Impact of the Dietary Approaches to Stop Hypertension (DASH) diet on glycaemic control and consumption of processed and ultraprocessed foods in pregnant women with pre-gestational diabetes mellitus: a randomised clinical trial

Abstract

The aim of this study was to evaluate the impact of the Dietary Approaches to Stop Hypertension (DASH) diet on glycaemic control and consumption of processed (PF) and ultraprocessed (UPF) foods in pregnant women with pre-gestational diabetes mellitus (PGDM). This is a randomised, controlled, single-blind clinical trial with forty-nine adult women with PGDM, followed at a public maternity hospital in Rio de Janeiro, Brazil. The control group (CG) received a standard diet consisting of 45–55 % of the total energy intake of carbohydrates, 15–20 % of proteins and 25–30 % of lipids. The DASH group (DG) received an adapted DASH diet, which did not differ from the standard diet in the percentage of macronutrients, but had higher contents of fibre, unsaturated fats and minerals such as Ca, Mg and K; and lower contents of Na and saturated fats than the standard diet. In the analysis by protocol, the DG presented a higher incidence of glycaemic control after 12 weeks of intervention (57·1 v. 8·3 %, P = 0·01, moderate effect size) and a lower mean consumption of UPF (−9·9 %, P = 0·01) compared with the CG. There was no statistically significant difference in fasting and postprandial blood glucose concentrations, or in the consumption of PF between the groups (P > 0·05). The DASH diet may be a strategy for glycaemic control in pregnant women with PGDM, favouring the adoption of a nutritionally adequate diet with lower consumption of UPF. Further studies are needed to investigate the effect of the DASH diet on glycaemic profile, and maternal and perinatal outcomes in women with PGDM.

Ultra-Processed Foods: A Narrative Review of the Impact on the Human Gut Microbiome and Variations in Classification Methods

“…To date, only one study (resulting in at least two publications) has been completed that compares a study-provided UPF diet to an unprocessed diet [ 62 , 63 ]; however, at least two additional studies are currently underway [ 31 , 64 ]. For the studies not providing a UPF diet, two used 24 h dietary recalls [ 65 , 66 ], three used FFQs [ 67 , 68 , 69 ], and one used food records [ 70 ] to collect food information. Generally, the RCT studies that include information on discrepancy resolution describe either a majority-rule or consensus method between study team members about unclear food and beverage items [ 66 , 67 , 69 , 70 ].…”

“…Food records and 24 h dietary recalls provide the most specific and individualized accounts of food information. To our knowledge, no RCT studies using these methods have been designed to examine UPFs vs. non-UPFs in free-living individuals as the primary outcome; however, several have examined intake of UPFs as a secondary analysis to other dietary or health-related interventions [ 65 , 66 , 70 ]. Because these are secondary analyses, information relevant to categorizing UPFs may be missing in some cases.…”

A Pilot Study of Dietetic, Phenotypic, and Genotypic Features Influencing Hypertensive Disorders of Pregnancy in Women with Pregestational Diabetes Mellitus

“…It also included a daily serving of nuts. The original version of the DASH diet was translated and adapted for the DASDIA trial to consider the characteristics of Brazilian pregnant women with DM, as detailed elsewhere [ 22 , 23 , 24 ].…”

Metabolites of Gut Microbiota and Possible Implication in Development of Diabetes Mellitus

“…Functional foods like whole grains are able to increase the secretion of glucagon-like peptide-1 (GLP-1) and insulin, while nuts and cinnamon can alleviate the inflammation and improve insulin resistance . Dietary approaches to stop hypertension diet is beneficial to the glycaemic control in pre-GDM . Clinical trials show that vegan and Mediterranean dietary patterns are also beneficial for the glycemic control in T2DM, while almonds and peanuts added in diets are able to improve the fasting and postprandial blood glucose in T2DM patients …”

“…81 Dietary approaches to stop hypertension diet is beneficial to the glycaemic control in pre-GDM. 82 Clinical trials show that vegan and Mediterranean dietary patterns are also beneficial for the glycemic control in T2DM, 83 while almonds and peanuts added in diets are able to improve the fasting and postprandial blood glucose in T2DM patients. 84 ■ LPS AND GUT MICROBIOTA DYSBIOSIS IN DM Excessive Production of LPS and Inflammation.…”