Zinc Supplementation and the Effects on Pregnancy Outcomes in Gestational Diabetes: a Randomized, Double-blind, Placebo-controlled Trial.

OBJECTIVE: The current study was designed to determine the beneficial effects of zinc intake on biomarkers of inflammation, oxidative stress, and pregnancy outcomes among pregnant women with gestational diabetes (GDM). METHODS: This randomized, double-blind, placebo-controlled clinical trial was conducted among 50 women with GDM. Patients were randomly allocated to intake either 233 mg zinc gluconate (containing 30 mg zinc) (n=25) or a placebo (n=25) for 6 weeks. Fasting blood samples were taken at the fist of the study and after 6 weeks of intervention to quantify related variables. Newborn's weight, height, head circumference, Apgar score, and hyperbilirubinemia were determined. RESULTS: The change in serum zinc levels after 6 weeks of supplementation was greater in women consuming zinc than in the placebo group (+8.5±13.5 vs. -3.6±16.2 mg/dL, P=0.006). Changes in serum high sensitivity C-reactive protein (hs-CRP) (-110.1±1 475.5 vs. +1 137.8±2 429.2 ng/mL, P=0.03) and plasma total antioxidant capacity (TAC) concentrations (+60.0±129.0 vs. -28.4±81.4 mmol/L, P=0.006) were significantly different between the supplemented women and placebo group. We did not find any significant effect of zinc administration on pregnancy outcomes. CONCLUSION: Taken together, zinc administration among patients with GDM was associated with decreased hs-CRP and increased TAC concentrations; however, it did not influence maternal plasma nitric oxide (NO), glutathione (GSH), malondialdehyde (MDA) levels, or pregnancy outcomes.

The effect of DASH diet on pregnancy outcomes in gestational diabetes: a randomized controlled clinical trial.

BACKGROUND/OBJECTIVES: The current study was performed to investigate the effects of the Dietary Approaches to Stop Hypertension (DASH) eating plan on pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). SUBJECTS/METHODS: This randomized controlled clinical trial was performed among 52 women diagnosed with GDM. Participants were randomly assigned to consume either the control (n=26) or the DASH diet (n=26) for 4 weeks. The control diet was designed to contain 45-55% carbohydrates, 15-20% protein and 25-30% total fat. The DASH diet was rich in fruits, vegetables, whole grains and low-fat dairy products, and contained lower amounts of saturated fats, cholesterol and refined grains with a total of 2400 mg/day sodium. The numbers of women who commenced insulin therapy after dietary intervention, the mode of delivery and prevalence of polyhydramnios were assessed. The length, weight and head circumference of infants were measured during the first 24 h after birth. RESULTS: Whereas 46.2% of women in the DASH diet needed to have a cesarean section, this percentage for the control group was 80.8% (P=0.01). The percentage of those who needed to commence insulin therapy after intervention was also significantly different between the two groups (23% for DASH vs 73% for control group, P<0.0001). Infants born to mothers on the DASH diet had significantly lower weight (3222.7 vs 3818.8 g, P<0.0001), head circumference (34.2 vs 35.1 cm, P=0.01) and ponderal index (2.50 vs 2.87 kg/m(3), P<0.0001) compared with those born to mothers on the control diet. CONCLUSIONS: In conclusion, consumption of DASH diet for 4 weeks among pregnant women with GDM resulted in improved pregnancy outcomes.

Effect of daily consumption of probiotic yoghurt on insulin resistance in pregnant women: a randomized controlled trial.

BACKGROUND/OBJECTIVES: Owing to excess body weight and increased secretion of inflammatory cytokines primarily during the third trimester, pregnancy is associated with elevated insulin resistance. To our knowledge, no report is available indicating the effects of probiotic yoghurt consumption on serum insulin levels in pregnant women. This study was designed to determine the effects of daily consumption of probiotic yoghurt on insulin resistance and serum insulin levels of Iranian pregnant women. SUBJECTS/METHODS: In this randomized controlled clinical trial, 70 primigravida pregnant women with singleton pregnancy at their third trimester were participated. We randomly assigned participants to consume 200 g per day of conventional (n=33) or the probiotic group (n=37) for 9 weeks. The probiotic yoghurt was a commercially available product prepared with the starter cultures of Streptococcus thermophilus and Lactobacillus bulgaricus, enriched with probiotic culture of two strains of lactobacilli (Lactobacillus acidophilus LA5) and bifidobacteria (Bifidobacterium animalis BB12) with a total of min 1 × 107 colony-forming units. Fasting blood samples were taken at baseline and after 9-week intervention to measure fasting plasma glucose and serum insulin levels. Homeostatic model assessment of insulin resistance (HOMA-IR) was used to calculate insulin resistance score. RESULTS: Although consumption of probiotic yogurt for 9 weeks did not affect serum insulin levels and HOMA-IR score, significant differences were found comparing changes in these variables between probiotic and conventional yogurts (changes from baseline in serum insulin levels: +1.2±1.2 vs +5.0±1.1 µIU/ml, respectively, P=0.02; and in HOMA-IR score: -0.2±0.3 vs 0.7±0.2, respectively, P=0.01). CONCLUSIONS: It is concluded that in contrast to conventional yogurt, daily consumption of probiotic yogurt for 9 weeks maintains serum insulin levels and might help pregnant women prevent developing insulin resistance.

A randomized controlled clinical trial investigating the effect of calcium supplement plus low-dose aspirin on hs-CRP, oxidative stress and insulin resistance in pregnant women at risk for pre-eclampsia.

Increased levels of pro-inflammatory factors, markers of oxidative stress and insulin resistance during pregnancy have been associated with the development of pre-eclampsia. There is some evidence to suggest that calcium supplement and aspirin can reduce the risk of the disorder. To our knowledge, no reports are available indicating the effects of consumed calcium supplement plus aspirin on high sensitivity C-reactive protein (hs-CRP), oxidative stress parameters and insulin resistance in pregnant women at risk for pre-eclampsia. This study was designed to investigate the effects of consumed calcium supplement plus low-dose aspirin on hs-CRP, oxidative stress parameters and insulin resistance among Iranian pregnant women at risk for pre-eclampsia. This randomized single-blind controlled clinical trial was carried out among 42 pregnant women at risk for pre-eclampsia, primigravida, aged 18-40 year old who were carrying singleton pregnancy at their third trimester. Subjects were randomly assigned to received either the placebo (n = 22) or calcium supplement plus low-dose aspirin (n = 20) for 9 weeks. Calcium supplement plus low-dose aspirin were containing 500 mg carbonate calcium plus 80 mg aspirin. Fasting blood samples were taken at baseline and after 9 weeks intervention to measure serum hs-CRP, oxidative stress parameters including plasma Total Antioxidant Capacity (TAC) and Total Glutathione (GSH), Fasting Plasma Glucose (FPG), serum insulin and HOMA-IR score. Consumption of calcium supplement plus low-dose aspirin resulted in a significant difference serum hs-CRP levels as compared to the placebo (102.87 vs. 3227.75 ng mL(-1), p = 0.01). Also, mean changes for plasma TAC (68.96 vs. -74.46 mmol L(-1), p = 0.04) and total GSH levels (304.33 vs. -39.33 micromol L(-1), p = 0.03) were significantly different between the two groups. No significant differences were found comparing calcium supplement plus low-dose aspirin and placebo in terms of their effects on FPG, serum insulin levels and HOMA-IR. Within-group differences in the placebo group revealed a significant increase in serum hs-CRP levels (3227.75 ng mL(-1), p = 0.008) and marginally significant increase in plasma total GSH levels (304.33 micromol L(-1), p = 0.07). In conclusion, consumption calcium supplement plus low-dose aspirin during pregnancy for 9 weeks in pregnant women at risk for pre-eclampsia resulted in a significant difference serum hs-CRP and increased levels of plasma TAC and total GSH as compared to the placebo group, but could not affect serum insulin levels and HOMA-IR score.