Effect of the Dietary Approaches to Stop Hypertension (DASH) diet on the development of preeclampsia and metabolic outcomes in pregnant women with pre-existing diabetes mellitus: a randomised, controlled, single-blind trial

Abstract

Preeclampsia (PE) affects up to five times more women with pre-existing diabetes mellitus (PDM) than women without it. The present study aimed to identify the effect of the DASH diet on PE incidence (primary outcome) and blood pressure, glycated haemoglobin (GH), serum lipids, glutathione peroxidase (GP), C-reactive protein (CRP – secondary outcomes) in pregnant with PDM. This randomised, controlled, single-blind trial studied sixty-eight pregnant women with PDM throughout prenatal care until delivery (18 weeks) at a public maternity hospital, Brazil. The standard diet group (SDG) received a diet containing 45–65 % carbohydrates, 15–20 % protein and 25–30 % lipids. The DASH diet group (DDG) received the adapted DASH diet with a similar macronutrient distribution, but with a higher concentration of fibres, unsaturated fats, calcium, magnesium and potassium as well as lower saturated fat. Student's t, Mann–Whitney U and the Chi-square tests were used to compare outcomes. PE incidence was 22⋅9 % in the SDG and 12⋅1 % in the DDG (P = 0⋅25). GP levels significantly increased in the DDG (intra-group analysis; mean difference = 1588 [CI 181, 2994], P = 0⋅03) and tended to be different from the variation in the SDG (mean difference = −29⋅5 [CI −1305; 1⋅365]; v. DDG: 1588 [CI 181; 2994], P = 0⋅09). GH levels decreased significantly and similarly between groups (SDG: −0⋅61 [CI −0⋅26, −0⋅96], P = 0⋅00) v. DDG: −1⋅1 [CI −0⋅57, −1⋅62], P = 0⋅00). There was no evidence of a difference in PE incidence at the end of the intervention between the two diets. The DASH diet seems to favour PE-related biochemical markers.

Influence of the DASH Diet on Gestational Weight Gain and Perinatal Outcomes in Women with Pre-Existing Diabetes Mellitus: A Randomized, Single-Blind, Controlled Clinical Trial

“…Although there were two fetal deaths (one was premature delivery at 34 weeks and 3 days, a newborn with Potter syndrome in the DDG, and the other was born at 36 weeks and 4 days in SDG-of unknown cause), there was no difference in the incidence of maternal complications between the study groups (SDG: 31%, n = 11, v. DDG: 30%, n = 10; p = 0.92),the most frequent being pre-eclampsia that affected 18% of women, without difference between study groups (p = 0.24; Tables in [17]). There was a mean reduction in glycated hemoglobin for both study groups, with no statistical difference between them (p = 0.12-Tables in [17]).…”

“…Regarding diet adherence in both groups, at least 48% of pregnant women showed good adherence to the diet considering all appointments with the nutritionist, and there was no difference between groups at any of the nutritional appointments (p > 0.05-Tables in [17]).…”

“…This study presents secondary results from the randomized, controlled, single-blind clinical trial. Details on the diets applied in the intervention for DDG and SDG are described in the publications by Belfort et al [17] and Fagherazzi et al [18]…”

C-reactive protein, pharmacological treatments and diet: how to target your inflammatory burden

“…The positive effect of DASH nutrition is mainly on anthropometric indices such as body-mass index, but also improvements in blood pressure and glucose levels [53–55]. A small number of studies have reported lowered levels of CRP after initiation of the DASH diet, whilst other report conflicting results (see Table 3 for selected randomized-controlled trials investigating the effect of the DASH diet on inflammatory biomarkers) [56 ▪▪ ,57–59]. From a mechanistic viewpoint, the ani-inflammatory effect of the DASH diet could be mostly attributed to an increased uptake of vegetables as well as fruits, which have been proven to reduce inflammatory burden [60].…”

Gestasyonel Diyabette Akdeniz ve DASH Diyetinin Yeri

“…Çalışmalar Akdeniz diyetine bağlılığın, GDM gelişim riskini azaltabileceğini göstermiştir [12], [13]. Yapılan çalışmalarda, Hipertansiyonu Durdurmaya Yönelik Diyet Yaklaşımları (DASH) diyetinin fetüs üzerindeki yararlı etkilerine ek olarak, bu diyetin GDM'li kadınlar tarafından uzun süreli uygulanması aynı zamanda açlık ve tokluk kan şekerini, serum lipitlerini ve anne kan basıncını azaltarak anne sağlığının iyileştirilmesine de katkıda bulunabileceğini ortaya konulmuştur [14], [15], [16].…”