Identification of potential biomarkers and metabolic insights for gestational diabetes prevention: A review of evidence contrasting gestational diabetes versus weight loss studies that may direct future nutritional metabolomics studies.

Gestational diabetes mellitus (GDM) significantly increases maternal health risks and adverse effects for the offspring. Observational studies suggest that weight loss before pregnancy may be a promising GDM prevention method. Still, biochemical pathways linking preconception weight changes with subsequent development of GDM among women who are overweight or obese remain unclear. Metabolomic assessment is a powerful approach for understanding the global biochemical pathways linking preconception weight changes and subsequent GDM. We hypothesize that many of the alterations of metabolite levels associated with GDM will change in one direction in GDM studies but will change in the opposite direction in studies focusing on lifestyle interventions for weight loss. The present review summarizes available evidence from 21 studies comparing women with GDM with healthy participants and 12 intervention studies that investigated metabolite changes that occurred during weight loss using caloric restriction and behavioral interventions. We discuss 15 metabolites, including amino acids, lipids, amines, carbohydrates, and carbohydrate derivatives. Of particular note are the altered levels of branched-chain amino acids, alanine, palmitoleic acid, lysophosphatidylcholine 18:1, and hypoxanthine because of their mechanistic links to insulin resistance and weight change. Mechanisms that may explain how these metabolite modifications contribute to GDM development in those who are overweight or obese are proposed, including insulin resistance pathways. Future nutritional metabolomics preconception intervention studies in overweight or obese are necessary to investigate whether weight loss through lifestyle intervention can reduce GDM occurrence in association with these metabolite alterations and to test the value of these metabolites as potential diagnostic biomarkers of GDM development.

Assessment of a University Campus Food Environment, California, 2015.

INTRODUCTION: University campuses offer an opportunity to study the extent to which modifying the food environment influences eating, but in-depth characterizations of campus food environments are needed to identify potential targets for intervention. The objective of this project was to describe the availability, accessibility, and quality of healthful food choices in dining venues and food stores at or near a public, 4-year university in California. METHODS: Trained assessors used the Nutrition Environment Measures Survey for campus dining (NEMS-CD) to evaluate all 18 campus dining venues, and NEMS for stores (NEMS-S) to evaluate 2 on-campus and 37 off-campus food stores. We calculated prevalence of healthful and unhealthful constructs (eg, availability of selected food items, presence of signage encouraging healthful eating, pricing options that encourage healthful eating), based on the NEMS and compared scores across different types of venues. RESULTS: NEMS-CD scores ranged from 4 to 47 (mean [SD], 26.0 [14.4]) out of a possible maximum score of 97; 12% of entrées and 36% of main dish salads served in these venues were classified as healthful. NEMS-S score for the 2 on-campus food stores (24 for both) was intermediate between off-campus convenience stores (mean [SD], 12.0 [5.3]) and grocery/supermarket stores (mean [SD], 31.1 [10.0]), with a possible maximum score of 54. CONCLUSION: Standardized environmental evaluation provides insights into both positive and negative aspects of campus community food venues. Environmental assessment identifies potential targets for modification and baseline data for designing and implementing action-oriented research aimed at improving the campus food environment's support of healthful food choices for college students.