Associations of Dietary Bioactive Compounds with Maternal Adiposity and Inflammation in Gestational Diabetes: An Update on Observational and Clinical Studies

Abstract

Gestational diabetes mellitus (GDM) is a common complication of pregnancy that adversely affects maternal and offspring health. Maternal obesity, oxidative stress, and inflammation have been implicated in GDM. In non-pregnant adults, intakes of dietary bioactive compounds inversely associate with insulin resistance and inflammation. However, associations of dietary bioactive compounds with biomarkers of adiposity, antioxidant vitamin and mineral status, oxidative stress, and inflammation in GDM have not been fully elucidated. We addressed this gap by conducting a semi-quantitative review of observational studies and randomized controlled trials published between 2010 and 2020 and retrieved from Google Scholar, Medline, and PubMed. Our analysis revealed that women with GDM are more likely to consume a pro-inflammatory diet before pregnancy and tend to consume fewer antioxidant vitamins and minerals during pregnancy than healthy pregnant women. Women with GDM also have lower blood levels of vitamins A, C, and D and certain adipokines. Several dietary bioactive compounds were noted to improve antioxidant status and biomarkers of inflammation. The Dietary Approaches to Stop Hypertension (DASH) diet and soybean oligosaccharides increased antioxidant enzyme levels. Supplementing n-3 fatty acids, probiotics, synbiotics, and trace elements increased antioxidant enzymes and reduced hs-CRP and MDA. Improvements in inflammation by vitamin D may be contingent upon co-supplementation with other dietary bioactive compounds.

The effect of synbiotic supplementation on atherogenic indices, hs-CRP, and malondialdehyde, as major CVD-related parameters, in women with gestational diabetes mellitus: a secondary data-analysis of a randomized double-blind, placebo-controlled study

“…On the other hand, the role of inflammation and increased oxidative stress in the initiation and development of atherosclerosis and susceptibility to CVD is well established [ 7 ]. Gestational diabetes mellitus is demonstrably associated with increased levels of both inflammation and oxidative stress [ 8 ]. Insulin resistance causes an increase in blood high-sensitive C-reactive protein (hs-CRP) and malondialdehyde (MDA), which are important inflammatory and oxidative stress markers in women with GDM [ 9 , 10 ].…”

Inflammation and Oxidative Stress Induced by Obesity, Gestational Diabetes, and Preeclampsia in Pregnancy: Role of High-Density Lipoproteins as Vectors for Bioactive Compounds

“…Some of these bioactive compounds include phytochemicals, phenolic compounds, polysaccharides, and unsaturated fatty acids. During pregnancy, the consumption and functionality of these compounds have been established [26], especially in the prevention of diseases and health promotion for both mother and fetus in the different phases of the gestational period [27][28][29].…”

Lipidomics in gestational diabetes mellitus

“…Due to the multifactorial etiology, pathogenesis mechanisms of GDM remain largely unknown. Nevertheless, insulin resistance caused by obesity, inflammation and oxidative stress is currently considered the major pathogenic mechanism of GDM [9][10][11][12][13], in which lipids are involved [9,14,15]. Previous mechanistic studies have demonstrated that some classes of lipids, such as free fatty acids [16][17][18], phospholipids [19,20] and sphingolipids [20][21][22] are closely related to insulin resistance.…”