine prospective associations between caffeine exposure in early-and mid-pregnancy and maternal cardiometabolic health, including GDM, preeclampsia, and gestational hypertension as well as cardiometabolic biomarkers and blood pressure. ...
Importance
Women are recommended to limit caffeine consumption to less than 200 mg per day based on risks to fetal health. Impacts of caffeine on maternal health remain unclear.
Objective
To determine whether caffeinated-beverage intake and plasma caffeine and paraxanthine are associated with cardiometabolic complications in pregnancy (ie, gestational diabetes [GDM], preeclampsia, and gestational hypertension [GH]).
Design, Setting, and Participants
This cohort study used data from a longitudinal pregnancy cohort study from the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons (2009-2013). This post hoc secondary analysis of 2802 pregnant women without major chronic conditions enrolled at 12 US clinical sites was completed in 2021. The final sample for caffeinated beverage analyses included 2583 women. After excluding women who did not consent to have their biospecimens stored for future research (n = 54), plasma caffeine analyses included 2529 women. Analyses of caffeine consumption and fasting cardiometabolic profiles included 319 women.
Exposures
Daily total caffeine intake was estimated at 10 to 13 gestational weeks and 16 to 22 gestational weeks based on self-reported past week intake of caffeinated coffee, tea, soda, and energy drinks. Plasma caffeine and paraxanthine were measured in specimens collected at 10 to 13 weeks.
Main Outcomes and Measures
Clinical diagnoses of GDM, preeclampsia, GH, glucose concentrations from GDM screening, and blood pressure were extracted from medical records.
Results
Participants had a mean (SD) age of 28.1 (5.5) years and 422 participants (16.3%) were Asian/Pacific Islander women, 741 (28.9%) were Hispanic women, 717 (27.8%) were non-Hispanic Black women, and 703 (27.2%) were non-Hispanic White women. At 10 to 13 weeks, 1073 women (41.5%) reported consuming no caffeinated beverages, 1317 (51.0%) reported consuming 1 mg/d to 100 mg/d, 173 (6.7%) reported consuming 101 mg/d to 200 mg/d, and 20 (0.8%) reported consuming more than 200 mg/d. At 16 to 22 weeks, 599 women (23.6%) reported consuming no caffeinated beverages, 1734 (68.3%) reported consuming 1 mg/d to 100 mg/d, 186 (7.3%) reported consuming 101 mg/d to 200 mg/d, and 20 (0.8%) reported consuming more than 200 mg/d caffeinated beverages. Intake at 16 to 22 weeks was associated with lower GDM risk and lower glucose concentrations (1 mg/d to 100 mg/d vs none: relative risk, 0.53 [95% CI, 0.35 to 0.80]; β, –2.7 mg/dL [95% CI, –5.4 mg/dL to 0 mg/dL]) and lower C-reactive protein and C-peptide concentrations and favorable lipid profiles. Total plasma caffeine and paraxanthine at 10 to 13 weeks was inversely associated with glucose (quartile 4 vs quartile 1: β = –3.8 mg/dL [95% CI, –7.0 mg/dL to –0.5 mg/dL]; trend of P = .01). No associations were observed with preeclampsia or GH.
Conclusions and Relevance
In this cohort study, second trimester caffeinated beverage intake within current recommendations was associated with lower GDM risk, but not preeclampsia or GH. These findings may be reassuring for women with moderate caffeine intake.
... Some significant associations were reported by a single study as follows. Individual studies indicated that pre-pregnancy consumption of 0.5 to 7 caffeinated coffee cups/week and a higher intake of fruit juice before pregnancy was associated with a lower risk of GDM, but cultured-milk drinks were associated with an increased risk of GDM (Adeney et al. 2007;Yong et al. 2021). The pooled results obtained for different nutrients by comparing the highest with the lowest consumption categories suggested that a higher intake of dietary fiber and folic acid supplementation were associated with a decreased risk of GDM, but a higher intake of heme iron was associated with an increased risk of GDM. ...
... A study in this review showed that the risk of GDM was reduced by 50% in women who drank 0.5 to 7 cups of caffeinated coffee every week before pregnancy (Adeney et al. 2007). The association between coffee consumption and a decreased risk of type 2 diabetes has been widely reported in adults (Carlström and Larsson 2018). ...
This study aimed to summarize the evidence regarding the effects of dietary intake before conception on pregnancy outcomes by performing a systematic review and meta-analysis of prospective studies. Electronic databases were searched from inception up to August 2021. Overall, 65 studies involving 831 798 participants were included and 38 studies were quantitatively pooled. With regard to maternal outcomes, pre-pregnancy intake of fried food, fast food, red and processed meat, heme iron and a low-carbohydrate dietary pattern was positively associated with the risk of gestational diabetes mellitus (GDM) (all P < 0.05). However, a high dietary fiber intake and folic acid supplementation were negatively associated with GDM risk (both P < 0.05). With regard to neonatal outcomes, maternal caffeine intake before pregnancy significantly increased the risk of spontaneous abortion, while folic acid supplementation had protective effects on total adverse neonatal outcomes, preterm birth, and small-for-gestational age (SGA, all P < 0.05). However, no significant associations were found between adverse pregnancy outcomes (i.e., GDM and SGA) and the pre-pregnancy dietary intake of sugar-sweetened beverages, potato, fish, and carbohydrates and the Healthy Eating Index. Our study suggests that maintaining a healthy diet before conception has significant beneficial effects on pregnancy outcomes.
Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1989658
... A pregnant mother with a history of large gestational age in weeks [22,29,31,32], and 60.7% less likely was linked with the occurrence of GDM than small for gestational age. From other evidence, those mothers with increase gestational age have a higher risk of developing GDM [33]. ...
... Similar findings have been stated in studies conducted in Seattle, Tacoma, and Washington. Women who reported moderate prepregnancy caffeinated coffee intake had a significantly reduced risk of GDM (adjusted RR 0.50; 95% CI 0.29, 0.85) compared with nonconsumers [32]. Researchers at Harvard tracked over found that people who increased their coffee intake by over one cup per day had an 11% lower risk of developing GDM. ...
Introduction. In low- and middle-income countries, gestational diabetes mellitus is increasing globally; it is also a double burden of illness for both mothers and children. While gestational diabetes mellitus is recognized in Ethiopia, according to recent diagnostic criteria, information regarding it remains scarce. Objective. To assess the prevalence of gestational diabetes mellitus and associated factors among women attending antenatal care in Hadiya Zone public Hospitals, Southern Ethiopia. Methods. An institution-based cross-sectional research on a total of 470 pregnant mothers was conducted in the Hadiya Region from August 2019 to December 2020. Finally, via the systematic random sampling process, the study subjects were chosen. A two-hour oral glucose tolerance test of 75 g was used to conduct the universal one-step screening and diagnostic technique. Bivariate and multivariate analyses were used to identify factors associated with gestational diabetes mellitus. Results. Gestational diabetes mellitus prevalence was 26.2% (95% CI, 21.8, 30.5). Urban residents (AOR: 2.181; 95% CI: 1.274, 3.733), primary education (AOR:2.286; 95% CI: 1.396, 3.745), without previous history of abortion (AOR: 0.097; 95% CI: 0.048, 0.196), with history of late gestational age in weeks (29-32) (AOR: 0.393; 95% CI: 0.213, 0.723), with no history of coffee drinking (AOR: 2.704; 95% CI: 1.044, 7.006), and adequate dietary diversity (AOR: 2.740; 95% CI: 1.585, 4.739) were significantly associated with gestational diabetes mellitus. Conclusion. In Hadiya Zone public Hospitals, the prevalence of gestational diabetes mellitus among women attending antenatal treatment was higher compared to other studies conducted. The urban residents, primary schooling, no prior history of abortion, late gestational age, no history of coffee drinking, and sufficient dietary diversity were significantly linked with gestational diabetes mellitus. To enhance maternal and child health, reinforcing screening, treatment, and prevention strategies for gestational diabetes mellitus is essential.
1. Introduction
Gestational diabetes mellitus (GDM) is generally characterized as glucose intolerance that changes the degree of severity that begins or is first detected during pregnancy, usually after the 24th week of gestation [1–4]. It is also known as intolerance to carbohydrates resulting in variable severity hyperglycemia with onset or first recognition during pregnancy [5].
Diabetes diagnosed in the second or third trimester of pregnancy has been ruled out because of overt diabetes early in pregnancy and is not preexisting type 1 or type 2 diabetes [6, 7]. Gestational diabetes mellitus occurs either when the pancreas does not produce enough insulin or when the insulin it produces cannot be used efficiently by the body. Insulin is a blood sugar-regulating hormone [8]. Symptoms include blurred vision; fatigue; regular infections like bladder, vagina, and skin; increased vision like thirst, appetite, and urination; nausea and vomiting; and loss of weight [9].
The global effect of gestational diabetes is growing and both mothers and infants are doubly burdened by the disease. The prevalence in the general population compares with the pregnancy rate [10, 11]. It affects up to 1 out of 7/10 pregnancies worldwide and, in combination with other noncommunicable diseases (NCDs), accounts for 70% of all deaths worldwide [1, 7, 12].
The global prevalence of all births can range from 2.4 to 21% [12, 13]. The prevalence was approximately 16.9 percent among women in the reproductive age group [1, 2]. This varies greatly depending on the studied population and the diagnostic test used [12].
The burden is rising in low- and middle-income countries, with some 90% of cases occurring in developed countries. The estimated total prevalence in Africa was 5% [1, 7, 12]. It also makes about 4% of all pregnancies difficult and women with it have an estimated 7-fold chance of developing type 2 diabetes in the future, as well as their children and subsequent generations [10, 14].
While diabetes mellitus is recognized as one of the major chronic diseases in Ethiopia, the prevalence ranges from 4 to 13% for NCDs [1]. Increased risk of preeclampsia in mothers and increased risk of macrosomia, hypoglycemia, jaundice, respiratory failure, polycythemia, and hypocalcemia in newborn babies. There is postpartum progression if no treatment is needed [10, 11, 15].
Because of postpartum development, women with GDM are advised to be screened for type 2 diabetes 4-12 weeks postpartum and referred for follow-up if diabetes is identified [16]. Therefore, early diagnosis of GDM is important for prevention [6].
In our country, the prevalence of GDM among pregnant mothers and factors associated with it have not been well researched. There is no research on gestational diabetes mellitus and associated risk factors, especially in the field of study up to the investigator’s knowledge. Because of all these causes, the consciousness of the community about the conditions is low.
It will be necessary to recognize the prevalence of the problem and common risk factors to mitigate the problem on a timely basis and to promote health policy and enhancement of the program. Therefore, the purpose of the study was to evaluate the prevalence and associated risk factors of gestational diabetes mellitus among pregnant mothers in the Hadiya region of southern Ethiopia; besides, the findings will be used as a guideline for those interested in researching the same subjects.
2. Methods and Materials
2.1. Study Setting
The study was conducted in Hadiya Zone public hospitals among a cohort of pregnant mothers recruited from the general population attending antenatal care in public hospitals of the Zone. The Zone was found in Southern Nation Nationality People Regional State (SNNPR). The Zone is located in South West of Ethiopia, 230 km far away from Addis Ababa, the capital city of Ethiopia, and 194 km from the regional capital city, Hawassa.
Administratively, the Hadiya Zone was organized by 4 administrative towns, 13 districts, 305 rural Kebeles, and 30 urban Kebeles, and estimated population size of 1,727,920 with male 856,357 (49.56%) and female 871,563 (50.44%). Estimated number of reproductive age mothers in the Zone, which was about 402,605 (23.3%), which comprises an estimated 23,155 (3.46%), pregnant mothers, from age 18 to 49 years on study area based on 2007 census conversion factor projection and have a population density of 92 inhabitants per km² [17, 18].
In the Zone, there were a total of 376 health institutions from this; there is 1 general hospital, 3 primary hospitals, 3 primary hospitals (under construction), 61 health center, 311 health posts, and 81 private clinics (1 higher, 16 medium, and 64 lower) and 39 private pharmacies (2 pharmacies, 17 drug stores, and 20 rural drug vendors), which would deliver routine health services to the community. Health coverage was not yet satisfied, and all health facilities were not currently providing blood glucose level tests for GDM patients [17–19].
2.2. Study Design and Period
From August 2019 to December 2020, an institution-based cross-sectional study design was carried out in public hospitals of the Hadiya Region among a cohort of pregnant mothers recruited from the general population attending antenatal care in public hospitals of the Zone.
2.3. Source Population
The source population was all pregnant mothers aged 18-49 years living in the Zone.
2.4. Study Population
The research population of all selected pregnant mothers with 24-32 weeks of gestational age living in the Zone.
2.4.1. Sample Size Determination
The sample size was calculated using single population proportion formula, considering the following assumptions and taking the prevalence of gestational diabetes mellitus 12.8% which was a study conducted in Northwest Ethiopia [20]. where is the desired sample size, is the prevalence of gestational diabetes mellitus (12.8%) (which was taken from a study conducted at Gondar town public health facilities, Northwest Ethiopia, 2019), is the critical value at 95% confidence level (1.96), is the margin of error (5%), . For possible none response during the study, the final sample size was increased by10% to of 172 which is 17.2, by adding; then, the total sample size was 189.
2.5. The Sample Size for Second Objectives
Since the sample size calculated for the second objectives was larger than the sample size calculated for the first objectives, so the sample size of 470 was a sample size of the study, where is the percent of outcome in unexposed groups ratio, unexposed to exposed OR (odds ratio), odds of exposed to unexposed and power, and the probability of rejecting the null hypothesis when it is false (see Table 1).
Variables
Assumption
Sample size
Previous cesarean section
, , ratio 1 : 1, ,
50 [1]
Family history of type II diabetes
, , ratio 1 : 1, ,
62 [1]
Previous history of spontaneous abortion
, , ratio 1 : 1, ,
114 [1]
Dietary diversity status
, , ratio 1 : 1, ,
470 [20]
MUAC
, , ratio 1 : 1, ,
438 [20]
Level of physical activity
, , ratio 1 : 1, ,
104 [20]
Family history of DM
, , ratio 1 : 1, ,
128 [20]
Antenatal depression
, , ratio 1 : 1, ,
124 [20]
Previous GDM
, , ratio 1 : 1, ,
76 [20]
... The meta-analysis by Huxley et al. (15) included only six studies on decaffeinated coffee, and estimates were less precise than for caffeinated coffee because of lower consumption levels. Eight subsequent prospective studies evaluated the association with decaffeinated coffee, approximately doubling the amount of data on decaffeinated coffee and diabetes risk (8,10,12,(18)(19)(20)(21)24). We therefore performed an updated systematic review and a dose-response meta-analysis of all available data on the association of both caffeinated and decaffeinated coffee consumption with the risk of type 2 diabetes. ...
... We excluded six studies with a cross-sectional study design, three that were abstracts of conference posters, and two that were repeated in the same cohort. The results of the remaining 28 studies, comprising 1,109,272 study participants and 45,335 cases of type 2 diabetes, were included in the meta-analysis (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(17)(18)(19)(20)(21)(22)(23)(24)(27)(28)(29)(30)(31)(32)(33)(34)(35). Characteristics of all 28 studies were shown in Table 1. ...
OBJECTIVE
Previous meta-analyses identified an inverse association of coffee consumption with the risk of type 2 diabetes. However, an updated meta-analysis is needed because new studies comparing the trends of association for caffeinated and decaffeinated coffee have since been published.RESEARCH DESIGN AND METHODS
PubMed and Embase were searched for cohort or nested case-control studies that assessed the relationship of coffee consumption and risk of type 2 diabetes from 1966 to February 2013. A restricted cubic spline random-effects model was used.RESULTSTwenty-eight prospective studies were included in the analysis, with 1,109,272 study participants and 45,335 cases of type 2 diabetes. The follow-up duration ranged from 10 months to 20 years. Compared with no or rare coffee consumption, the relative risk (RR; 95% CI) for diabetes was 0.92 (0.90-0.94), 0.85 (0.82-0.88), 0.79 (0.75-0.83), 0.75 (0.71-0.80), 0.71 (0.65-0.76), and 0.67 (0.61-0.74) for 1-6 cups/day, respectively. The RR of diabetes for a 1 cup/day increase was 0.91 (0.89-0.94) for caffeinated coffee consumption and 0.94 (0.91-0.98) for decaffeinated coffee consumption (P for difference = 0.17).CONCLUSIONS
Coffee consumption was inversely associated with the risk of type 2 diabetes in a dose-response manner. Both caffeinated and decaffeinated coffee was associated with reduced diabetes risk.
... However, other investigators failed to find any association between caffeine intake and poor pregnancy outcomes (18). Adeney et al (19) revealed that moderate caffeine consumption during pregnancy exerts a protective effect towards gestational diabetes mellitus (GDM) (19). These mixed results may arise due to the problem of accurately assessing the caffeine intake. ...
... However, other investigators failed to find any association between caffeine intake and poor pregnancy outcomes (18). Adeney et al (19) revealed that moderate caffeine consumption during pregnancy exerts a protective effect towards gestational diabetes mellitus (GDM) (19). These mixed results may arise due to the problem of accurately assessing the caffeine intake. ...
Pregnancy is associated with major physiological and future psychosocial changes, and maternal adaptation to these changes is crucial for normal foetal development. Psychological stress in pregnancy predicts an earlier birth and lower birth weight. Pregnancy-specific stress contributes directly to preterm delivery. The importance of nutrition and exercise during pregnancy with regard to pregnancy outcome has long been acknowledged. This importance has only been further emphasized by the recent changes in food quality and availability, lifestyle changes and a new understanding of foetal programming's effects on adult outcomes. We hypothesised that for a successful pregnancy certain events at a nutritional, immune, psycho-emotional and genetic level should be tightly linked. Therefore, in this study we followed an 'integrative' approach to investigate how maternal stress, nutrition, pregnancy planning and exercise influence pregnancy outcome. A key finding of our study is that there was a significant reduction in the intake of alcohol, caffeine-containing and sugary drinks during pregnancy. However, passive smoking in the household remained unchanged. In terms of immune profile, a significant inverse correlation was noted between difficulty to 'fight' an infection and number of colds (r=-0.289, P=0.003) as well as the number of infections (r=-0.446, P<0.0001) during pregnancy. The vast majority of the pregnant women acquired a more sedentary lifestyle in the third trimester. In planned, but not in unplanned, pregnancies stress predicted infant weight, independent of age and body mass index (BMI). Notably, in mothers with negative attitudes towards the pregnancy, those with an unplanned pregnancy gave birth to infants with significantly higher weights than those with planned pregnancies. Collectively these data suggest that there is a higher order of complexity, possibly involving gene-environment interactions that work together to ensure a positive outcome for the mother as well as the foetus.
... The meta-analysis by Huxley et al. (15) included only six studies on decaffeinated coffee, and estimates were less precise than for caffeinated coffee because of lower consumption levels. Eight subsequent prospective studies evaluated the association with decaffeinated coffee, approximately doubling the amount of data on decaffeinated coffee and diabetes risk (8,10,12,(18)(19)(20)(21)24). We therefore performed an updated systematic review and a dose-response meta-analysis of all available data on the association of both caffeinated and decaffeinated coffee consumption with the risk of type 2 diabetes. ...
... We excluded six studies with a cross-sectional study design, three that were abstracts of conference posters, and two that were repeated in the same cohort. The results of the remaining 28 studies, comprising 1,109,272 study participants and 45,335 cases of type 2 diabetes, were included in the meta-analysis (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(17)(18)(19)(20)(21)(22)(23)(24)(27)(28)(29)(30)(31)(32)(33)(34)(35). Characteristics of all 28 studies were shown in Table 1. ...
Background:
Consumption of caffeinated beverages such as coffee and tea has been associated with a lower risk of type 2 diabetes (T2D). Paradoxically, short-term metabolic studies have shown that caffeine impairs postprandial glycemic control.
Objective:
The objective was to prospectively examine the association of caffeinated compared with caffeine-free beverages, including coffee, tea, sugar-sweetened beverages (SSBs), and carbonated artificially sweetened beverages (ASBs), with T2D risk.
Design:
We prospectively observed 74,749 women from the Nurses' Health Study (NHS, 1984-2008) and 39,059 men from the Health Professionals Follow-Up Study (HPFS, 1986-2008) who were free of diabetes, cardiovascular diseases, and cancer at baseline.
Results:
We documented 7370 incident cases of T2D during 24 y of follow-up in the NHS and 2865 new cases during 22 y of follow-up in the HPFS. After major lifestyle and dietary risk factors were controlled for, caffeinated and caffeine-free SSB intake was significantly associated with a higher risk of T2D in the NHS (RR per serving: 13% for caffeinated SSBs, 11% for caffeine-free SSBs; P < 0.05) and in the HPFS (RR per serving: 16% for caffeinated SSBs, 23% for caffeine-free SSBs; P < 0.01). Only caffeine-free ASB intake in NHS participants was associated with a higher risk of T2D (RR: 6% per serving; P < 0.001). Conversely, the consumption of caffeinated and decaffeinated coffee was associated with a lower risk of T2D [RR per serving: 8% for both caffeinated and decaffeinated coffee in the NHS (P < 0.0001) and 4% for caffeinated and 7% for decaffeinated coffee in the HPFS (P < 0.01)]. Only caffeinated tea was associated with a lower T2D risk among NHS participants (RR per serving: 5%; P < 0.0001).
Conclusion:
Irrespective of the caffeine content, SSB intake was associated with a higher risk of T2D, and coffee intake was associated with a lower risk of T2D.
... Increasing frequency of tea intake indicated a potential protective effect against GDM risk. [32] Increasing frequency of fast food intake prior to pregnancy was associated with a significant increased risk or incidence of GDM. [33] Interestingly, Schoenacker et, al., observed fruit and low-fat dairy intake found be beneficial among GDM subjects by reducing the risk. ...
Aim: The current study aims in assessing the levels of Zinc, vitamin D, and nutrient intake among GDM women. Methods: Hospital-based case-control study with n=60 subjects grouped into cases (n=30, women diagnosed with GDM) and control (n=30, healthy pregnant women) were recruited for the study. Vitamin D and Zinc were analyzed, anthropometric measurements and dietary data were obtained. Frequency and percent were calculated for descriptive data. ANOVA was applied to compare the nutrient intake among the groups and Pearson correlation to study the correlation between vitamin D and zinc. Results: The levels of vitamin D (32.782 ±2.56 ng/ml and 34.754 ±5.13 ng/ml) and Zinc (70.62±17.9 µg/dL and 78.56±6.82 µg/dL) was found to be at lower end, among cases. Significant positive correlation was observed for vitamin D and Zinc. Significant difference was observed for energy, protein, vitamin D, zinc, iron, and vitamin E compared to RDA. Conclusion: Creating awareness on the importance of each nutrient and addressing the consequences of nutrient deficiencies among reproductive-age and gravid women is crucial in promoting healthy pregnancies and optimal maternal-fetal outcomes. By providing personalized nutritional counseling and emphasizing the significance of proper nutrition, women may be empowered to make informed choices and prioritize their well-being, ultimately contributing to healthier generations to come.
... In 2007, Adeney and colleagues looked at the association between coffee consumption and the risk of vitamin D deficiency development in pregnant women for the first time [12]. They observed that the risk of vitamin D deficiency was reduced among pregnant women who consumed a moderate amount of caffeinated coffee. ...
Abstract
Aim: This study aimed to investigate the relationship between vitamin D status and diet between pregnant
and non-pregnant women who attended a Maternity Teaching Hospital (MTH) in Sulaymaniyah, Iraq.
Materials and methods: A descriptive-analytic (cross-sectional) study was conducted at the MTH in
Sulaymaniyah, Iraq. Data was collected from January to October 2022, including demographics, obstetric
information, and dietary data. Vitamin D levels were measured using the Roche Elecsys assay (Roche
Diagnostics, Indianapolis, Indiana, United States). The non-pregnant group consisted of women who were
not pregnant at the time of this study, and the pregnant group had women with second trimester pregnancy
at the time of enrollment.
Result: The study revealed a significant prevalence of vitamin D deficiency among pregnant women. In the
study, pregnant participants (56.0% aged 30-39) and non-pregnant participants (54.3% aged 20-29) had
similar ages (p>0.05). Both groups mostly had overweight individuals, with pregnant participants having a
slightly higher mean body mass index (BMI). While vitamin D deficiency was more prevalent among
pregnant women, the differences were not statistically significant. Notably, higher dairy intake was
positively associated with higher vitamin D levels. Urban residency was common in both groups. Dietary
habits were mostly similar, except for tea consumption (p<0.05), with non-tea drinkers having higher
vitamin D levels. However, dietary patterns did not strongly correlate with vitamin D levels in the nonpregnant
group.
Conclusion: This study reveals a significant prevalence of vitamin D deficiency among pregnant women,
although the differences between pregnant and non-pregnant groups were not statistically significant. The
positive association between higher dairy intake and increased vitamin D levels underscores the potential
impact of dietary choices on vitamin D status during pregnancy. However, the study also suggests that
dietary patterns alone may not strongly correlate with vitamin D levels in non-pregnant women. Overall, this
highlights the importance of addressing vitamin D deficiency in pregnant women and underscores the need
for personalized dietary guidance, taking into account individual preferences and habits to promote better
maternal health.
... Studies also showed that antioxidant and prebiotic-like properties, such as chlorogenic, ferulic, caffeic, and n-coumaric acids found in coffee or tea tend to improve glucose control, insulin sensitivity, and appetite regulation [41]. The present study supports previous findings also showing non-significant associations between coffee or tea consumption in early pregnancy and GDM risk [42,43]. The low intake of these beverages among women in the present study, whereby most of the women consumed less than 1 2 cup per day of coffee or tea during pregnancy, may explain the absence of any significant association, despite its potential contribution to total sugar intake. ...
The contribution and impact of beverage intake to total nutrient and energy intake may be substantial. Given the link between lifestyle, diet, and the risk of pregnancy complications, this study investigated the association between the quantity and types of beverages with gestational diabetes mellitus (GDM) risk. The study included 452 women from the Seremban Cohort Study (SECOST). The mean energy by beverage intake was 273 ± 23.83 kcal/day (pre-pregnancy), 349 ± 69.46 kcal/day (first trimester) and 361 ± 64.24 kcal/day (second trimester). Women significantly increased intake of maternal milks and malted drinks, but significantly reduced the intake of carbonated drinks and other drinks from before until the second trimester of pregnancy. For chocolate drinks, carbonated drinks, and soy milk, women increased intake from pre-conception to the first trimester, but reduced their intake from the first to the second trimester. While higher intake of cultured-milk drinks was associated with an increased risk of GDM, higher fruit juice intake was associated with a lower risk of GDM. However, these associations were only observed for intake prior to pregnancy and during the first trimester. Further research is needed to corroborate these findings and investigate the contributions of different beverages to overall diet quality as well as adverse health outcomes during pregnancy.
... 66 Moderate prepregnancy caffeine intake has also been reported to have a protective association with gestational diabetes mellitus. 67 These perceived benefits of caffeine as well as the urge for increased alertness and stimulation even among FIG. 7. Bar charts showing the cell density in the molecular layer (a) and thickness of the EGL (b) from PND 19 to 21. ...
... Coffee consumption was reported to be associated with reduced risks of development type 2 diabetes mellitus [7], metabolic disorders [8]. Intake of coffee defends the body against gestational diabetes [9]. The data available in literature reports that coffee consumption has favourable effects in various disease states. ...
Coffee is widely consumed beverage in the world. Incidence of chronic liver disease decreases with intake of coffee.The main objective of this study is to elucidate the hepatoprotective as well as chemo protective effect of coffee consumption in relation to previous published data. Prospective cohort studies based on relationship between coffee intake and ultimate effects on liver cancer have drawn various conclusions. Coffee’s beneficial effects in various disease states have been demonstrated in variety of studies. Studies have provided data regarding effects of coffee in hot as well as in cold state. Level of blood cholesterol, following filtration, is affected by the coffee components. Among the components of coffee, caffeine played the significant role in reducing the level of ALT in coffee consumers as compared with non-coffee consumers. Coffee intake is associated with cardiovascular events and hypertension risks. However, intake of coffee has been found to be inversely related to the level of serum enzymes like gamma-glutamyltransferase, and alanine aminotransferase when studies relating to coffee effect on liver were performed in different countries. Moreover, the data based on epidemiological analysis, clearly suggested that liver cirrhosis had inverse relationship with coffee consumption; however, the results obtained were not sufficient to demonstrate that coffee may have hepatoprotective effect in liver injury. There is emerging evidence revealing that consumption of coffee has been associated with reduction of risks of various types of cancers. The emerging data on coffee consumption has revealed that it has beneficial effects in colorectal, pancreatic, and pharyngeal as well as in liver cancer. A systematic review was performed regarding association of coffee consumption and effect of coffee intake on liver diseases like hepatocellular carcinoma (HCC), viral hepatitis, cirrhosis and nonalcoholic fatty liver disease (NAFLD). Coffee consumption, in dose dependent manner, was found to improve the level of serum gamma-glutamyltransferase, alanine aminotransferase and aspartate aminotransferase in individuals which were found to be at risk of liver diseases. Anticancer effect of coffee on liver is achieved by induction as well as inhibition of specific enzymes. The patients with history of chronic liver disease who consume coffee, were reported to be at a reduced risk of liver to be cirrhotic, and a decreased mortality rate was observed in cirrhosis patients, as well as a decreased rate of development of Hepatocellular carcinoma was observed. In individuals with history of chronic hepatitis C, coffee intake was found to be associated with enhanced virologic reaction to antiviral drug therapy. Furthermore, coffee intake was reported to be inversely associated with the severeness of steatohepatitis in individuals with non-alcoholic fatty liver disorder. Therefore, in patients with chronic liver disease, coffee consumption on daily basis should be persuaded.
... Once thought to be related to an increased risk of cardiovascular disease and hypertension, recent prospective studies and meta-analyses demonstrate a beneficial effect [4]. Coffee consumption also results in a lower risk of developing type 2 diabetes [5] and metabolic syndrome [6], and prevents gestational diabetes [7]. Moderate coffee intake may also reduce the risk of neurodegenerative conditions such as Parkinson's Disease and Alzheimer's disease [8,9]. ...
There is emerging evidence for the positive effects or benefits of coffee in patients with liver disease. We conducted a retrospective cross-sectional study on patients with non-alcoholic fatty liver disease (NAFLD), hepatitis C virus (HCV), and hepatitis B virus (HBV) infection to determine the effects of coffee intake on a non-invasive marker of liver fibrosis: liver stiffness assessed by transient elastography (TE). We assessed coffee and tea intake and measured TE in 1018 patients with NAFLD, HCV, and HBV (155 with NAFLD, 378 with HCV and 485 with HBV). Univariate and multivariate regression models were performed taking into account potential confounders. Liver stiffness was higher in males compared to females (p < 0.05). Patients with HBV had lower liver stiffness than those with HCV and NAFLD. After adjustment for age, gender, smoking, alcohol consumption, M or XL probe, and disease state (NAFLD, HCV, and HBV status), those who drank 2 or more cups of coffee per day had a lower liver stiffness (p = 0.044). Tea consumption had no effect (p = 0.9). Coffee consumption decreases liver stiffness, which may indicate less fibrosis and inflammation, independent of disease state. This study adds further evidence to the notion of coffee maybe beneficial in patients with liver disease.
... Moderate caffeine consumption up to 200mg in the form of caffeinated beverages, tea and coffee decreases the risk of type 2 diabetes among the young and middle aged women [29]. Caffeine may impair insulin sensitivity in women with gestational diabetes mellitus [30]. Risks of gestational diabetes become higher in a woman who takes 8 cups of coffee per day. ...
... Moreover, it is seen that, coffee and tea consumption is associated with a decreased type 2 diabetes risk in non-pregnant adults .Moderate coffee (less than 8 cup a day) and tea (any amount) intake in first trimester is not associated with gestational diabetes, moreover it may have protective effect (Hinkle S, 2014). Even, moderate pre-pregnancy caffeine consumption has protective effect on gestational diabetes (Adeney KL1, 2007). Caffeine consumption is associated with insulin resistance in non-pregnant condition. ...
... A prior study of U.S. women found that compared to non-consumers pre-pregnancy consumption of 0.5-7 caffeinated coffee cups/wk was associated with a reduced risk for GDM, but observed no significant association with >7 cups/wk, and similar to our study, observed no significant association when first trimester intake was also considered. (30) The different results for type 2 diabetes may be due to the length of time for the exposure to have an impact. Alternatively, insulin resistance during pregnancy tends to be peripheral rather than hepatic and thus the mechanisms may be different. ...
Objective
Coffee and tea consumption is associated with a decreased type 2 diabetes risk in non-pregnant adults. We examined the relation between first trimester coffee and tea consumption and gestational diabetes mellitus (GDM) risk.DesignPopulation-based cohort study.SettingDenmark 1996-2002.PopulationNon-diabetic women with singleton pregnancies in the Danish National Birth Cohort (n = 71 239).Methods
Estimated adjusted relative risks (RR) and 95% confidence intervals (95%CI) for the association between first trimester coffee and tea or estimated total caffeine and GDM.Main outcome measuresGDM ascertained from the National Hospital Discharge Register or maternal interview.ResultsCoffee or tea intake was reported in 81.2% (n = 57 882) and 1.3% (n = 912) of pregnancies were complicated by GDM. Among non-consumers, 1.5% of pregnancies were complicated by GDM. Among coffee drinkers, GDM was highest among women who drank ≥8 cups/day (1.8%) with no significant difference across intake levels (P = 0.10). Among tea drinkers, there was no difference in GDM across intake levels (1.2%; P = 0.98). After adjustment for age, socio-occupational status, parity, pre-pregnancy body mass index, smoking, and cola, there was suggestion of a protective, but non-significant association with increasing coffee (RR ≥8 versus 0 cups/day = 0.89 [95%CI 0.64-1.25]) and tea (RR ≥8 versus 0 cups/day = 0.77 [95%CI 0.55-1.08]). Results were similar by smoking status, except a non-significant 1.45-fold increased risk with ≥8 coffee cups/day for non-smokers. There was a non-significant reduced GDM risk with increasing total caffeine.Conclusions
Our results suggest that moderate first trimester coffee and tea intake were not associated with GDM increased risk and possibly may have a protective effect.
... Los estudios epidemiológicos indican que el consumo prolongado de café se asocia con un menor riesgo de desarrollo de diabetes tipo 2 en la adultez (50), aunque el consumo agudo puede asociarse con una menor sensibilidad a la insulina (51), lo cual ha motivado a numerosos investigadores a estudiar el efecto del café y de la cafeína durante el embarazo y su relación con la diabetes gestacional. Lo estudios sobre el efecto de la cafeína en la diabetes gestacional son relativamente recientes, ya que el primero de ellos se publicó en 2002 (52) y a partir de este estudio todos los estudios posteriores y meta análisis de cohortes han encontrado una correlación inversa de dosis-respuesta entre el consumo de café y la mayor incidencia de diabetes gestacional (50,(53)(54)(55). ...
Caffeine is the principal active component of coffee and the effects of coffee consumption are mainly associated to this component. Caffeine is a methylxanthine, which acts as antagonist of adenine receptors at the nervous system. A great number of health effects, both beneficial and detrimental, have been associated to caffeine consumption: such as cardiovascular disease, type 2 diabetes, glucose tolerance and insulin sensitivity, hepatic cirrhosis, hepatocellular carcinoma, are included as the main targets. The present work reviews two of the main concerns about coffee and caffeine consumption: cardiovascular disease and maternal health (perinatal period). The general conclusion is that caffeine consumption up to 300 mg/day does not constitute a risk of myocardial infarction, hypertension, or modification of cardiovascular risk markers such as reactive C protein or homocysteine plasmatic levels. Similar conclusions are reached about the maternal health. Moderate caffeine consumption (300 mg/day or less) does not constitute a major risk of less conception, increased gestational diabetes, decrease fetal growth, or congenital defects. However, absence frisk may not be interpreted as a signal to stimulate coffee consumption during pregnancy. Future mothers, which are moderated coffee consumers, may be suggested to continue this consumption during pregnancy, but under medical supervision.
... The systematic review of Van Dam and Hu [23] concluded that habitual coffee consumption was associated with a substantially lower risk of type 2 diabetes, but Wedick et al. [22], on the other hand, could not demonstrate changes in glycemia or insulin sensitivity with coffee consumption. The study by Adeney et al. [24] concluded that moderate prepregnancy caffeinated coffee consumption may have a protective association with GDM. Our study agrees with these previous findings and emphasizes the fact that a higher level of consumption can nullify this protective effect. ...
The aim of this study is to establish a risk appraisal model for GDM by identifying modifiable factors that can help predict the risk of GDM in a large population of 2194 women living in Spain. They were recruited between 2009-2010 when screening for GDM was performed. Participants completed a questionnaire on socio-demographic, anthropomorphic and behavioral characteristics, and reproductive and medical history. A total of 213 (9.7%) women were diagnosed as having GDM. Age, pregestational body weight (BW) and body mass index (BMI), and number of events of medical, obstetric and family history were significantly associated with GDM. After logistic regression model, biscuits and pastries intake <4 times/week, red and processed meats intake <6 servings/week, sugared drinks <4 servings/week, light walking >30 minutes/day, and 30 minutes/day of sports at least 2 days/week, compared with opposite consumption, was associated with less GDM risk. Our study identified several pregestational modifiable lifestyle risk factors associated with an increase in the risk of developing GDM. This may represent a promising approach for the prevention of GDM and subsequent complications. Further intervention studies are needed to evaluate if this appraisal model of risk calculation can be useful for prevention and treatment of GDM.
... There appears to be a dose response effect, with greatest benefit seen in those consuming ≥4 cups per day. Furthermore, those with pre-diabetes also demonstrate a reduced likelihood of progression to diabetes if they were current or even past coffee consumers [26] and habitual coffee consumption also reduces the risk of developing gestational diabetes [27]. The present study of acute ingestion is also in contrast to a recent 8 week randomised controlled trial of caffeinated or decaffeinated instant coffee compared with water in healthy but overweight individuals without diabetes where there was no difference in glucose tolerance, insulin sensitivity or secretion [16]. ...
The objective was to determine the effect of a single dose of espresso caffeinated coffee, decaffeinated coffee, or water on glucose tolerance and insulin sensitivity in people with type 2 diabetes mellitus. Eighteen participants who were habitual coffee drinkers, were studied using a random-order cross-over design. After a fasting blood sample participants consumed either a double-shot black espresso coffee, decaffeinated coffee, or hot water. The main outcomes were area under the curve (AUC) glucose and insulin, and insulin sensitivity (Matsuda index) during a 75 g oral glucose tolerance test (OGTT) performed one hour later. Other outcomes were change in glucose and insulin and also the insulinogenic index (IGI) and disposition index (DI). AUC glucose was marginally different between beverages (P=.06) being greater following caffeinated coffee than water, mean difference 104 mmol/L/180 min (95% CI 0.1 to 198.1, P=.031), or decaffeinated coffee, mean difference 92.1 mmol/L/180 min (95% CI -1.9 to 186.1, P=.055). There was no difference in AUC insulin (P=.87) or insulin sensitivity (P=.47), nor in change in glucose or insulin over the hour following beverage consumption. There was a marginal difference in IGI between beverages (P=.097) with coffee having a lower incremental increase in insulin/glucose than water (P=.037) though no difference between coffee and decaffeinated coffee (P=.54) and no difference in DI (P=.23). Black espresso coffee in people with type 2 diabetes mellitus results in a marginally greater excursion of glucose during a following OGTT compared with water or decaffeinated coffee. This effect does not appear to be mediated by changes in insulin sensitivity.
... Die Auswertungen weiterer Langzeitbeobachtungen [38][39][40][41][42] und Querschnittsanalysen [43] ergaben übereinstimmend ein geringeres Auftreten von beeinträchtigter Glukosetoleranz und Typ-2-Diabetes mit steigendem Kaffeekonsum. Auch scheint ein inverses Verhältnis zwischen dem Kaffeekonsum vor und während der Schwangerschaft und dem Auftreten eines Schwangerschaftsdiabetes zu bestehen [44]. Ebenso konnte gezeigt werden, dass regelmäßiger Kaffeekonsum Personen mit bereits beeinträchtigtem Glukosestoffwechsel vor Typ-2-Diabetes schützt [45] und besonders solche mit erhöhten Serum Gamma-Glutamyl-Transferase-(GGT)-Spiegeln [46]. ...
Lack of physical activity and high caloric diet are main causes for increasing diabetes prevalence. Thus, it is possible to influence blood glucose levels by lifestyle modifications. Coffee is an important lifestyle factor in Germany with a mean consumption of about 150 litres per inhabitant. It is important to know that coffee cannot be equated with caffeine. Scientific investigations have shown that caffeine can temporarily have a negative impact on cardiovascular risk factors but does not promote development of cardiovascular events. On the other hand, several international prospective studies demonstrate a protective effect of coffee on the development of type 2 diabetes as coffee consumption can reduce glucose uptake. Coffee components, e.g. chlorogenic acid, play a central role, as they can inhibit oxidative stress and inflammation in addition. In the context of lifestyle tasks coffee consumption therefore is an additional option for modifying diabetes risk.
... Furthermore, the daily consumption of 400 mg of caffeine for 7 d by healthy normoglycemic young adults did not affect fasting plasma glucose concentrations [80] and the chronic consumption of about 400 mg of caffeine daily did not cause increased hyperglycemia or hyperinsulinemia after an acute glucose challenge [81]. In addition, in a prospective study of 1744 previously non-diabetic pregnant women, the routine daily consumption of 6 to 10 cups of caffeinated coffee (equivalent to 1000 to 1500 mg of caffeine [44]) contributed to successful pregnancy outcomes by cutting in half the risk of developing gestational diabetes [82]. Consistent with this finding, the results of the 18-y prospective Nurses' Health Study and the 12-y prospective Health Professionals Follow-up Study indicated that the risk for developing type 2 diabetes decreases as habitual caffeine intake increases in men and women [83]. ...
The beneficial effects of human caffeine consumption deserve clarification.
A detailed literature review was conducted and summarized.
A large body of scientific evidence describes the beneficial effects of human caffeine consumption on a number of physiologic systems.
The consumption of moderate amounts of caffeine 1) increases energy availability, 2) increases daily energy expenditure, 3) decreases fatigue, 4) decreases the sense of effort associated with physical activity, 5) enhances physical performance, 6) enhances motor performance, 7) enhances cognitive performance, 8) increases alertness, wakefulness, and feelings of "energy," 9) decreases mental fatigue, 10) quickens reactions, 11) increases the accuracy of reactions, 12) increases the ability to concentrate and focus attention, 13) enhances short-term memory, 14) increases the ability to solve problems requiring reasoning, 15) increases the ability to make correct decisions, 16) enhances cognitive functioning capabilities and neuromuscular coordination, and 17) in otherwise healthy non-pregnant adults is safe.
... Potential confounding by gestational diabetes was also not considered. Mild gestational diabetes has been identified previously as a risk factor of cryptorchidism (Virtanen et al., 2006) while coffee consumption during pregnancy has been linked to a reduced risk of gestational diabetes (Adeney et al., 2007). Thus, gestational diabetes may serve as a negative confounder of the association between caffeine and cryptorchidism. ...
This review of human studies of caffeine and reproductive health published between January 2000 and December 2009 serves to update the comprehensive review published by Leviton and Cowan (2002). The adverse reproductive outcomes addressed in this review include: (1) measures of subfecundity; (2) spontaneous abortion; (3) fetal death; (4) preterm birth; (5) congenital malformations; and (6) fetal growth restriction. Methodologic challenges and considerations relevant to investigations of each reproductive endpoint are summarized, followed by a brief critical review of each study. The evidence for an effect of caffeine on reproductive health and fetal development is limited by the inability to rule out plausible alternative explanations for the observed associations, namely confounding by pregnancy symptoms and smoking, and by exposure measurement error. Because of these limitations, the weight of evidence does not support a positive relationship between caffeine consumption and adverse reproductive or perinatal outcomes.
Background:
Females with a history of gestational diabetes mellitus (GDM) are at higher risk of developing type 2 diabetes mellitus (T2D) later in life.
Objective:
This study prospectively examined whether greater habitual coffee consumption was related to a lower risk of T2D among females with a history of GDM.
Methods:
We followed 4522 participants with a history of GDM in the NHS II for incident T2D between 1991 and 2017. Demographic, lifestyle factors including diet, and disease outcomes were updated every 2-4 y. Participants reported consumption of caffeinated and decaffeinated coffee on validated FFQs. Fasting blood samples were collected in 2012-2014 from a subset of participants free of diabetes to measure glucose metabolism biomarkers (HbA1c, insulin, C-peptide; n = 518). We used multivariable Cox regression models to calculate adjusted HRs and 95% CIs for the risk of T2D. We estimated the least squares mean of glucose metabolic biomarkers according to coffee consumption.
Results:
A total of 979 participants developed T2D. Caffeinated coffee consumption was inversely associated with the risk of T2D. Adjusted HR (95% CI) for ≤1 (nonzero), 2-3, and 4+ cups/d compared with 0 cup/d (reference) was 0.91 (0.78, 1.06), 0.83 (0.69, 1.01), and 0.46 (0.28, 0.76), respectively (P-trend = 0.004). Replacement of 1 serving/d of sugar-sweetened beverage and artificially sweetened beverage with 1 cup/d of caffeinated coffee was associated with a 17% (risk ratio [RR] = 0.83, 95% CI: 0.75, 0.93) and 9% (RR = 0.91, 95% CI: 0.84, 0.99) lower risk of T2D, respectively. Greater caffeinated coffee consumption was associated with lower fasting insulin and C-peptide concentrations (all P-trend <0.05). Decaffeinated coffee intake was not significantly related to T2D but was inversely associated with C-peptide concentrations (P-trend = 0.003).
Conclusions:
Among predominantly Caucasian females with a history of GDM, greater consumption of caffeinated coffee was associated with a lower risk of T2D and a more favorable metabolic profile.
With its fascinating historical, botanical and economic significance, coffee is now one of the most consumed beverages by mankind. Numerous prospective studies have almost unequivocally established the inverse association between risk for type 2 diabetes (T2D) and intake of both caffeinated and decaffeinated coffee. By disentangling the effect of acute coffee or caffeine intake on raising blood pressure, increased blood glucose and insulin resistance, from the long-term effect of coffee intake on metabolic syndrome, this chapter outlines the chemical and pharmacological basis of both roasted and unroasted coffee beans. These include, the polyphenolic compounds dominated by chlorogenic acids, the alkaloids such as trigonelline and its derivatives, diterpenes compounds (e.g. cafestol and kahweol) that have some positive outcome along with hypercholesterolaemic/hyperlipidaemic effect, etc. Data from in vitro, in vivo and plethora of clinical studies relevant to the various components of metabolic syndrome are presented.
Caffeine is widely used by pregnant women; consumption greater than 500–600 mg a day is considered abuse. Moderate use has a minimal effect on obstetric and neonatal outcomes and does not preclude breastfeeding. Obstetric and anesthetic management in pregnant women are not different than in the non-caffeine-using parturient.
Background: The pattern of tobacco consumption survey among the students in a private dental college in Mangalore helps us to assess the awareness and pattern of tobacco consumption among the dental students and also to assess the preparedness for tobacco control among the future health care professionals in India. Aim: To study the awareness and pattern of tobacco use among undergraduate dental students of a private dental College, at Dakshina Kannada, Karnataka. Materials and Method: A Cross-sectional study was conducted among 100 dental students using a predesigned and pretested, semi-structured self-administered anonymous questionnaire. Data was analyzed by Microsoft excel and SPSS v 16.Statistical analysis comprised calculating proportion and the chi-square (χ2) test with Yates correction. Results: Among 100 participants, of which 52 students were males and 48 females, out of which 49% believed that the minimum number of cigarettes a person can smoke without causing harm to one’s health. About 89% of the students believe that it is the doctor’s duty to advice patients not to smoke or chew tobacco. 81% believe that health professional intervention would help the patient quit the habit. Conclusion: Awareness about harmful effects of tobacco abuse was good and the students feel that tobacco cessation modules should be incorporated in the dental curriculum. Given their important future role as exemplars, more effective measures to help reduce tobacco smoking among dental students are clearly needed worldwide. © 2017, Indian Journal of Public Health Research and Development. All rights reserved.
Given its complex composition and its widespread use in the world, the effects of coffee on health are the subject of numerous studies. Epidemiological studies converged in their conclusions, and have shown a significant reduction in the risk of type 2 diabetes with at least daily consumption of coffee, compared with zero consumption. Clinical arguments, however, remain insufficiently documented, and minimum quantities to recommend still to be defined.
Caffeine is the principal active component of coffee and the effects of coffee consumption are mainly associated to this component. Caffeine is a methylxanthine which acts as antagonist of adenine receptors at the nervous system. A great number of health effects, both beneficial and detrimental, have been associated to caffeine consumption: such as cardiovascular disease, type 2 diabetes, glucose tolerance and insulin sensitivity, hepatic cirrhosis, hepatocellular carcinoma, are included as the main targets. The present work reviews two of the main concerns about coffee and caffeine consumption: cardiovascular disease and maternal health (perinatal period). The general conclusion is that caffeine consumption up to 300 mg/day does not constitute a risk of myocardial infarction, hypertension, or modification of cardiovascular risk markers such as reactive C protein or homocysteine plasmatic levels. Similar conclusions are reached about the maternal health. Moderate caffeine consumption (300 mg/day or less) does not constitute a major risk of less conception, increased gestational diabetes, decrease fetal growth, or congenital defects. However, absence of risk may not be interpreted as a signal to stimulate coffee consumption during pregnancy. Future mothers, which are moderated coffee consumers, may be suggested to continue this consumption during pregnancy, but under medical supervision.
Résumé
Compte tenu de sa composition complexe et de sa consommation très répandue dans le monde, les effets du café sur l’état de santé sont l’objet de nombreuses études. Des études épidémiologiques, convergentes dans leurs conclusions, ont ainsi montré une réduction significative du risque de diabète de type 2 avec une consommation au moins quotidienne de café, par rapport à une consommation nulle. Les arguments cliniques restent toutefois insuffisamment documentés, et les quantités minimales à recommander doivent être encore définies.
Coffee is one of the most widely consumed beverages in the world, and has been implicated in many health conditions. Coffee is a complex exposure with pleiotropic effects, and the physiological response to coffee varies among individuals. Epidemiological studies of gene-coffee interactions may inform causality, parse the constituents of coffee responsible for disease, and identify subgroups most likely to benefit from increasing or decreasing coffee consumption. Cancers, cardiovascular disease, Parkinson’s disease, and pregnancy outcomes have been the subject of gene-coffee interaction studies and have yielded promising preliminary results. Most studies have targeted the caffeine component of coffee and have examined only a limited number of genetic variants. Depending upon the disease of study, coffee appears to exert beneficial, adverse, or no effects, which may be more pronounced when accounting for genetics. With continued investment, studies of gene-coffee interactions promise to provide the necessary foundation for personalized coffee consumption recommendations.
Caffeine is one of the most widely consumed psychoactive substances in the world. This methylxanthine occurs in coffee, tea, maté, cocoa products, cola beverages and in different types of pharmaceutical drugs. Its effects on health are controversial. The intake of high doses can produce negative effects such as anxiety in some sensitive individuals and has been associated with adverse consequences in calcium balance, blood pressure and risk of miscarriage.In contrast, moderate consumption can promote a sense of well being, improvement of alertness and short term memory and a decrease in the risk of development or improvement of consequences of diseases such as Parkinson and Alzheimer's. These and other important aspects related to the consumption of caffeine and health will be approached in this chapter.
Maternal caffeine consumption during pregnancy may have adverse effects on fetal, neonatal and maternal outcomes.
This review investigates the effects of restricting caffeine intake by mothers on fetal, neonatal and pregnancy outcomes.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2012), scanned bibliographies of published studies and corresponded with investigators.
Randomised controlled trials (RCTs) including quasi-RCTs investigating the effect of caffeine and/or supplementary caffeine versus restricted caffeine intake or placebo on pregnancy outcomes.
Two review authors independently assessed trial quality and extracted data.
Two studies met the inclusion criteria but only one contributed data for the prespecified outcomes. Caffeinated instant coffee (568 women) was compared with decaffeinated instant coffee (629 women) and it was found that reducing the caffeine intake of regular coffee drinkers (3+ cups/day) during the second and third trimester by an average of 182 mg/day did not affect birthweight or length of gestation.
There is insufficient evidence to confirm or refute the effectiveness of caffeine avoidance on birthweight or other pregnancy outcomes. There is a need to conduct high-quality, double-blinded RCTs to determine whether caffeine has any effect on pregnancy outcome.
Introduction Observational associations between coffee consumption and type 2 diabetes risk Coffee preparation Observational associations between coffee consumption and diabetes risk factors Intervention studies in human subjects Possible mechanisms of action Summary and conclusions References
BIOACTIVE COMPOUNDS AND ANTIOXIDANT ACTIVITY OF CONILON COFFEE SUBMITTED TO DIFFERENT DEGREES OF ROASTING. The bioactive compounds and antioxidant activity presented by Conilon coffee (C. Canephora) variety, produced in the Espírito Santo State, Brazil, were quantified. The light roast coffee showed the highest level of total phenols, trigonelline, caffeic and chlorogenic acids. The proanthocyanidin level was the highest for dark roast coffee, while caffeine level didn't show significative changes for the light and middle roast coffees. All the Conilon coffee extracts showed antioxidant activity depending on bioactive compounds concentration and roasting degree. The coffee samples submitted to a light roasting degree showed the highest antioxidant activity.
Coffee consumption has been associated with a lower risk of type 2 diabetes. This association does not depend on race, gender, geographic distribution of the study populations, or the type of coffee consumed (i.e., caffeinated or decaffeinated). This review discusses the strength of this relationship, examines the possibility that the pattern of coffee consumption could influence the association, and evaluates the possible relationship between coffee consumption and other risk factors associated with diabetes. Particular attention is paid to the identification, on the basis of the scientific evidence, of the possible mechanisms by which coffee components might affect diabetes development, especially in light of the paradoxical effect of caffeine on glucose metabolism. In addition to the role of coffee in reducing the risk of developing type 2 diabetes, the possible role of coffee in the course of the illness is explored. Finally, the possibility that coffee can also affect the risk of other forms of diabetes (e.g., type 1 diabetes and gestational diabetes) is examined.
Outside pregnancy, acute caffeine consumption is associated with insulin resistance. We investigated if during pregnancy plasma concentrations of caffeine and its metabolite, paraxanthine, were associated with insulin resistance. Caffeine, paraxanthine, glucose, and insulin were measured and insulin resistance estimated by homeostasis model assessment (HOMA) in banked samples from 251 fasting subjects at mean gestational age of 20.3 ± 2.0 weeks. Analysis of covariance and adjusted logistic regression were performed. Most (96.4%) women had caffeine and/or paraxanthine present. Caffeine concentrations in the upper two quartiles (>266 ng/mL) were associated with threefold higher odds of having higher insulin resistance estimated by log HOMA ≥75th percentile (third quartile odds ratio [OR], 3.02; 95% confidence interval [CI]: 1.21 to 7.54 and fourth quartile OR, 2.95; 95% CI: 1.19 to 7.31). Paraxanthine concentrations in the upper quartile (>392 ng/mL) were also associated with threefold higher odds of having higher insulin resistance (OR, 3.04; 95% CI: 1.28 to 7.25). Adjusted mean HOMA in the first caffeine-to-paraxanthine ratio quartile was 1.5 ± 2.2 versus 1.3 ± 2.3 in the fourth quartile ( P < 0.01). Both high caffeine and paraxanthine concentrations were associated with insulin resistance, but slow versus fast metabolism did not make an important difference.
When considering methylxanthines and human health, it must be recognized that in many countries most caffeine is consumed as coffee. This is further confounded by the fact that coffee contains many bioactive substances in addition to caffeine; it is rich in phenols (quinides, chlorogenic acid, and lactones) and also has diterpenes (fatty acid esters), potassium, niacin, magnesium, and the vitamin B(3) precursor trigonelline. There is a paradox as consumption of either caffeine or caffeinated coffee results in a marked insulin resistance and yet habitual coffee consumption has repeatedly been reported to markedly reduce the risk for type 2 diabetes. There is strong evidence that caffeine reduces insulin sensitivity in skeletal muscle and this may be due to a combination of direct antagonism of A(1) receptors and indirectly β-adrenergic stimulation as a result of increased sympathetic activity. Caffeine may also induce reduced hepatic glucose output. With the exception of bone mineral, there is little evidence that caffeine impacts negatively on other health issues. Coffee does not increase the risk of cardiovascular diseases or cancers and there is some evidence suggesting a positive relationship for the former and for some cancers, particularly hepatic cancer.
Maternal caffeine consumption during pregnancy may have adverse effects on fetal, neonatal and maternal outcomes.
This review investigates the effects of restricting caffeine intake by mothers on fetal, neonatal and pregnancy outcomes.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2008), scanned bibliographies of published studies and corresponded with investigators.
Randomised controlled trials including quasi-randomised controlled trials (RCTs) investigating the effect of caffeine and/or supplementary caffeine versus restricted caffeine intake or placebo on pregnancy outcome.
The two review authors independently assessed trial quality and extracted data.
One study met the inclusion criteria. Caffeinated instant coffee (568 women) was compared with decaffeinated instant coffee (629 women) and it was found that reducing the caffeine intake of regular coffee drinkers (3+ cups/day) during the second and third trimester by an average of 182 mg/day did not affect birthweight or length of gestation.
There is insufficient evidence to confirm or refute the effectiveness of caffeine avoidance on birthweight or other pregnancy outcomes. There is a need to conduct high-quality, double-blinded RCTs to determine whether caffeine has any effect on pregnancy outcome.
We summarize the dietary modifications that optimize fertility treatment outcomes.
Body weight and nutritional status are closely related to reproductive function. However, few studies have investigated the direct effects of dietary modification on fertility treatment outcomes. Research on nutrition in pregnancy suggests that reduction in glycemic load and micronutrient supplementation may improve pregnancy outcomes.
Body weight and specific dietary factors may affect fertility but evidence regarding dietary effects on fertility treatment outcomes is lacking. Research suggests that diets with a low glycemic load during pregnancy may reduce the risk of gestational diabetes or large-for-gestational-age births after adjusting for body mass index and total energy intake, but the effect of protein modification remains controversial. There is also lack of information on the impact of energy restriction during pregnancy on maternal and infant outcomes. Folate supplementation is recommended for prevention of birth defects but further research is required to determine the optimal dose to reduce the risks of multiple gestations. Further information on the upper limits of caffeine and alcohol intake during pregnancy would also be useful.
The magnitude of coffee-induced thermogenesis and the influence of coffee ingestion on substrate oxidation were investigated in 10 lean and 10 obese women, over two 24-h periods in a respiratory chamber. On one occasion the subjects consumed caffeinated coffee and on the other occasion, decaffeinated coffee. The magnitude of thermogenesis was smaller in obese (4.9 +/- 2.0%) than in lean subjects (7.6 +/- 1.3%). The thermogeneic response to caffeine was prolonged during the night in lean women only. The coffee-induced stimulation of energy expenditure was mediated by a concomitant increase in lipid and carbohydrate oxidation. During the next day, in postabsorptive basal conditions, the thermogenic effect of coffee had vanished, but a significant increase in lipid oxidation was observed in both groups. The magnitude of this effect was, however, blunted in obese women (lipid oxidation increased by 29 and 10% in lean and obese women, respectively). Caffeine increased urinary epinephrine excretion. Whereas urinary caffeine excretion was similar in both groups, obese women excreted more theobromine, theophylline, and paraxanthine than lean women. Despite the high levels of urinary methylxanthine excretion, thermogenesis and lipid oxidation were less stimulated in obese than in lean subjects.
To examine factors associated with variation in the risk for type 2 diabetes in women with prior gestational diabetes mellitus (GDM).
We conducted a systematic literature review of articles published between January 1965 and August 2001, in which subjects underwent testing for GDM and then testing for type 2 diabetes after delivery. We abstracted diagnostic criteria for GDM and type 2 diabetes, cumulative incidence of type 2 diabetes, and factors that predicted incidence of type 2 diabetes.
A total of 28 studies were examined. After the index pregnancy, the cumulative incidence of diabetes ranged from 2.6% to over 70% in studies that examined women 6 weeks postpartum to 28 years postpartum. Differences in rates of progression between ethnic groups was reduced by adjustment for various lengths of follow-up and testing rates, so that women appeared to progress to type 2 diabetes at similar rates after a diagnosis of GDM. Cumulative incidence of type 2 diabetes increased markedly in the first 5 years after delivery and appeared to plateau after 10 years. An elevated fasting glucose level during pregnancy was the risk factor most commonly associated with future risk of type 2 diabetes.
Conversion of GDM to type 2 diabetes varies with the length of follow-up and cohort retention. Adjustment for these differences reveals rapid increases in the cumulative incidence occurring in the first 5 years after delivery for different racial groups. Targeting women with elevated fasting glucose levels during pregnancy may prove to have the greatest effect for the effort required.
Only a few studies of coffee consumption and diabetes mellitus (DM) have been reported, even though coffee is the most consumed beverage in the world.
To determine the relationship between coffee consumption and the incidence of type 2 DM among Finnish individuals, who have the highest coffee consumption in the world.
A prospective study from combined surveys conducted in 1982, 1987, and 1992 of 6974 Finnish men and 7655 women aged 35 to 64 years without history of stroke, coronary heart disease, or DM at baseline, with 175 682 person-years of follow-up. Coffee consumption and other study parameters were determined at baseline using standardized measurements.
Hazard ratios (HRs) for the incidence of type 2 DM were estimated for different levels of daily coffee consumption.
During a mean follow-up of 12 years, there were 381 incident cases of type 2 DM. After adjustment for confounding factors (age, study year, body mass index, systolic blood pressure, education, occupational, commuting and leisure-time physical activity, alcohol and tea consumption, and smoking), the HRs of DM associated with the amount of coffee consumed daily (0-2, 3-4, 5-6, 7-9, > or =10 cups) were 1.00, 0.71 (95% confidence interval [CI], 0.48-1.05), 0.39 (95% CI, 0.25-0.60), 0.39 (95% CI, 0.20-0.74), and 0.21 (95% CI, 0.06-0.69) (P for trend<.001) in women, and 1.00, 0.73 (95% CI, 0.47-1.13), 0.70 (95% CI, 0.45-1.05), 0.67 (95% CI, 0.40-1.12), and 0.45 (95% CI, 0.25-0.81) (P for trend =.12) in men, respectively. In both sexes combined, the multivariate-adjusted inverse association was significant (P for trend <.001) and persisted when stratified by younger and older than 50 years; smokers and never smokers; healthy weight, overweight, and obese participants; alcohol drinker and nondrinker; and participants drinking filtered and nonfiltered coffee.
Coffee drinking has a graded inverse association with the risk of type 2 DM; however, the reasons for this risk reduction associated with coffee remain unclear.
Physical activity has been associated with a reduced risk of gestational diabetes mellitus, but inferences have been hampered by recall and selection bias. The authors examined the relation between recreational physical activity before and during pregnancy and risk of gestational diabetes mellitus in a prospective cohort study. In 1996-2000, 909 normotensive, nondiabetic women in Seattle and Tacoma, Washington, were questioned during early gestation about physical activity performed during the year before and 7 days prior to the interview during pregnancy. Compared with inactive women, women who participated in any physical activity during the year before experienced a 56% risk reduction (relative risk (RR) = 0.44, 95% confidence interval (CI): 0.21, 0.91). Women spending >/=4.2 hours/week engaged in physical activity experienced a 76% reduction in gestational diabetes mellitus risk (RR = 0.24, 95% CI: 0.10, 0.64), and those expending >/=21.1 metabolic equivalent-hours/week experienced a 74% reduction (RR = 0.26, 95% CI: 0.10, 0.65) compared with inactive women. Physical activity during pregnancy was also associated with reductions in gestational diabetes mellitus risk. Women who engaged in physical activity during both time periods experienced a 69% reduced risk (RR = 0.31, 95% CI: 0.12, 0.79). Findings suggest that efforts to increase maternal physical activity may contribute to substantial reductions in gestational diabetes mellitus risk.
Coffee contains several substances that may affect glucose metabolism. The aim of this study was to evaluate the relationship between habitual coffee consumption and the incidence of IFG, IGT and type 2 diabetes.
We used cross-sectional and prospective data from the population-based Hoorn Study, which included Dutch men and women aged 50-74 years. An OGTT was performed at baseline and after a mean follow-up period of 6.4 years. Associations were adjusted for potential confounders including BMI, cigarette smoking, physical activity, alcohol consumption and dietary factors.
At baseline, a 5 cup per day higher coffee consumption was significantly associated with lower fasting insulin concentrations (-5.6%, 95% CI -9.3 to -1.6%) and 2-h glucose concentrations (-8.8%, 95% CI -11.8 to -5.6%), but was not associated with lower fasting glucose concentrations (-0.8%, 95% CI -2.1 to 0.6%). In the prospective analyses, the odds ratio (OR) for IGT was 0.59 (95% CI 0.36-0.97) for 3-4 cups per day, 0.46 (95% CI 0.26-0.81) for 5-6 cups per day, and 0.37 (95% CI 0.16-0.84) for 7 or more cups per day, as compared with the corresponding values for the consumption of 2 or fewer cups of coffee per day (p=0.001 for trend). Higher coffee consumption also tended to be associated with a lower incidence of type 2 diabetes (OR 0.69, CI 0.31-1.51 for >/=7 vs </=2 cups per day, p=0.09 for trend), but was not associated with the incidence of IFG (OR 1.35, CI 0.80-2.27 for >/=7 vs </=2 cups per day, p=0.49 for trend).
Our findings indicate that habitual coffee consumption can reduce the risk of IGT, and affects post-load rather than fasting glucose metabolism.
We investigated the effect of caffeine ingestion on insulin sensitivity in sedentary lean men (n = 8) and obese men with (n = 7) and without (n = 8) type 2 diabetes. We also examined whether chronic exercise influences the relationship between caffeine and insulin sensitivity in these individuals.
Subjects underwent two hyperinsulinemic-euglycemic clamp procedures, caffeine (5 mg/kg body wt) and placebo, in a double-blind, randomized manner before and after a 3-month aerobic exercise program. Body composition was measured by magnetic resonance imaging.
At baseline, caffeine ingestion was associated with a significant reduction (P < 0.05) in insulin sensitivity by a similar magnitude in the lean (33%), obese (33%), and type 2 diabetic (37%) groups in comparison with placebo. After exercise training, caffeine ingestion was still associated with a reduction (P < 0.05) in insulin sensitivity by a similar magnitude in the lean (23%), obese (26%), and type 2 diabetic (36%) groups in comparison with placebo. Exercise was not associated with a significant increase in insulin sensitivity in either the caffeine or placebo trials, independent of group (P > 0.10).
Caffeine consumption is associated with a substantial reduction in insulin-mediated glucose uptake independent of obesity, type 2 diabetes, and chronic exercise.
The consumption of fruits and vegetables reduces the risk of major chronic degenerative diseases. The active compounds and the mechanisms involved in this protective effect have not been well defined. The objective of this study was to determine the contribution of various food groups to total antioxidant intake, and to assess the correlations of the total antioxidant intake from various food groups with plasma antioxidants. We collected 7-d weighed dietary records in a group of 61 adults with corresponding plasma samples, and used data from a nationwide survey of 2672 Norwegian adults based on an extensive FFQ. The total intake of antioxidants was approximately 17 mmol/d with beta-carotene, alpha-tocopherol, and vitamin C contributing <10%. The intake of coffee contributed approximately 11.1 mmol, followed by fruits (1.8 mmol), tea (1.4 mmol), wine (0.8 mmol), cereals (i.e., all grain containing foods; 0.8 mmol), and vegetables (0.4 mmol). The intake of total antioxidants was significantly correlated with plasma lutein, zeaxanthin, and lycopene. Among individual food groups, coffee, wine, and vegetables were significantly correlated with dietary zeaxanthin, beta-carotene, and alpha-carotene. These data agree with the hypothesis that dietary antioxidants other than the well-known antioxidants contribute to our antioxidant defense. Surprisingly, the single greatest contributor to the total antioxidant intake was coffee.
Coffee is a major source of caffeine, which has been shown to acutely reduce sensitivity to insulin, but also has potentially beneficial effects. We prospectively investigated the association between coffee consumption and risk of clinical type 2 diabetes in a population-based cohort of 17 111 Dutch men and women aged 30-60 years. During 125 774 person years of follow-up, 306 new cases of type 2 diabetes were reported. After adjustment for potential confounders, individuals who drank at least seven cups of coffee a day were 0-50 (95% CI 0.35-0.72, p=0.0002) times as likely as those who drank two cups or fewer a day to develop type 2 diabetes. Coffee consumption was associated with a substantially lower risk of clinical type 2 diabetes.
Generalized linear models (GLMs) extend standard linear (Gaussian) regression techniques to models with a non-Gaussian, or even discrete, response. GLM theory is predicated on the exponential family of distributions—a class so rich that it includes the commonly used logit, probit, and Poisson distributions. Although one can fit these models in Stata by using specialized commands (e.g., logit for logit models), fitting them under the GLM paradigm with Stata’s glm command offers the advantage of having many models under the same roof. For example, model diagnostics may be calculated and interpreted similarly regardless of the assumed distribution. This text thoroughly covers GLMs, both theoretically and computationally. The theory consists of showing how the various GLMs are special cases of the exponential family, general properties of this family of distributions, and the derivation of maximum likelihood (ML) estimators and standard errors. The book shows how iteratively reweighted least squares, another method of parameter estimation, is a consequence of ML estimation via Fisher scoring. The authors also discuss different methods of estimating standard errors, including robust methods, robust methods with clustering, Newey–West, outer product of the gradient, bootstrap, and jackknife.
The origin of indices for recording gingivitis and plaque is reviewed. Each index seems to have been constructed for a special purpose. The development so far has been towards more and more delicately graded indices which are well suited for evaluation of short term clinical trials. The increased sensitively, though advantageous for scientific purpose, is not always practical from a public dental health point of view. It seems that at present there is a need for several different types of index systems. In order to be able to conduct his preventive programs the practicing dentist needs a simple and well defined recording system for oral hygiene and gingival inflammation. Such an index system should be as easy and natural to use as is the scoring of decayed and filled surfaces today. Instead of using individual mean scores of multi-graded plaque and gingival indices, the use of the site prevalence of a single finding is suggested. For recording of gingivitis in daily dental practice the number of gingival margins bleeding on pressure is recommended to be determined as a percentage of the sites examined (Fig. 1,2 and 3). For oral hygiene, correspondingly, the frequency of occurrence of tooth surfaces covered with clearly visible plaque could be used as a clinically relevant parameter (Fig. 4). Keeping visible plaque and gingival bleeding away is also suggested to be a clearly understandable and practical aim in the dental health education of the individual patient.
Previous studies of maternal caffeine use and pregnancy outcome have relied on self-reported use. Even if these were perfectly accurate, inter-individual differences in caffeine metabolism result in a relatively weak correlation between caffeine intake and serum concentration. The purpose of this study was to determine whether the serum concentration of caffeine or its primary metabolite, paraxanthine, obtained at an unknown time during working hours, is useful to distinguish between pregnant women who report consuming small and large amounts of caffeine.
We selected from the Birmingham fetal growth study 60 women with normal pregnancy outcomes who reported consuming < or = 0.8 mg/kg/day of caffeine in a 24-hour dietary recall, 60 who consumed 0.81-2.5 mg/kg/day, 60 who consumed 2.51-5.0 mg/kg/day and 59 who consumed > or = 5.01 mg/kg/day. These women had serum drawn for storage during regular clinic hours on the same day as the recall interview. Caffeine and paraxanthine were measured in the stored serum using high performance liquid chromatography.
The weighted kappa coefficient between strata of caffeine intake and quartiles of serum paraxanthine was 0.58 among smokers and 0.53 among nonsmokers, versus 0.44 and 0.51, respectively, for quartiles of serum caffeine. The Pearson correlation coefficient between intake and paraxanthine was 0.50 for smokers and 0.53 for nonsmokers, and 0.37 and 0.51, respectively, for serum caffeine. These values are comparable to the correlation between reported smoking and serum cotinine in pregnancy.
The serum concentrations of paraxanthine, and to a lesser degree, caffeine are useful to distinguish between women with varying levels of caffeine intake.
The Women's Health Initiative (WHI) is the largest research program ever initiated in the United States with a focus on diet and health. Therefore, it is important to understand and document the measurement characteristics of the key dietary assessment instrument: the WHI food frequency questionnaire (FFQ).
Data are from 113 women screened for participation in the WHI in 1995. We assessed bias and precision of the FFQ by comparing the intake of 30 nutrients estimated from the FFQ with means from four 24-hour dietary recalls and a 4-day food record.
For most nutrients, means estimated by the FFQ were within 10% of the records or recalls. Precision, defined as the correlation between the FFQ and the records and recalls, was similar to other FFQs. Energy adjusted correlation coefficients ranged from 0.2 (vitamin B12) to 0.7 (magnesium) with a mean of 0.5. The correlation for percentage energy from fat (a key measure in WHI) was 0.6. Vitamin supplement use was common. For example, almost half of total vitamin E intake was obtained from supplements. Including supplemental vitamins and minerals increased micronutrient correlation coefficients, which ranged from 0.2 (thiamin) to 0.8 (vitamin E) with a mean of 0.6.
The WHI FFQ produced nutrient estimate, that were similar to those obtained from short-term dietary recall and recording methods. Comparison of WHI FFQ nutrient intake measures to independent and unbiased measures, such as doubly labeled water estimates of energy expenditure, are needed to help address the validity of the FFQ in this population.
Caffeine is a central stimulant that increases the release of catecholamines. As a component of popular beverages, caffeine is widely used around the world. Its pharmacological effects are predominantly due to adenosine receptor antagonism and include release of catecholamines. We hypothesized that caffeine reduces insulin sensitivity, either due to catecholamines and/or as a result of blocking adenosine-mediated stimulation of peripheral glucose uptake.
Hyperinsulinemic-euglycemic glucose clamps were used to assess insulin sensitivity. Caffeine or placebo was administered intravenously to 12 healthy volunteers in a randomized, double-blind, crossover design. Measurements included plasma levels of insulin, catecholamines, free fatty acids (FFAs), and hemodynamic parameters. Insulin sensitivity was calculated as whole-body glucose uptake corrected for the insulin concentration. In a second study, the adenosine reuptake inhibitor dipyridamole was tested using an identical protocol in 10 healthy subjects.
Caffeine decreased insulin sensitivity by 15% (P < 0.05 vs. placebo). After caffeine administration, plasma FFAs increased (P < 0.05) and remained higher than during placebo. Plasma epinephrine increased fivefold (P < 0.0005), and smaller increases were recorded in plasma norepinephrine (P < 0.02) and blood pressure (P < 0.001). Dipyridamole did not alter insulin sensitivity and only increased plasma norepinephrine (P < 0.01).
Caffeine can decrease insulin sensitivity in healthy humans, possibly as a result of elevated plasma epinephrine levels. Because dipyridamole did not affect glucose uptake, peripheral adenosine receptor antagonism does not appear to contribute to this effect.
Coffee is a major source of caffeine, which has been shown to acutely reduce sensitivity to insulin, but also has potentially beneficial effects. We prospectively investigated the association between coffee consumption and risk of clinical type 2 diabetes in a population-based cohort of 17111 Dutch men and women aged 30-60 years. During 125774 person years of follow-up, 306 new cases of type 2 diabetes were reported. After adjustment for potential confounders, individuals who drank at least seven cups of coffee a day were 0.50 (95% CI 0.35-0.72, p=0.0002) times as likely as those who drank two cups or fewer a day to develop type 2 diabetes. Coffee consumption was associated with a substantially lower risk of clinical type 2 diabetes.
Low plasma adiponectin has been identified as a risk factor for type 2 diabetes. Our objective was to determine the extent to which low maternal plasma adiponectin is predictive of gestational diabetes mellitus (GDM), a condition that is biochemically and epidemiologically similar to type 2 diabetes. We used a prospective, nested case-control study design to compare maternal plasma adiponectin concentrations in 41 cases with 70 controls. Subjects were selected from a population of 968 women who provided blood samples in early pregnancy. Plasma adiponectin was determined using an ELISA. Adiponectin concentrations were statistically significantly lower in women with GDM than controls (4.4 vs. 8.1 micro g/ml, P < 0.001). Approximately 73% of women with GDM, compared with 33% of controls, had adiponectin concentrations less than 6.4 micro g/ml. After adjusting for confounding, women with adiponectin concentrations less than 6.4 micro g/ml experienced a 4.6-fold increased risk of GDM, as compared with those with higher concentrations (95% confidence interval, 1.8-11.6). Our findings are consistent with other reports suggesting an association between hypoadiponectemia and risk of type 2 diabetes. Our findings extend the literature to include GDM. Studies designed to examine the effect of dietary and pharmacological mediators of adiponectin concentrations in pregnant and nonpregnant subjects are warranted.
Coffee is probably the most frequently ingested beverage worldwide. Especially Scandinavia has a high prevalence of coffee-drinkers, and they traditionally make their coffee by boiling ground coffee beans and water. Because of its consumption in most countries in the world, it is interesting, from both a public and a scientific perspective, to discuss its potential benefits or adverse aspects in relation to especially two main health problems, namely cardiovascular disease and type 2 diabetes mellitus. Epidemiological studies suggest that consumption of boiled coffee is associated with elevated risk for cardiovascular disease. This is mainly due to the two diterpenes identified in the lipid fraction of coffee grounds, cafestol and kahweol. These compounds promote increased plasma concentration of cholesterol in humans. Coffee is also a rich source of many other ingredients that may contribute to its biological activity, like heterocyclic compounds that exhibit strong antioxidant activity. Based on the literature reviewed, it is apparent that moderate daily filtered, coffee intake is not associated with any adverse effects on cardiovascular outcome. On the contrary, the data shows that coffee has a significant antioxidant activity, and may have an inverse association with the risk of type 2 diabetes mellitus.
Emerging epidemiological evidence suggests that higher coffee consumption may reduce the risk of type 2 diabetes.
To examine the association between habitual coffee consumption and risk of type 2 diabetes and related outcomes.
We searched MEDLINE through January 2005 and examined the reference lists of the retrieved articles. Because this review focuses on studies of habitual coffee consumption and risk of type 2 diabetes, we excluded studies of type 1 diabetes, animal studies, and studies of short-term exposure to coffee or caffeine, leaving 15 epidemiological studies (cohort or cross-sectional).
Information on study design, participant characteristics, measurement of coffee consumption and outcomes, adjustment for potential confounders, and estimates of associations was abstracted independently by 2 investigators.
We identified 9 cohort studies of coffee consumption and risk of type 2 diabetes, including 193 473 participants and 8394 incident cases of type 2 diabetes, and calculated summary relative risks (RRs) using a random-effects model. The RR of type 2 diabetes was 0.65 (95% confidence interval [CI], 0.54-0.78) for the highest (>or=6 or >or=7 cups per day) and 0.72 (95% CI, 0.62-0.83) for the second highest (4-6 cups per day) category of coffee consumption compared with the lowest consumption category (0 or <or=2 cups per day). These associations did not differ substantially by sex, obesity, or region (United States and Europe). In the cross-sectional studies conducted in northern Europe, southern Europe, and Japan, higher coffee consumption was consistently associated with a lower prevalence of newly detected hyperglycemia, particularly postprandial hyperglycemia.
This systematic review supports the hypothesis that habitual coffee consumption is associated with a substantially lower risk of type 2 diabetes. Longer-term intervention studies of coffee consumption and glucose metabolism are warranted to examine the mechanisms underlying the relationship between coffee consumption and type 2 diabetes.
Coffee is among the most commonly consumed beverages in The Netherlands. Caffeine can acutely lower insulin sensitivity, but it is not clear whether tolerance for this effect develops after long-term regular intake. Furthermore, it is plausible that the effects of coffee are different from those of caffeine. Coffee contains hundreds of substances and there are indications that certain components may partly counter-act the effect of caffeine or may have independent beneficial effects. Intake of the coffee components chlorogenic acid, quinides, lignans, and trigonelline improved glucose metabolism in animal studies. Habitual coffee consumption has been studied in relation to the risk of diabetes mellitus type 2 in 12 cohort studies in Europe, the USA, and Japan. Generally, high coffee consumption was associated with a substantially lower risk of type-2 diabetes. The findings were similar for caffeinated and decaffeinated coffee, suggesting that the non-caffeine components of coffee may be responsible. Identification of these coffee components may lead to the development or selection of coffee types with improved effects on health.
To examine the long-term incidence of diabetes in relation to coffee consumption in Swedish women.
Prospective longitudinal cohort study.
City of Göteborg, Sweden.
A random population sample of 1361 women, aged 39-65 years, without prior diabetes or cardiovascular disease took part in a screening study in 1979-1981 with questionnaires, physical examination and blood sampling.
The development of diabetes until 1999 was identified by questionnaires in a second screening and the Swedish hospital discharge register.
Altogether, there were 74 new cases of diabetes. The risk of developing diabetes was 475 per 100 000 person-years in women who consumed two cups of coffee or less per day, 271 in women who consumed three to four cups per day, 202 with a consumption of five to six cups per day, and 267 in drinkers of seven cups or more per day. Associated hazard ratios, after adjustment for age, smoking, low physical activity, education and body mass index were 0.55 (0.32-0.95), 0.39 (0.20-0.77) and 0.48 (0.22-1.06) for daily consumption of three to four, five to six and seven cups or more, respectively, with a consumption of less than two per day as reference. Additional adjustment for serum cholesterol and triglycerides attenuated the relation between coffee and diabetes slightly, indicating a possible mediating effect on the effect of coffee by serum lipids.
The findings of the present study support the hypothesis that coffee consumption protects from the development of diabetes in women.
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