Departments of Pediatrics, University of California, Irvine, CA 92697, USA.
UC Irvine Development, Health and Disease Research Program, University of California, Irvine, CA 92697, USA.
Nutrients. 2020 Feb 6;12(2):420. doi: 10.3390/nu12020420.
There is inconsistent evidence that healthy dietary interventions can effectively mitigate the risk of adverse outcomes associated with elevated insulin resistance in pregnancy, suggesting that other moderating factors may be at play. Maternal psychological state is an important factor to consider in this regard, because stress/mood state can directly influence glycemia and a bidirectional relationship may exist between nutrition and psychological state. The objective of this study was to examine the interaction between maternal negative affect and diet quality on third trimester insulin resistance. We conducted a prospective longitudinal study of = 203 women with assessments in early and mid-pregnancy, which included an ecological momentary assessment of maternal psychological state, from which a negative affect score (NAS) was derived, and 24-h dietary recalls, from which the Mediterranean Diet Score (MDS) was computed. The homeostasis model assessment of insulin resistance (HOMA-IR) was computed from third trimester fasting plasma glucose and insulin values. Early pregnancy MDS was inversely associated with the HOMA-IR, but this did not maintain significance after adjusting for covariates. There was a significant effect of the mid-pregnancy MDS*NAS interaction term with the HOMA-IR in the adjusted model, such that a higher negative affect was found to override the beneficial effects of a Mediterranean diet on insulin resistance. These results highlight the need to consider nutrition and affective state concurrently in the context of gestational insulin resistance.
有不一致的证据表明，健康的饮食干预可以有效地降低与妊娠期间胰岛素抵抗升高相关的不良结局的风险，这表明可能存在其他调节因素。在这方面，产妇的心理状态是一个重要的考虑因素，因为压力/情绪状态可以直接影响血糖，营养和心理状态之间可能存在双向关系。本研究的目的是研究母体负性情绪和饮食质量对妊娠晚期胰岛素抵抗的相互作用。我们对 203 名女性进行了前瞻性纵向研究，在妊娠早期和中期进行了评估，包括对产妇心理状态的生态瞬时评估，从中得出负性情绪评分（NAS），并进行 24 小时膳食回忆，从中计算出地中海饮食评分（MDS）。稳态模型评估的胰岛素抵抗（HOMA-IR）是根据孕晚期空腹血糖和胰岛素值计算得出的。妊娠早期 MDS 与 HOMA-IR 呈负相关，但在调整协变量后，这一关系不再具有统计学意义。在调整模型中，存在中孕期 MDS*NAS 交互项与 HOMA-IR 的显著效应，即发现较高的负性情绪会抵消地中海饮食对胰岛素抵抗的有益影响。这些结果强调了在妊娠胰岛素抵抗的背景下，需要同时考虑营养和情感状态。
