Preeclampsia Alternatives
May 25, 2011 Written by JP [Font too small?]Think of all the pregnancies that take place during the course of a given year. Thankfully, most are relatively free of serious complications. But, about 5% to 8% of all expectant mothers must contend with a condition known as preeclampsia (PE) that threatens both woman and child. Preeclampsia is characterized by a dangerous rise in blood pressure that occurs after the 20th week of pregnancy. Some of the possible symptoms include abdominal pain, nausea, vomiting, blurred vision with the appearance of auras and spots, and swelling in the eyes, face and hands or edema. According to the Preeclampsia Foundation this contributes approximately seven billion dollars a year in US health care spending alone. Worldwide, it may account for as many as 76,000 deaths annually. (1,2,3)
There are numerous known and suspected risk factors for preeclampsia. A history of diabetes, high blood pressure and kidney disease tops the list. First pregnancy and “multiple pregnancy (twins or more)”, also increases the likelihood. Obesity and pregnancies involving mothers over the age of 35 are similarly linked to pregnancy induced hypertension.
Diet is the first issue to address in the hope of reducing preeclampsia risk. Several recent studies in the medical literature describe a style of eating that may afford significant protection. The primary approach for dealing with PE nutritionally involves maintaining optimal blood sugar levels. This can largely be accomplished by eating a whole food based diet that’s rich in healthy sources of fat and protein, low glycemic fruits and non-starchy vegetables. Such a menu plan is naturally high in antioxidants, fiber, minerals and vitamins. It not only helps to minimize excessive weight gain, but also supports insulin sensitivity. This latter point is pivotal because insulin resistance has been repeatedly linked to greater preeclampsia incidence. (4,5,6,7,8,9,10)
Experiencing distress as part of pregnancy is not uncommon. However, that’s not to say that stress should simply be accepted as the norm and that there are no consequences involved. Feeling stressed out isn’t just a state of mind. Psychological distress is known to adversely affect immune and neuroendocrine function. In fact, higher levels of stress hormones, such as cortisol, may actually contribute to preeclampsia risk and subsequent mental health issues in offspring. Mind/body therapies ranging from gentle forms of exercise and yoga to guided imagery have all been shown to improve quality of life and moderate blood pressure in hypertensive pregnant women. (11,12,13,14,15)
Next, let’s discuss so-called “medicinal foods”. The amino acid arginine may be of specific value to women at risk for preeclampsia. The latest issue of the British Medical Journal describes how a nutritional bar providing a total of 6.6 grams of arginine/day effectively reduced the risk of PE in a group of 222 pregnant women. A placebo bar and a bar containing added antioxidants (Vitamins C and E) were used as comparison models. The interventional bar also contained Vitamins C and E along with supplemental arginine. It outperformed both the placebo and the antioxidant-only bars. This finding is supported by several previous trials that have utilized encapsulated and tablet forms of the amino acid. Cardiologists believe that arginine invokes a hypotensive response by increasing the production of nitric oxide, a vasodilator. A few points of note about this protein component: a) it only appears to lower blood pressure when used for prolonged periods of time; b) many foods are abundant sources of naturally occurring arginine including: crab, peanuts, sesame seeds, shrimp, soybeans, spinach, turkey and watercress. (16,17,18,19,20)
Preparing for pregnancy by taking a high potency prenatal or female specific multivitamin/mineral is another proactive step one can take to avoid PE. Well formulated multi-nutrient supplements will provide optimal quantities of macro and micro nutrients such as magnesium, selenium, Vitamin D and zinc which have all been associated with lower preeclampsia occurrence. Calcium, one of the most important minerals with respect to PE, probably won’t be found in sufficient amounts in one-a-day products. Therefore, a separate calcium or calcium/magnesium supplement is often recommended. (21,22,23,24,25,26,27)
Changes in Calcium Metabolism During Pregnancy May Contribute to Preeclampsia Risk
Source: Curr Clin Pharmacol. 2009 September; 4(3): 172–190. (link)
Two “C”s come to mind when I think of preeclampsia. The first C is for chocolate. That’s right, chocolate. Recent studies indicate that moderate amounts of chocolate consumption may significantly reduce the risk of preeclampsia and gestational hypertension. One publication found that eating chocolate regularly reduced the odds of PE by over 40%. Another investigation found that women who ate 5 or more servings of cocoa per week exhibited a decreased risk of 19% during their first trimester and 40% in the final three months of pregnancy. The second C stands for Coenzyme Q10, a lipid soluble antioxidant that plays an important role in cellular energy production. Publications dating back to 2003 have identified lower plasma levels of CoQ10 in patients with preeclampsia. In 2009, a trial set out to determine whether supplemental CoQ10 (200 mg/day) would aid those with PE. The results revealed a relative risk reduction of 44% in those receiving CoQ10 compared to a placebo. Unfortunately there hasn’t been any follow-up research in this area. As such, the initial promise of CoQ10 should be considered preliminary. (28,29,30,31,32,33)
Protecting yourself and your baby from preeclampsia starts with treating yourself right. As you were reading today’s column you may have noticed that many of the points I made could very well have been included in blogs about completely different health topics. The promotion of good health often functions in just that way. There are definite crossover benefits that apply to core diet and lifestyle guidelines. But, there are also some provisions that are condition specific. A final example has to do with one of my favorite dietary components: tea. Surprisingly, drinking tea daily may increase the risk of PE, possibly due to interference with the absorption and retention of essential nutrients including folic acid and iron. This simply goes to show that not every natural food and remedy is appropriate under every circumstance. But it also illustrates how much more control we can exert over our own health care future by simply being well informed. (34,35,36,37,38)
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Be well!
JP
Tags: Arginine, High Blood Pressure, Pregnancy
Posted in Children's Health, Nutrition, Women's Health
May 26th, 2011 at 7:18 pm
Hi JP,
A very valuable conclusion: you must stay informed!
Even drinking healthy teas needs to be done in moderation otherwise you may hinder the absortion of folic acid or iron!
This are unexpected news!. So the bottom line is: stay informed and vary your diet!
Thank you for keeping us informed!
God bless you dedication to your passion!
Paul
May 26th, 2011 at 7:34 pm
Thank you, Paul! 🙂
We agree once again!
Be well!
JP
May 27th, 2011 at 2:14 pm
Thanks for touching on Preeclampsia… We have had more than a few friends go through this in the last year or two… Hopefully we are able to limit the number of cases in the future.
January 30th, 2015 at 2:55 pm
Update:
http://www.nature.com/ejcn/journal/vaop/ncurrent/full/ejcn2014295a.html
Eur J Clin Nutr. 2015 Jan 28.
Folic acid supplementation and dietary folate intake, and risk of preeclampsia.
Background/Objectives: Folic acid supplementation has been suggested to reduce the risk of preeclampsia. However, results from few epidemiologic studies have been inconclusive. We investigated the hypothesis that folic acid supplementation and dietary folate intake before conception and during pregnancy reduce the risk of preeclampsia.
Subjects/Methods: A birth cohort study was conducted in 2010-2012 at the Gansu Provincial Maternity & Child Care Hospital in Lanzhou, China. A total of 10 041 pregnant women without chronic hypertension or gestational hypertension were enrolled.
Results: Compared with nonusers, folic acid supplement users had a reduced risk of preeclampsia (OR=0.61, 95% CI: 0.43-0.87). A significant dose-response of duration of use was observed among women who used folic acid supplemention during pregnancy only (P-trend=0.007). The reduced risk associated with folic acid supplement was similar for mild or severe preeclampsia and for early- or late-onset preeclampsia, although the statistical significant associations were only observed for mild (OR=0.50, 95% CI: 0.30-0.81) and late-onset (OR=0.60, 95% CI: 0.42-0.86) preeclampsia. The reduced risk associated with dietary folate intake during pregnancy was only seen for severe preeclampsia (OR=0.52, 95% CI: 0.31-0.87, for the highest quartile of dietary folate intake compared with the lowest).
Conclusions: Our study results suggest that folic acid supplementation and higher dietary folate intake during pregnancy reduce the risk of preeclampsia. Future studies are needed to confirm the associations.
Be well!
JP
May 6th, 2015 at 3:45 pm
Update 05/06/15:
https://www.thieme-connect.com/DOI/DOI?10.1055/s-0035-1548835
Horm Metab Res. 2015 May 4.
Effects of High-Dose Vitamin D Supplementation on Metabolic Status and Pregnancy Outcomes in Pregnant Women at Risk for Pre-Eclampsia.
This study was designed to assess the beneficial effects of high-dose (cholecalciferol) vitamin D supplementation on metabolic profiles and pregnancy outcomes among pregnant women at risk for pre-eclampsia. This randomized double-blind placebo-controlled clinical trial was performed among 60 pregnant women at risk for pre-eclampsia according to abnormal uterine artery Doppler waveform. Subjects were randomly divided into 2 groups to receive 50 000 IU vitamin D supplements (n=30) or receive placebo (n=30) every 2 weeks from 20 to 32 weeks of gestation. Fasting blood samples were taken at baseline study and 12 weeks after the intervention to quantify relevant variables. Newborn’s anthropometric measurements were determined. Pregnant women who received cholecalciferol supplements had significantly increased serum 25-hydroxyvitamin D concentrations (+17.92±2.28 vs. +0.27±3.19 ng/ml, p<0.001) compared with the placebo. The administration of cholecalciferol supplements, compared with the placebo, resulted in significant differences in serum insulin concentrations (+1.08±6.80 vs. +9.57±10.32 μIU/ml, p<0.001), homeostasis model of assessment-insulin resistance (HOMA-IR) (+0.19±1.47 vs. +2.10±2.67, p<0.001), homeostatic model assessment-beta cell function (HOMA-B) (+5.82±29.58 vs. +39.81±38.00, p<0.001) and quantitative insulin sensitivity check index (QUICKI) score (-0.009±0.03 vs. -0.04±0.03, p=0.004). Furthermore, cholecalciferol-supplemented pregnant women had increased HDL-cholesterol concentrations (+2.67 ± 8.83 vs. -3.23±7.76 mg/dl, p=0.008) compared with the placebo. Finally, cholecalciferol supplementation led to a significant rise in plasma total antioxidant capacity (TAC) concentrations (+79.00±136.69 vs. -66.91±176.02 mmol/l, p=0.001) compared with the placebo. Totally, the administration of cholecalciferol supplements among pregnant women at risk for pre-eclampsia for 12 weeks had favorable effects on insulin metabolism parameters, serum HDL-cholesterol, and plasma TAC concentrations.
Be well!
JP
July 15th, 2015 at 2:22 pm
Update 07/15/15:
http://onlinelibrary.wiley.com/doi/10.1111/ijn.12171/abstract
Int J Nurs Pract. 2015 May;21 Suppl 2:19-31.
Calcium supplementation reducing the risk of hypertensive disorders of pregnancy and related problems: A meta-analysis of multicentre randomized controlled trials.
Hypertensive disorders of pregnancy are closely related to maternal mortality and morbidity. Calcium supplementation during pregnancy seems to reduce the risk of hypertensive disorders. No systematic review on multicentre RCTs of calcium supplementation during pregnancy has been published. The purpose of this study was to report a quantitative systematic review of the effectiveness of calcium supplementation during pregnancy on reducing the risk of hypertensive disorders of pregnancy and related problems. Publications over the years of 1991-2012 were searched through PubMed, Science Direct, EMBASE, CINAHL and Web of Science. The literatures were selected of the multicentre RCTs on calcium supplementation during pregnancy in prevention of hypertensive disorders and related problems. Reference lists from the studies were also examined for additional references. Studies were critically appraised by three independent reviewers, and the Cochrane Handbook was used to assess the quality of those included trials. Four studies were included in this systematic review. All included studies were high quality, with low risk of bias. There was an observed risk reduction in hypertension in calcium group. However, there was no reduction in the risk of severe gestational hypertension, pre-eclampsia, severe pre-eclampsia, preterm birth and low birthweight. Calcium supplementation appears to reduce the risk of hypertension in pregnancy.
Be well!
JP
July 15th, 2015 at 2:24 pm
Update 07/15/15:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490485/
Int J Mol Sci. 2015 Jun 9;16(6):13043-64.
A Proposed Molecular Mechanism of High-Dose Vitamin D3 Supplementation in Prevention and Treatment of Preeclampsia.
A randomized prospective clinical study performed on a group of 74 pregnant women (43 presenting with severe preeclampsia) proved that urinary levels of 15-F2t-isoprostane were significantly higher in preeclamptic patients relative to the control (3.05 vs. 2.00 ng/mg creatinine). Surprisingly enough, plasma levels of 25-hydroxyvitamin D3 in both study groups were below the clinical reference range with no significant difference between the groups. In vitro study performed on isolated placental mitochondria and placental cell line showed that suicidal self-oxidation of cytochrome P450scc may lead to structural disintegration of heme, potentially contributing to enhancement of oxidative stress phenomena in the course of preeclampsia. As placental cytochrome P450scc pleiotropic activity is implicated in the metabolism of free radical mediated arachidonic acid derivatives as well as multiple Vitamin D3 hydroxylations and progesterone synthesis, we propose that Vitamin D3 might act as a competitive inhibitor of placental cytochrome P450scc preventing the production of lipid peroxides or excess progesterone synthesis, both of which may contribute to the etiopathogenesis of preeclampsia. The proposed molecular mechanism is in accord with the preliminary clinical observations on the surprisingly high efficacy of high-dose Vitamin D3 supplementation in prevention and treatment of preeclampsia.
Be well!
JP
August 6th, 2015 at 3:51 pm
Updated 08/06/15:
http://www.ncbi.nlm.nih.gov/pubmed/26233572?dopt=Abstract
J Diabetes Complications. 2015 Jul 4.
Zinc supplementation and the effects on metabolic status in gestational diabetes: A randomized, double-blind, placebo-controlled trial.
OBJECTIVE: To the best of our knowledge, no reports are available indicating the effects of zinc supplementation on metabolic status in women with gestational diabetes (GDM). This study was designed to determine the effects of zinc supplementation on glucose homeostasis parameters and lipid concentrations in GDM women.
METHODS: This randomized, double-blind, placebo-controlled trial was performed among 58 women diagnosed with GDM, primigravida and aged 18-40years old. Patients were randomly divided into two groups to receive 233mg zinc gluconate (containing 30mg zinc) supplements (n=29) or placebo (n=29) per day for 6weeks. Fasting blood samples were taken at the beginning and end of the trial to quantify glucose, insulin and lipid concentrations.
RESULTS: Patients who received zinc supplements had significantly higher serum zinc concentrations (+6.9±13.2 vs. -1.5±16.5mg/dL, P=0.03) than those received the placebo. In addition, zinc-supplemented patients had reduced fasting plasma glucose (FPG) (-6.6±11.2 vs. +0.6±6.7mg/dL, P=0.005), serum insulin levels (-1.3±6.6 vs. +6.6±12.2μIU/mL, P=0.003), homeostasis model of assessment-insulin resistance (HOMA-IR) (-0.5±1.6 vs. +1.5±2.7, P=0.001), homeostatic model assessment-Beta cell function (HOMA-B) (-0.7±25.0 vs. +26.5±49.5, P=0.01) and increased quantitative insulin sensitivity check index (QUICKI) (+0.01±0.01 vs. -0.01±0.02, P=0.004) compared with the placebo. Additionally, significant differences in serum triglycerides (+13.6±61.4 vs. +45.9±36.5mg/dL, P=0.01) and VLDL-cholesterol concentrations (+2.7±12.3 vs. +9.2±7.3mg/dL, P=0.01) were observed following the administration of zinc supplements compared with the placebo.We did not observe any significant effects of taking zinc supplements on other lipid profiles.
CONCLUSIONS: Taken together, 30mg zinc supplementation per day for 6weeks among GDM women had beneficial effects on metabolic profiles.
Be well!
JP
September 6th, 2015 at 10:13 pm
Updated 09/06/15:
http://www.nutritionjrnl.com/article/S0899-9007%2815%2900179-3/abstract
Nutrition. 2015 Oct;31(10):1235-42.
Effects of selenium supplementation on glucose homeostasis, inflammation, and oxidative stress in gestational diabetes: Randomized, double-blind, placebo-controlled trial.
OBJECTIVE: To our knowledge, no reports are available indicating the effects of selenium supplementation on metabolic parameters, inflammatory factors, and oxidative stress in gestational diabetes mellitus (GDM). The aim of this study was to assess the effects of selenium supplementation on metabolic status in pregnant women with GDM who were not on oral hypoglycemic agents.
METHODS: This randomized, double-blind, placebo-controlled clinical trial was performed with 70 women with GDM. Patients were randomly assigned to receive either 200 μg selenium supplements as tablet (n = 35) or placebo (n = 35) for 6 wk from weeks 24 to 28 of gestation. Fasting plasma samples were taken at study baseline and after 6 wk of intervention to quantify related variables.
RESULTS: Selenium supplementation, compared with placebo, resulted in a significant reduction in fasting plasma glucose (-10.5 ± 11.9 versus +4.5 ± 12.9 mg/dL; P < 0.001), serum insulin levels (-1.98 ± 11.25 versus +5.26 ± 9.33 μIU/mL; P = 0.005), homeostasis model of assessment (HOMA)-insulin resistance (-0.84 ± 2.76 versus +1.47 ± 2.46; P < 0.001) and a significant increase in quantitative insulin sensitivity check index (+0.008 ± 0.03 versus -0.01 ± 0.01; P = 0.009). Additionally, a significant decrease in serum high-sensitivity C-reactive protein (hs-CRP) levels (-791.8 ± 2271.8 versus +500.5 ± 2563.3 ng/mL; P = 0.02) was seen after the administration of selenium supplements compared with placebo. Additionally, we observed a significant elevation in plasma glutathione (+52.14 ± 58.31 versus -39.93 ± 153.52 μmol/L; P = 0.002) and a significant reduction in plasma malondialdehyde levels (-0.01 ± 0.36 versus +0.67 ± 1.90 μmol/L; P = 0.04) after consumption of selenium supplements compared with placebo. We did not find any significant effect of taking selenium supplements on HOMA β-cell function, lipid profiles, plasma nitric oxide, or total antioxidant capacity concentrations. CONCLUSION: Selenium supplementation in pregnant women with GDM demonstrated beneficial effects on glucose metabolism, hs-CRP levels, and biomarkers of oxidative stress. Be well! JP
September 22nd, 2015 at 3:42 pm
Updated 09/22/15:
http://www.mdpi.com/2072-6643/7/9/5366/htm
Nutrients 2015, 7(9), 7806-7820
The Relationship between Serum Zinc Level and Preeclampsia: A Meta-Analysis
The association between serum zinc level and preeclampsia (PE) remains controversial. A systematic literature search was performed in PubMed, Web of Science and Embase for relevant available articles. The articles were limited to those in English from January 1990 to April 2015. Observational studies evaluating the association between serum zinc level and PE were included. The I2 was used to assess heterogeneity and the random effect model (REM) was adopted as the pooling method. The pooled standard mean difference (SMD) with 95% confidence interval (CI) was used to estimate the association between serum zinc level and PE. Seventeen observational studies were included. Compared with healthy pregnancy controls, PE patients have lower serum zinc level in 14 studies about total PE (SMD (95% CI): −0.587 (−0.963, −0.212), Z = 3.06, p for Z = 0.002; I2 = 88.4%, p for I2 < 0.0001). In subgroup analysis, a lower serum zinc level in PE patients compared with healthy pregnancy controls was observed in studies conducted in Asia, studies with zinc level measured in serum, and studies involving fasting participants. The SMD did not differ significantly between studies with healthy pregnancy controls matched by individual age (yes or no), and by individual gestational age (yes or no), respectively. Results from this meta-analysis indicate that serum zinc level in PE patients is significantly lower than that in healthy pregnancy controls. A moderate amount of zinc supplementation during pregnancy is advocated to reduce the incidence of PE. Be well! JP
February 24th, 2016 at 11:40 pm
Updated 02/24/16:
http://www.ncbi.nlm.nih.gov/pubmed/26901463
PLoS One. 2016 Feb 22;11(2):e0149818.
Folic Acid Supplementation in Pregnancy and the Risk of Pre-Eclampsia-A Cohort Study.
This prospective cohort study designed to assess the effect of folic acid supplementation in pregnancy on the risk of preeclampsia (PE) took place in Ottawa, ON and Kingston, ON, Canada, from September 1, 2002 to August 31, 2008. Pregnant women, less than 20 weeks gestational age were recruited and delivered in the Ottawa region and the Kingston General Hospital. Demographic characteristics of the study participants and the patterns of supplementation of folic acid were described and occurrence of PE between women with folic acid supplementation during pregnancy and women without were compared. Multiple logistic regression was used in the estimation of the independent effect of supplementation of folic acid. Additional analyses assessing the effect of low RBC and serum folate and dose-response relationship were performed. Analyses were performed in all study participants, and then in high risk and low risk sub-groups, respectively. A total of 7,669 participants were included in the final analysis. Ninety five percent of the study participants were taking folic acid supplementation in early second trimester. The rate of PE was lower in the supplementation group than in the no supplementation group, and the difference was statistically significant in high risk women. Similar patterns of associations were observed in analysis by RBC and serum folate levels and in dose-response analysis. Folic acid supplementation in pregnancy may reduce PE risk in pregnant women, especially in those women with increased risk of developing PE.
Be well!
JP
May 13th, 2016 at 12:45 pm
Updated 05/13/16:
http://www.ncbi.nlm.nih.gov/pubmed/27166794
PLoS One. 2016 May 11;11(5):e0154400.
The Effect of High Dose Folic Acid throughout Pregnancy on Homocysteine (Hcy) Concentration and Pre-Eclampsia: A Randomized Clinical Trial.
Pre-eclampsia is a pregnancy-related multi-systemic hypertensive disorder and affects at least 5% of pregnancies. This randomized clinical trial aimed at assessing the effect of low doses and high doses of folic acid on homocysteine (Hcy) levels, blood pressure, urea, creatinine and neonatal outcome. A randomized clinical trial was done at Alzahra Teaching Hospital, Tabriz University of Medical Sciences from April 2008 to March 2013. Four-hundred and sixty nulliparous pregnant women were randomly assigned into two groups. Group 1 (n = 230) received 0.5 mg of folic acid and group 2 (n = 230) received 5 mg of folic acid per daily. They were followed until delivery. Blood pressure and laboratory changes, including plasma Hcy levels, were measured and compared between the groups. Homocysteine concentrations were significantly higher at the time of delivery in group 1 (13.17±3.89 μmol/l) than in group 2 (10.31±3.54, μmol/l) (p<0.001). No statistically significant differences were observed in systolic and diastolic blood pressure (p = 0.84 and 0.15, respectively). Birth weight was significantly higher in group 2 (p = 0.031) and early abortion was significantly higher in group 1 than group 2 (p = 0.001). This study has provided evidence that a high dosage of folic acid supplements throughout pregnancy reduces Hcy concentrations at the time of delivery.
Be well!
JP
June 2nd, 2016 at 12:37 pm
Updated 06/02/16:
http://e-nrp.org/DOIx.php?id=10.4162/nrp.2016.10.3.328
Nutr Res Pract. 2016 Jun;10(3):328-35.
Effects of vitamin D supplementation on metabolic indices and hs-CRP levels in gestational diabetes mellitus patients: a randomized, double-blinded, placebo-controlled clinical trial.
BACKGROUND/OBJECTIVES: Vitamin D plays an important role in the etiology of gestational diabetes mellitus (GDM). This study evaluated the effect of vitamin D supplementation on metabolic indices and hs-C-reactive protein (CRP) levels in GDM patients.
SUBJECTS/METHODS: The study was a randomized, placebo-controlled, double-blinded clinical trial. Seventy-six pregnant women with GDM and gestational age between 24-28 weeks were assigned to receive four oral treatments consisting of 50,000 IU of vitamin D3 (n = 38) or placebo (n = 38) once every 2 weeks for 2 months. Fasting blood glucose (FG), insulin, HbA1c, 25-hydroxyvitamin D, lipid profile, hs-CRP, and homeostasis model assessment-insulin resistance (HOMA-IR) were measured before and after treatment. Independent and paired t-tests were used to determine intra- and intergroup differences, respectively. ANCOVA was used to assess the effects of vitamin D supplementation on biochemical parameters.
RESULTS: Compared with the placebo group, in the vitamin D group, the serum level of 25-hydroxyvitamin D increased (19.15 vs. -0.40 ng/ml; P < 0.01) and that of FG (-4.72 vs. 5.27 mg/dl; P = 0.01) as well as HbA1c (-0.18% vs. 0.17%; P = 0.02) decreased. Improvements in the lipid profiles were observed in the vitamin D group, but without statistical significance. Significant increases in concentrations of hs-CRP, FG, HbA1c, total cholesterol, and LDL cholesterol were observed in the placebo group. No significant change in fasting insulin and HOMA-IR was observed in either group. CONCLUSIONS: In GDM patients, vitamin D supplementation improved FG and HbA1c but had no significant effects on lipid profile or hs-CRP. Be well! JP
February 19th, 2017 at 11:51 pm
Updated 02/19/17:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5276772/
J Phys Ther Sci. 2016 Dec;28(12):3411-3415.
Preliminary validation of an exercise program suitable for pregnant women with abnormal glucose metabolism: inhibitory effects of Tai Chi Yuttari-exercise on plasma glucose elevation.
[Purpose] There is insufficient evidence related to exercise programs that are safe and efficacious for pregnant women with abnormal glucose metabolism. Tai Chi Yuttari-exercise is an exercise program with validated safety and efficacy in improving physical function in the elderly. In this study, we investigated this program’s inhibitory effects on plasma glucose elevation when it was adapted to a pregnancy model. [Subjects and Methods] Twelve 18- to 19-year-old females without a history of pregnancy were randomly assorted into two groups: an intervention group, for which six subjects were outfitted with mock-pregnancy suits and asked to perform Tai Chi Yuttari-exercise, and a control group who did not perform exercise. The intervention group had a mean Borg Scale score of 11.1 ± 0.9 during the exercise. [Results] No significant intragroup differences were observed in fasting, baseline, or post-intervention/observation plasma glucose levels. On the other hand, the intergroup change in plasma glucose levels after intervention/observation was significant when comparing the intervention and control groups: -1.66 ± 7.0 and 9.42 ± 6.57 mg/dl, respectively. [Conclusion] Tai Chi Yuttari-exercise appears to effectively inhibit plasma glucose elevation at intensity and movement levels that can be safely applied to pregnant women with abnormal glucose metabolism.
Be well!
JP
March 8th, 2017 at 4:08 pm
Updated 03/08/17:
http://onlinelibrary.wiley.com/wol1/doi/10.1111/jhn.12470/abstract
J Hum Nutr Diet. 2017 Mar 6.
Dietary epigallocatechin 3-gallate supplement improves maternal and neonatal treatment outcome of gestational diabetes mellitus: a double-blind randomised controlled trial.
BACKGROUND: Gestational diabetes mellitus (GDM) is an increasing prevalent health risk in pregnant women. Epigallocatechin 3-gallate (EGCG) is known to benefit the insulin secretory machinery. We aimed to investigate the effect of daily dietary EGCG supplementation on both the maternal and neonatal treatment outcomes in GDM-affected pregnancies.
METHODS: In total, 472 pregnant women during their third trimester of pregnancy were diagnosed with GDM and subsequently enrolled into this trial. After exclusion, 404 patients were randomly assigned into EGCG and placebo study groups and subsequently administered either 500 mg of EGCG or placebo, respectively, on a daily basis until full term. The daily nutritional intake of all patients was monitored throughout the study. Maternal diabetic parameters at baseline and full term, including metabolism of glucose and insulin, as well as neonatal symptoms at birth, including birth weight, macrosomia, hypoglycaemia, respiratory distress and Apgar scores, were analysed.
RESULTS: In total, 176 and 150 patients from the EGCG and placebo study groups, respectively, completed the trial. Patients from the EGCG group displayed significantly improved maternal diabetic parameters, and fewer cases of neonatal complications, compared to the placebo group.
CONCLUSIONS: Daily dietary EGCG supplement improves both maternal and neonatal treatment outcomes of GDM.
Be well!
JP
September 25th, 2017 at 11:44 pm
Updated 09/25/17:
https://www.hindawi.com/journals/ogi/2017/8249264/
Obstet Gynecol Int. 2017;2017:8249264.
The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia.
INTRODUCTION: Preeclampsia is a pregnancy-specific syndrome. One of the hypotheses concerning the etiology of preeclampsia is vitamin D deficiency during pregnancy.
METHOD AND MATERIALS: The present study is a randomized controlled clinical trial which aims to determine the effect of vitamin D supplement on reducing the probability of recurrent preeclampsia. 72 patients were placed in control group while 70 patients were randomized to the intervention group. The intervention group received a 50000 IU pearl vitamin D3 once every two weeks. The control group was administered placebo. Vitamin D or placebo was given until the 36th week of pregnancy.
RESULTS: The patients in intervention group have significantly lower (P value = 0.036) probability of preeclampsia than patients in the control group. The risk of preeclampsia for the control group was 1.94 times higher than that for the intervention group (95% CI 1.02, 3.71).
CONCLUSION: The intended intervention (i.e., prescription of vitamin D) has a protective effect against recurrent preeclampsia. Vitamin D supplementation therapy in pregnancy could help in reducing the incidence of gestational hypertension/preeclampsia.
Be well!
JP