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The role of nutrition in the development and management of gestational diabetes among Iranian women: a systematic review and meta-analysis

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Abstract

Purpose

We aimed to review existing evidence on nutrition associations with gestational diabetes mellitus (GDM) development and management among Iranian women.

Methods

Web of Science, PubMed, Scopus, SID, and Magiran were searched up to August 2020. Observational studies on associations between circulatory markers of vitamins and minerals, dietary intakes, and GDM and clinical trials of the effects of nutritional supplementations or dietary modifications on management or prevention of GDM among Iranian women were selected.

Results

We reviewed 49 publications. Pooled analyses revealed that GDM women had lower serum vitamin D (-8.31 nmol/l (95% CIs= -14.4, -2.19), higher serum iron (26.2 μg/dl (95% CIs= 2.52, 49.8), ferritin (24.1 ng/ml (95% CIs= 15.0, 33.4), and haemoglobin (1.14 g/dl (95% CIs: 0.32, 1.96) levels than non-GDM women. Single studies found the inverse associations of the Mediterranean diet, dietary approaches to stop hypertension diet, plant-based dietary index, and the direct associations of dietary acid load and dietary inflammatory index with the odds of GDM. Vitamin D supplementation early in pregnancy prevented GDM in two clinical trials. In two studies, iron supplementation’s effect on GDM in non-anemic women was inconsistent. Pooled analyses of probiotic supplementation in women with GDM showed no significant impact on maternal glycemia.

Conclusions

Vitamin D supplementation early in pregnancy may reduce the incidence of GDM. There is no compelling evidence that vitamin D or probiotics can help with GDM management. There is currently inadequate data to recommend a specific dietary pattern to prevent GDM in Iranian women.

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Data availability

The data used and/ or analyzed during the current study available from the corresponding author on reasonable request.

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Funding

This study was supported by a grant by the Research Institute of Endocrine Sciences, Shahid Beheshti University Medical Sciences, Tehran, Iran.

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Authors and Affiliations

  1. Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Nazanin Moslehi, Fatemeh Rahimi Sakak, Farshad Teymoori & Parvin Mirmiran

  2. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Shahid Hafezi St., Farahzadi Blvd., Shahrak-e-qods, Tehran, 1981619573, Iran

    Parvin Mirmiran

  3. Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Fahimeh Ramezani Tehrani

  4. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Fereidoun Azizi

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  1. Nazanin Moslehi
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Contributions

FA and NM contributed to the conceptual design of the study. PM supervised the study. NM developed the overall research plan and study oversight. FRS and NM conducted the research.

NM, FRS and FT independently screened all records based on their titles and abstracts. NM contributed to data analyses and interpretation. NM and FRS drafted the manuscript. FA, PM and FRT provided intellectual comments. All authors reviewed and approved the final version of the manuscript.

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Correspondence to Parvin Mirmiran.

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The study protocol was approved by the Ethics Committee of the Research Institute for Endocrine Sciences at the Shahid Beheshti University of Medical Sciences (IR.SBMU.ENDOCRINE.REC.1399.027).

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Moslehi, N., Sakak, F.R., Teymoori, F. et al. The role of nutrition in the development and management of gestational diabetes among Iranian women: a systematic review and meta-analysis. J Diabetes Metab Disord 21, 951–970 (2022). https://doi.org/10.1007/s40200-021-00944-7

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