Dietary supplementation for gestational diabetes prevention and management: a meta-analysis of randomized controlled trials.

PURPOSE: The use of supplement to prevent and ease gestational diabetes (GDM) progression has been examined in various studies, but the results were inconclusive, and studies evaluated dietary supplements separately. The present review aimed to evaluate the efficacy of various dietary supplementation on GDM risk and the surrogate markers for cardiometabolic risk of pregnant women with GDM. METHODS: A comprehensive search on multiple databases were performed to identify randomized controlled trials. Random-effects model was used to pool the results in relative risk (RR) or mean difference. RESULTS: Fifty-three randomized controlled studies with 9443 pregnant women were included. Vitamin D (5 studies, RR 0.64; 95% CI 0.44, 0.94) and myo-inositol (4 studies, RR 0.34, 95% CI 0.20, 0.58) supplementation significantly reduced the risk of GDM. Myo-inositol, probiotics, and vitamin D showed significant intervention effect on surrogate markers related to glycemic control, lipid profile, inflammatory, and oxidative stress. However, the majority of included studies were clustered to Iran and Italy, which might convey a generalizability bias. CONCLUSION: Dietary supplementation including vitamin D and myoinositol supplementation has the potential in primary prevention and management of GDM, whereas probiotics demonstrated its ability in GDM management by improving the levels of surrogate markers for cardiometabolic risk. The potential for dietary supplement in preventing GDM or managing cardiometabolic risk of pregnant women should receive more attentions.

Reproducibility and Relative Validity of a Short Food Frequency Questionnaire for Chinese Older Adults in Hong Kong.

Changes in an individual's digestive system, hormones, senses of smell and taste, and energy requirement accompanying aging could lead to impaired appetite, but older adults may not notice their risk of nutrient deficiency. When assessing the dietary intake of older adults, it was found that they had more difficulties with short-term recall and open-ended recall and would experience greater fatigue and frustration when compared to younger individuals when completing a lengthy questionnaire. There is a need to develop a brief dietary assessment tool to examine the nutritional needs of older adults. In this study, we aimed to assess the diet of Hong Kong older adults using the short FFQ and examine its reproducibility and relative validity as a dietary assessment tool. Dietary data of 198 older adults were collected via FFQs and three-day dietary records. Correlation analyses, cross-tabulation, one-sample t-tests, and linear regression analyses were used to evaluate the relative validity of the short FFQ. In general, the short FFQ was accurate in assessing the intake of phosphorus, water, grains, and wine, as shown by a significant correlation (>0.7) between values reported in the FFQs and dietary records; good agreement (more than 50% of observations belonged to the same quartile) and insignificant differences detected with the one-sample t-tests and linear regression analyses were observed for the above four variables. Additionally, the intake of proteins, carbohydrates, total fat, magnesium, and eggs in terms of the values reported in the FFQs and dietary records showed good agreement.

Relative Validity of a Short Food Frequency Questionnaire for Disadvantaged Families in Hong Kong.

Individuals with lower socioeconomic status are more vulnerable in securing good nutritional quality. It was also found that people who had received a lower education level had greater difficulty in completing the conventional dietary assessment such as a food frequency questionnaire (FFQ). Previous studies have demonstrated the validity of a short FFQ in Hong Kong's pregnant women, but its validity among a wider community was still unknown. For the present study, we aimed to validate a short FFQ among disadvantaged communities in Hong Kong. Amongst 103 individuals participating in a dietary intervention programme, their dietary data were collected by FFQs and three-day dietary records. Relative validity was assessed by correlation analysis, cross-tabulation, one-sample t-test, and linear regression. In general, water and total energy intake had significant correlations (0.77 for crude water intake and 0.87 for crude total energy intake) between values reported by FFQ and dietary records, good agreement (both with over 50% of observations falling into the same quartile), and insignificant differences between assessment methods reported by one-sample t-test and linear regression. Meanwhile, several nutrients had good agreement in terms of the values reported by FFQ and dietary records, such as energy from total fat, carbohydrates, total fat, cholesterol, phosphorus, and potassium. The results of this study demonstrated that the short version FFQ could be a convenient assessment tool of multiple dietary behaviors, especially in total energy and water intakes.

Carotenoids and Vitamin A in Breastmilk of Hong Kong Lactating Mothers and Their Relationships with Maternal Diet.

Carotenoids and vitamin A are nutrients crucial to infants' development. To date, there is limited data on their availability in breastmilk and the associated dietary factors, especially in Hong Kong, where people follow a westernized Chinese diet. This study determined the selected breastmilk's carotenoid and vitamin A (retinol) contents by ultraperformance liquid chromatography with photodiode detection (UPLC-PDA) and the dietary intakes by three-day food records in 87 Hong Kong lactating mothers, who were grouped into tertiles based on their daily carotenoid intake. Low vitamin A intake (530.2 ± 34.2 µg RAE/day) and breastmilk retinol level (1013.4 ± 36.8 nmol/L) were reported in our participants, suggesting a poor vitamin A status of the lactating participants having relatively higher socioeconomic status in Hong Kong. Mothers in the highest tertile (T3) had higher breastmilk carotenoid levels than those in the lowest (T1) (p < 0.05). There were significant associations between maternal carotenoid intakes and breastmilk lutein levels in the linear regression models (p < 0.05) regardless of dietary supplement intake. Furthermore, maternal dark green vegetable intakes were associated with breastmilk retinol, lutein, and ß-carotene levels. These findings can serve as dietary references for lactating mothers to enhance breastmilk carotenoid and vitamin A contents for the benefits of child growth and development.

Levels of polyphenols and phenolic metabolites in breast milk and their association with plant-based food intake in Hong Kong lactating women.

Dietary polyphenols are phytonutrients exhibiting multiple health benefits in humans including those in infants. However, data on breast milk (poly)phenolic composition are limited, especially among Asian populations. This study aimed to assess the levels of dietary polyphenols and their microbial-derived metabolites in the breast milk of Hong Kong lactating women, and how maternal diet correlated with the phenolic composition in breast milk. Breast milk samples from 89 healthy Hong Kong lactating women (aged 19-40 years) were collected. Maternal intake of plant-based foods and polyphenols was estimated through 3-day dietary records and the Phenol-Explorer database. Twelve commonly consumed polyphenols including their microbial-derived metabolites in breast milk were quantified using an optimized and validated UHPLC-MS/MS method. The effect of maternal intake on breast milk phenolic levels was then examined via the Pearson correlation test. The mean concentrations of individual phenolic compounds ranged from 5.1 nmol L-1 (chlorogenic acid) to 731.5 nmol L-1 (3,4-dihydroxybenzoic acid). Despite suboptimal intake of fruits and vegetables among our participants, breast milk phenolic levels were comparable to those of foreign populations. Significant correlations were found between dietary intake and multiple phenolics, particularly legume and daidzein (r = 0.33, P = 0.001), and tea and epicatechin (r = 0.30, P = 0.03). Regarding phenolic metabolites, 3,4-dihydroxyphenylacetic acid was significantly correlated with several polyphenols, particularly quercetin (r = 0.34, P = 0.002), and equol was exclusively correlated with daidzein (r = 0.46, P < 0.001). Our findings support that intake of plant-based foods significantly affects breast milk phenolic composition. Future investigation on the bioavailability and health outcomes in infants is warranted to substantiate the transferability of these bioactive phytonutrients from mother to child through lactation, and to promote maternal intake of polyphenol-rich foods.