The role of dietary fiber on preventing gestational diabetes mellitus in an at-risk group of high triglyceride-glucose index women: a randomized controlled trial

Abstract

BackgroundPregnant women with a high triglyceride-glucose (TyG) index during early pregnancy may increase the risk of gestational diabetes mellitus (GDM), and dietary ber could play an important role in glucose and lipid metabolism. However, no trials have tested the effects of dietary ber on preventing GDM in women with a high TyG index. This study aims to investigate whether GDM can be prevented by dietary ber supplementation in women with a TyG index ≥ 8.5 during early pregnancy (< 20 weeks). MethodsA randomized clinical trial was performed among 295 women with a TyG index ≥ 8.5 before 20 weeks of gestation, divided into a ber group (24 g dietary ber powder/day) or a control group (usual care). The intervention was conducted from 20 to 24 + 6 gestational weeks, and both groups received guidance on exercise and diet. The primary outcomes were the incidence of GDM diagnosed by a 75 g oral glucose tolerance test (OGTT) at 25-28 gestational weeks, and levels of maternal blood glucose, lipids.Secondary outcomes include gestational hypertension, postpartum haemorrhage, preterm birth, and other maternal and neonatal complications. ResultsGDM occurred at 11.2% (10 of 89) in the ber group, which was signi cantly lower than 23.7 (44 of 186) in the control group (P = 0.015). The mean gestational weeks increased dramatically in the ber group compared with the control group (38.58 ± 1.44 weeks vs. 39.07 ± 1.08 weeks, P = 0.016). The incidence of preterm birth was 2.3% (2 of 86) of women randomized to the ber group compared with 9.4% (17 of 181) in the control group (P = 0.032). The concentrations of 2 hour postprandial blood glucose showed statistically higher in the control group compared with the intervention group (6.69 ± 1.65 mmol/L vs. 6.45 ± 1.25 mmol/L, P = 0.026);. There were no other signi cant differences between groups in lipid pro le values, or other secondary outcomes. ConclusionAn intervention with dietary ber supplementation during pregnancy may prevent GDM and preterm birth in women with a TyG index ≥ 8.5 before 20 weeks of gestation.

Consumption of Chokeberry Bio-Products Improves Specific Metabolic Parameters and Increases the Plasma Antioxidant Status

“…However, no effect on the lipid profile was observed [ 49 ]. In another study from 2023, it was observed that dietary fiber supplementation (24 g of dietary fiber powder/day) during pregnancy may prevent gestational diabetes mellitus and preterm birth in women before 20 weeks of gestation [ 50 ].…”

Strategies for Safeguarding High-Risk Pregnancies From Preterm Birth: A Narrative Review

“…Lifestyle modifications such as diet and physical activity can reduce gestational weight gain and may even reduce postnatal weight retention, GDM, hypertension, cesarean section, preeclampsia, and preterm birth [43]. Women with a high triglyceride-glucose index may be at increased risk for developing GDM; dietary fibers can reduce the risk of GDM significantly, decrease preterm birth, and significantly increase gestational age [44]. Smoking is associated with adverse neonatal outcomes; when compared with women who stopped smoking during pregnancy, women who continued smoking had a significantly higher risk of low birth weight and preterm birth (aOR=1.31) [45].…”

Nutrients as Risk Factors and Treatments for Gestational Diabetes

“…Dietary macronutrients have also been linked to increasing GDM risk including the consumption of low fiber, high glycemic index diets [12] and low carbohydrate, high-fat diets [13]. Of late a whole host of dietary strategies have been or are being studied to investigate potential links with alterations in GDM risk, including variations of the Mediterraneanstyle diet [14,15], high-fiber diets [16], diets with high complex carbohydrate contents [17], plant-based dietary patterns [18], diets high in probiotic yogurt contents [19], and diets with high colorful fruit and vegetable contents [20]. Further, observational dietary studies have reported associations between GDM risk and protein intake in early pregnancy (higher risk with increased early animal protein intakes and lower risk with increased early plant protein intakes [21]).…”