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Dietary intakes of women with Type 1 diabetes before and during pregnancy: a pre-specified secondary subgroup analysis among CONCEPTT participants.

ABSTRACT: AIM:To describe the dietary intakes of women with Type 1 diabetes before and during pregnancy. METHODS:This was a pre-specified subgroup analysis of CONCEPTT involving 63 women planning pregnancy and 93 pregnant women from 14 sites in England, Scotland and Ireland. Two hundred and forty-six 3-day food diaries (104 planning pregnancy, 142 pregnant) were matched to data source and food reference codes, and analysed using dietary software. Participants were informed that food diaries would be de-identified and used only for research purposes. RESULTS:Mean (sd) daily energy intake was 1588 (346) kcal and 1673 (384) kcal in women planning pregnancy and pregnant women respectively. Total carbohydrate intake was consistent with dietary guideline recommendations [180 (52) g planning pregnancy, 198 (54) g pregnant], but non-recommended sources (e.g. sugars, preserves, confectionery, biscuits, cakes) contributed to 46% of total daily carbohydrate intake. Fat consumption exceeded guideline recommendations [70 (21) g planning pregnancy, 72 (21) g pregnant]. Fibre [15.5 (5.3) g planning pregnancy, 15.4 (5.1) g pregnant], fruit and vegetable intakes [3.5 (2.2) and 3.1 (1.8) serves/day] were inadequate. Twelve women planning pregnancy (19%) and 24 pregnant women (26%) did not meet micronutrient requirements. CONCLUSIONS:The diets of pregnant women from England, Scotland and Ireland are characterized by high fat, low fibre and poor-quality carbohydrate intakes. Fruit and vegetable consumption is inadequate, with one in four women at risk of micronutrient deficiencies. Further research is needed to optimize maternal nutrition for glycaemic control and for maternal and offspring health.

SUBMITTER: Neoh SL

PROVIDER: S-EPMC7586790 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Dietary intakes of women with Type 1 diabetes before and during pregnancy: a pre-specified secondary subgroup analysis among CONCEPTT participants.

Neoh S L SL Grisoni J A JA Feig D S DS Murphy H R HR

Diabetic medicine : a journal of the British Diabetic Association 20190313 11

<h4>Aim</h4>To describe the dietary intakes of women with Type 1 diabetes before and during pregnancy.<h4>Methods</h4>This was a pre-specified subgroup analysis of CONCEPTT involving 63 women planning pregnancy and 93 pregnant women from 14 sites in England, Scotland and Ireland. Two hundred and forty-six 3-day food diaries (104 planning pregnancy, 142 pregnant) were matched to data source and food reference codes, and analysed using dietary software. Participants were informed that food diaries ...[more]

PMID: 30785640

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Project description:BackgroundOffspring of women with type 1 diabetes are at increased risk of fetal growth patterns which are associated with perinatal morbidity. Our aim was to compare rates of large- and small-for-gestational age (LGA; SGA) defined according to different criteria, using data from the Continuous Glucose Monitoring in Type 1 Diabetes Pregnancy Trial (CONCEPTT).MethodsThis was a pre-specified analysis of CONCEPTT involving 225 pregnant women and liveborn infants from 31 international centres ( ClinicalTrials.gov NCT01788527; registered 11/2/2013). Infants were weighed immediately at birth and GROW, INTERGROWTH and WHO centiles were calculated. Relative risk ratios, sensitivity and specificity were used to assess the different growth standards with respect to perinatal outcomes, including neonatal hypoglycaemia, hyperbilirubinaemia, respiratory distress, neonatal intensive care unit (NICU) admission and a composite neonatal outcome.ResultsAccelerated fetal growth was common, with mean birthweight percentiles of 82.1, 85.7 and 63.9 and LGA rates of 62, 67 and 30% using GROW, INTERGROWTH and WHO standards respectively. Corresponding rates of SGA were 2.2, 1.3 and 8.9% respectively. LGA defined according to GROW centiles showed stronger associations with preterm delivery, neonatal hypoglycaemia, hyperbilirubinaemia and NICU admission. Infants born >?97.7th centile were at highest risk of complications. SGA defined according to INTERGROWTH centiles showed slightly stronger associations with perinatal outcomes.ConclusionsGROW and INTERGROWTH standards performed similarly and identified similar numbers of neonates with LGA and SGA. GROW-defined LGA and INTERGROWTH-defined SGA had slightly stronger associations with neonatal complications. WHO standards underestimated size in preterm infants and are less applicable for use in type 1 diabetes.Trial registrationThis trial is registered with ClinicalTrials.gov . number NCT01788527 . Trial registered 11/2/2013.

Project description:Postdiagnosis diet and alcohol consumption may be associated with cancer prognosis, recurrence and mortality. Our aim was to investigate food, nutrient and alcohol intake variations between before and after cancer diagnosis and their determinants in a prospective cohort. Subjects (n?=?696) were incident cancer cases diagnosed in the NutriNet-Santé cohort between 2009 and 2016. Food, nutrient and alcohol intakes were prospectively collected using repeated nonconsecutive 24-hr dietary records since subjects' inclusion (i.e. an average of 2 y before diagnosis). Mean number of dietary records per subject was 5.9 before and 8.1 after diagnosis. All dietary data before and after diagnosis were compared by mixed models. Factors associated with the main dietary changes observed were also investigated using multivariable logistic regressions. We observed a decrease in intakes of vegetables (mean decrease in intake in patients who decreased their intake=-102.4?±?79.8 g/d), dairy products (-93.9?±?82.8 g/d), meat/offal (-35.5?±?27.8/d), soy products (-85.8?±?104.1 g/d), sweetened soft drinks (-77.9?±?95.4 g/d), and alcoholic drinks (-92.9?±?119.9 g/d), and an increase in broths (42.1?±?34.9 g/d) and fats/sauces (18.0?±?13.4 g/d). We observed a decrease in energy intake (-377.2?±?243.5 kcal/d) and in intakes of alcohol (-7.6?±?9.4 g/d) proteins (-17.4?±?12.5 g/d), and several vitamins (p?<?0.05) and micronutrients (p?<?0.05). Conversely, lipid (19.4?±?14.6 g/d), SFA (9.3?±?7.0 g/d), MUFA (8.3?±?6.3 g/d) and vitamin E (3.9?±?3.3 mg/d) intakes increased after diagnosis. This large prospective study suggests that cancer diagnosis is a key period for nutritional changes. It highlights some healthy behaviors such as a decrease in alcohol and sweetened drink consumption, but also less favorable trends, such as a decrease in vegetable consumption and in many vitamin and mineral intakes. These results provide insights to identify and target recommendations to put forward for better nutritional care of cancer survivors.

Dataset Information

Dietary intakes of women with Type 1 diabetes before and during pregnancy: a pre-specified secondary subgroup analysis among CONCEPTT participants.

Publications

Dietary intakes of women with Type 1 diabetes before and during pregnancy: a pre-specified secondary subgroup analysis among CONCEPTT participants.

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