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.

Background With 15.6 million smokers, Vietnam is one of the top 10 largest cigarette-consuming countries in the world. Unfortunately, smoking cessation programs are still scarce in Vietnam. Mindfulness-based and text messaging–based interventions have been increasingly used in smoking cessation studies in developed countries, with promising results. Given the exponential growth of mobile phone usage in Vietnam in recent years, mobile health interventions could be a potential strategy to increase smoking cessation in Vietnam. However, substantial cultural adaptations are needed to optimize the effectiveness of these interventions among Vietnamese smokers. Objective This study aims to involve qualitative research to inform the development of a mindfulness-based text messaging smoking cessation intervention for Vietnamese smokers. Methods A total of 10 focus groups were conducted with 71 Vietnamese male smokers aged between 18 and 65 years (5-9 participants per focus group). Overall, 5 focus groups were conducted with smokers who had the intention to quit (ie, preparation stage of change in the transtheoretical model), and 5 focus groups were conducted with smokers who did not have the intention to quit (contemplation or precontemplation stage). The focus groups were audio recorded, transcribed verbatim, and analyzed using NVivo 12 software (QSR International). Results The major themes included smoking triggers, barriers and facilitators for quitting, the perceptions of text messaging and mindfulness approaches for smoking cessation, and suggestions for the development of a text messaging–based smoking cessation program. Common smoking triggers included stress, difficulties concentrating, and fatigue. Frequently encountering other people who were smoking was a common barrier to quitting. However, participants indicated that concerns about the harmful effects of smoking on themselves and their wives and children, and encouragement from family members could motivate them to quit. The participants preferred diverse message content, including information about the consequences of smoking, encouragement to quit, and tips to cope with cravings. They suggested that text messages be clear and concise and use familiar language. Most smokers perceived that mindfulness training could be useful for smoking cessation. However, some suggested that videos or in-person training may also be needed to supplement teaching mindfulness through text messages. Conclusions This study provides important insights to inform the development of a text messaging–based smoking cessation program that incorporates mindfulness for Vietnamese male smokers. The results could also be useful for informing similar programs in other low- and middle-income countries.

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