The Role of Diet in the Prevention of Diabetes among Women with Prior Gestational Diabetes: A Systematic Review of Intervention and Observational Studies.
Study Goal
The researchers aimed to review evidence on the effects of dietary interventions, including low-carbohydrate diets, on the risk of developing type 2 diabetes mellitus (T2DM) in women with a history of gestational diabetes (GDM).
Results Summary
The study found trends toward beneficial effects of a low-carbohydrate diet on T2DM outcomes, but results were limited by unclear or high risk of bias in intervention studies. Observational studies suggested poorer outcomes for diets low in carbohydrates and high in animal fat and protein, but better outcomes for diets rich in fruits, vegetables, nuts, fish, and legumes.
Population
Women of any age with a history of gestational diabetes (GDM).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
low-glycemic index diet | decrease | T2DM outcomes | women with a history of GDM | - | trends toward beneficial effects | #1 |
low-carbohydrate diet | decrease | T2DM outcomes | women with a history of GDM | - | trends toward beneficial effects | #2 |
diet in line with general population dietary guidelines | decrease | T2DM outcomes | women with a history of GDM | - | trends toward beneficial effects | #3 |
higher intakes of branched-chain amino acids | increase | diabetes outcomes | women with a history of GDM | - | poorer diabetes outcomes | #4 |
higher intakes of total and heme iron | increase | diabetes outcomes | women with a history of GDM | - | poorer diabetes outcomes | #5 |
diet relatively low in carbohydrates and high in animal fat and protein | increase | diabetes outcomes | women with a history of GDM | - | poorer diabetes outcomes | #6 |
diets rich in fruit, vegetables, nuts, fish, and legumes, and low in red and processed meats and sugar-sweetened beverages | decrease | diabetes outcomes | women with a history of GDM | - | better outcomes | #7 |
BACKGROUND: Women with prior gestational diabetes (GDM) have an increased lifetime risk of developing type 2 diabetes mellitus (T2DM). There are no up-to-date systematic reviews analyzing the relationship of diet with risk of developing T2DM following GDM. OBJECTIVE: To systematically review the evidence from intervention and observational studies on effects of dietary interventions and associations of dietary intake with T2DM outcomes in women with a GDM history. METHODS: Six electronic databases were searched (Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, Cochrane Central, Proquest, and Scopus) for articles published until May 2019. This review includes intervention and observational studies among women of any age with a history of GDM that reported on the effects of dietary interventions or association of dietary intake (energy, nutrients, foods, dietary patterns) with T2DM, impaired glucose tolerance, impaired fasting glucose, or prediabetes. RESULTS: The systematic review identified five articles reporting results from four intervention studies, and seven articles reporting results from four observational studies. Findings from intervention studies indicated trends toward beneficial effects of a low-glycemic index diet, a low-carbohydrate diet, and a diet in line with general population dietary guidelines, but studies had unclear or high risk of bias. Findings from two cross-sectional and one prospective study indicated poorer diabetes outcomes for women with higher intakes of branched-chain amino acids, total and heme iron, and a diet relatively low in carbohydrates and high in animal fat and protein, and better outcomes among those consuming diets rich in fruit, vegetables, nuts, fish, and legumes, and low in red and processed meats and sugar-sweetened beverages, after adjustment for confounders, including body mass index. CONCLUSIONS: Findings from observational studies support current dietary guidelines for the prevention of T2DM. Further dietary intervention studies are needed to confirm whether or not dietary modification following a GDM pregnancy reduces women's risk of developing T2DM.