Wellness Check: Nutrition

Maternal iron and vitamin D status was associated with maternal depression during pregnancy

1. Higher serum levels of iron and vitamin D during the second trimester was associated with lower maternal depression scores during the third trimester.

2. Compared with participants who were iron and vitamin D replete, those who were either low in iron, vitamin D or both had significantly higher depression score during third trimester.

Evidence Rating Level: 2 (Good)

Adequate iron and vitamin D intake is an important part of proper nutrition during pregnancy since these micronutrients are associated with fetal neurodevelopment and maternal health. However, whether the currently recommended daily allowance of iron and vitamin D is sufficient during pregnancy is not well known. This study aimed to examine whether status of iron and vitamin D in pregnancy and postpartum is related to maternal health.

This was a cross-sectional study that included 2189 pregnant participants living in Alberta, Canada. Participants who were unable to answer questions in English or with plan to move outside of Alberta were excluded. Maternal intake of iron and vitamin D from supplements was estimated using self-reported Supplemental Intake Questionnaire and serum levels of both micronutrients were measured mid-pregnancy and at 3-month postpartum. The primary outcome measure was maternal depression assessed by the 10-item Edinburgh Postnatal Depression Scale (EPDS)

The results demonstrated that serum concentration of vitamin D was significant lower at 3-month post-partum compared to during the second or third trimester. Higher serum levels of iron and vitamin D during the second trimester was associated with lower EPDS score during the third trimester. Furthermore, compared with participants who were iron and vitamin D replete, those who were either low in iron, vitamin D or both had significantly higher EPDS score during third trimester. This study was limited by one time measurement of serum vitamin D concentration during pregnancy which may not accurately represent serum levels of this micronutrient during gestation. Nonetheless, these results prompt further studies to better understand optimal vitamin D and iron supplementation to ensure both fetal developmental and maternal well-being.

 

One low glycemic index meal had similar effect on glycemic control as fasting during night shift

1. Consumption of 1 or 3 low-glycemic index meals did not lead to significant changes in glucose homeostasis compared to fasting overnight.

2. Consumption of 1 high-glycemic index meal significantly increased all glycemic control variables not only during the night shifts but also in the morning.

Evidence Rating Level: 1 (Excellent)

Night-shift workers make up a significant portion of our workforce but have significantly higher risks of all-cause, cardiovascular and cancer mortality compared to day-time workers. One possible risk factor is meal mistiming with consumption of meals during circadian rest phase (nighttime). This study evaluated the effect of glycemic index (GI) and frequency of meals on glucose homeostasis during and after nightshifts.

This was a randomized cross-over trial that included 53 adult female nurses working night shifts for at least the past 3 months in the Netherlands. Individuals with diabetes, hypoglycemia, or unexplained weight loss were excluded. Participants were randomized to two arms and either received meals once (1-MEAL) or three times (3-MEAL) during the night. Within each arm, participants were provided with either no meal (fasted), low, or high-GI meals for three nights followed by 2-week washout periods in between each type of meal. The test meals were semi-skimmed yogurt with varying sugar amounts added. The primary outcome measured was glycemic control (GC) during the night, in the morning, and 24hr period after the night shift. This was measured using a continuous glucose monitor placed on abdomen of each participant.

The results demonstrated that compared to no meal, consumption of 1 or 3 low- GI meals did not lead to significant changes in glucose homeostasis compared to fasting overnight. In contrast, consumption of 1 high-GI meal significantly increased all glycemic control variables not only during the night shifts but also in the morning. This study was limited by individual variability in timing of consumption of meal. Nonetheless, these results offer valuable insight into ways to help optimize meal consumption for night workers to help reduce their increased cardiovascular risk.

 

Avocado consumption was associated with lower cardiometabolic risk measures

1. Participants who identified themselves as avocado consumers had lower body mass index, waist circumference, plasma glucose, and cholesterol level compared with non-consumers.

2. Avocado consumers also consumed more fruit and vegetables compared to non-consumers.

Evidence Rating Level: 2 (Good)

Cardiovascular disease affects a large population worldwide, with many efforts aimed at establishing interventions that prevent development of high blood pressure, elevated cholesterol and blood glucose, which all increase the risk for cardiovascular disease. The effect of dietary patterns in lowering these parameters has been evaluated but fewer studies have looked at the effect of one specific food. This study examined the association between avocado consumption and cardiometabolic risk measures.

This was a cross-sectional study that included 2376 Australian adults. Participants who were pregnant or breastfeeding were excluded. Avocado consumption was evaluated through a 24-hour food intake recall survey. The primary outcomes were body mass index, waist circumferences and serum levels of cardiometabolic risk factors including lipid, cholesterol, HbA1c, plasma glucose, and blood pressure.

The results demonstrated that participants who identified themselves as avocado consumers had lower body mass index, waist circumference, plasma glucose, and cholesterol level compared with non-consumers. Interestingly, compared to non-consumers, avocado consumers also consumed more fruit and vegetables. Therefore, this study was limited by the inability to truly isolate avocado intake as the variable associated with the primary outcome. Nonetheless, this study suggests utility of future studies that evaluate the impact of specific foods, which could help improve feasibility of patient engagement in cardiometabolic risk lowering interventions

Image: PD

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