膳食蓝莓和可溶性膳食纤维补充剂可降低肥胖女性妊娠期糖尿病的风险：一项随机对照试验。
Dietary Blueberry and Soluble Fiber Supplementation Reduces Risk of Gestational Diabetes in Women with Obesity in a Randomized Controlled Trial.
机构信息
Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA.
School of Nursing, University of Nevada at Las Vegas, Las Vegas, NV, USA.
出版信息
J Nutr. 2021 May 11;151(5):1128-1138. doi: 10.1093/jn/nxaa435.
BACKGROUND
Gestational diabetes mellitus (GDM) is a growing public health concern and maternal obesity and poor dietary intakes could be implicated. Dietary polyphenols and fiber mitigate the risk of diabetes and its complications, but little is known about their efficacy in preventing GDM.
OBJECTIVES
We examined the effects of whole blueberry and soluble fiber supplementation on primary outcomes of cardiometabolic profiles in women at high risk of developing GDM.
METHODS
Women (n = 34; mean ± SD age: 27 ± 5 y; BMI: 35.5 ± 4.0 kg/m2; previous history of GDM ∼56%; Hispanic ∼79%) were recruited in early pregnancy (<20 weeks of gestation) and randomly assigned to 1 of the following 2 groups for 18 wk: intervention (280 g whole blueberries and 12 g soluble fiber per day) and standard prenatal care (control). Both groups received nutrition education and maintained 24-h food recalls throughout the study. Data on anthropometrics, blood pressure, and blood samples for biochemical analyses were collected at baseline (<20 weeks), midpoint (24-28 weeks), and end (32-36 weeks) of gestation. Diagnosis of GDM was based on a 2-step glucose challenge test (GCT). Data were analyzed using a mixed-model ANOVA.
RESULTS
Maternal weight gain was significantly lower in the dietary intervention than in the control group at the end of the trial (mean ± SD: 6.8 ± 3.2 kg compared with 12.0 ± 4.1 kg, P = 0.001). C-reactive protein was also lower in the intervention than in the control group (baseline: 6.1 ± 4.0 compared with 6.8 ± 7.2 mg/L; midpoint: 6.1 ± 3.7 compared with 7.5 ± 7.3 mg/L; end: 5.5 ± 2.2 compared with 9.5 ± 6.6 mg/L, respectively, P = 0.002). Blood glucose based on GCT was lower in the intervention than in the control (100 ± 33 mg/dL compared with 131 ± 40 mg/dL, P < 0.05). Conventional lipids (total, LDL, and HDL cholesterol and triglycerides) did not differ between groups over time. No differences were noted in infant birth weight.
CONCLUSIONS
Whole blueberry and soluble fiber supplementation may prevent excess gestational weight gain and improve glycemic control and inflammation in women with obesity.This trial was registered at clinicaltrials.gov as NCT03467503.
背景
妊娠糖尿病（GDM）是一个日益严重的公共卫生问题，孕妇肥胖和不良饮食摄入可能与此有关。膳食多酚和膳食纤维可以降低糖尿病及其并发症的风险，但它们在预防 GDM 方面的功效知之甚少。
目的
我们研究了全蓝莓和可溶性纤维补充剂对发生 GDM 风险较高的女性的心血管代谢特征主要结局的影响。
方法
招募了 34 名女性（平均年龄 ± 标准差：27 ± 5 岁；BMI：35.5 ± 4.0 kg/m2；既往 GDM 病史约 56%；西班牙裔约 79%），在妊娠早期（<20 孕周）入组，并随机分为以下 2 组中的 1 组进行 18 周的干预：干预组（每天 280 g 全蓝莓和 12 g 可溶性纤维）和标准产前护理（对照组）。两组均接受营养教育，并在整个研究期间保持 24 小时食物回忆。在妊娠<20 周、妊娠 24-28 周和妊娠 32-36 周时收集人体测量学、血压和血液样本进行生化分析。GDM 的诊断基于两步葡萄糖挑战试验（GCT）。使用混合模型方差分析对数据进行分析。
结果
与对照组相比，膳食干预组在试验结束时的体重增加明显较少（平均 ± 标准差：6.8 ± 3.2 kg 与 12.0 ± 4.1 kg，P=0.001）。干预组的 C 反应蛋白也低于对照组（基线：6.1 ± 4.0 与 6.8 ± 7.2 mg/L；中点：6.1 ± 3.7 与 7.5 ± 7.3 mg/L；终点：5.5 ± 2.2 与 9.5 ± 6.6 mg/L，分别，P=0.002）。基于 GCT 的血糖在干预组中低于对照组（100 ± 33 mg/dL 与 131 ± 40 mg/dL，P<0.05）。常规脂质（总胆固醇、LDL 胆固醇、HDL 胆固醇和甘油三酯）在各时间点均无组间差异。两组婴儿出生体重无差异。
结论
全蓝莓和可溶性纤维补充剂可能预防肥胖女性的妊娠体重过度增加，并改善血糖控制和炎症。本试验在 clinicaltrials.gov 上注册为 NCT03467503。
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