Could gestational diabetes mellitus be managed through dietary bioactive compounds? Current knowledge and future perspectives.

Carmela Santangelo, Alessandra Zicari, Elisabetta Mandosi, Beatrice Scazzocchio, Emanuela Mari, Susanna Morano, Roberta Masella

Journal: The British journal of nutrition 2016;115(7):1129-44

PMID: 26879600

Plain Language Summary

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Gestational diabetes mellitus (GDM) is the most common metabolic disorder during pregnancy. Women with GDM are at a high risk of developing type 2 diabetes (T2D) later in life. Moreover, uncontrolled GDM is linked with a detrimental intra-uterine environment, which leads to foetal complications and an increased risk for the child of developing obesity and metabolic disorders.  The aim of the review is to examine the current knowledge and issues about the impact of dietary polyphenols on the mechanisms and/or factors regulating glucose homeostasis, inflammation and adipose tissue function in metabolic alterations linked with GDM. Moreover, this study also reviews the role of Omega-3 fatty acids in pregnancy. The study is a descriptive review based on several studies. Literature data is mainly derived from in vitro and animal models. In vitro and animal studies show that almost all subclasses of flavonoids, stilbene RSV and some olive oil phenolic compounds, interact and modulate several molecular pathways regulating insulin. Obesity worsens GDM with increased risk of developing metabolic disorders in both mother and offspring later in life. The adoption of healthy lifestyle, with adherence to a healthy dietary pattern, has positive effects on the prevention and management of diabetes.  

Abstract

Gestational diabetes mellitus (GDM) is a serious problem growing worldwide that needs to be addressed with urgency in consideration of the resulting severe complications for both mother and fetus. Growing evidence indicates that a healthy diet rich in fruit, vegetables, nuts, extra-virgin olive oil and fish has beneficial effects in both the prevention and management of several human diseases and metabolic disorders. In this review, we discuss the latest data concerning the effects of dietary bioactive compounds such as polyphenols and PUFA on the molecular mechanisms regulating glucose homoeostasis. Several studies, mostly based on in vitro and animal models, indicate that dietary polyphenols, mainly flavonoids, positively modulate the insulin signalling pathway by attenuating hyperglycaemia and insulin resistance, reducing inflammatory adipokines, and modifying microRNA (miRNA) profiles. Very few data about the influence of dietary exposure on GDM outcomes are available, although this approach deserves careful consideration. Further investigation, which includes exploring the 'omics' world, is needed to better understand the complex interaction between dietary compounds and GDM.

Address: 1Department of Veterinary Public Health and Food Safety,Unit of Nutrition,Italian National Institute of Health,Viale Regina Elena 299,00161 Rome,Italy.; 2Department of Experimental Medicine,2nd Section of Cell Pathology,Sapienza University of Rome,Viale Regina Elena 324,00161 Rome,Italy.; 3Department of Experimental Medicine,Section of Medical Pathophysiology, Food Science and Endocrinology,Sapienza University of Rome,Viale Regina Elena 324,00161 Rome,Italy.
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