Abstract
Fetal growth and development is primarily dependent upon the nutritional, hormonal and metabolic environment provided by the mother. A wartime famine study in Holland first showed that a low food intake reduces the glucose offered to the fetus and thus produces smaller size infants at birth. Maternal glucose regulation is however affected by numerous factors including physiological changes of pregnancy (e.g. insulin resistance [IR]), pathological conditions (e.g. gestational diabetes mellitus) and maternal nutrition. Maternal glucose is substantially influenced by the type of carbohydrates in the diet through its direct effect on glycemia. The rate at which each carbohydrate raises blood glucose levels after ingestion, can be measured via the dietary glycemic index (GI). Carbohydrate type and the GI of the diet enhance or inhibit abnormal hyperglycemia during pregnancy caused by either pathological conditions or the inability of the mother to cope with the physiological IR of pregnancy. In turn, maternal gestational hyperglycemia may be involved in the pathogenesis of IR, impaired glucose tolerance, type 2 diabetes mellitus, the Metabolic Syndrome and subsequent cardiovascular diseases in adult offspring. A low GI maternal diet has been associated with measurable benefits to the offspring. These include a positive effect on altering maternal blood glucose production, insulinemia and reduced adiposity as well as fetal and placental insulin and glucose regulation, fetal growth, birth weight and offspring adiposity. We review the possible links between dietary carbohydrate in health during pregnancy and the effect of maternal carbohydrate ingestion on programming the offspring’s metabolic profile.
Highlights
Over-nutrition, under-nutrition or unbalanced nutrition is considered a major cause of ill-health worldwide
The prevalence of overweight is high among children in most developed countries [1]. This increase in type 2 diabetes mellitus (DM) and the metabolic syndrome (MetS) in children possibly implies a combination of factors, the majority of which are related to nutrition during the life cycle [2]
In this article we review the evidence linking periconceptional, pregnancy and lactating diet, in terms of dietary carbohydrate, and the metabolic effects on the offspring’s health
Summary
Over-nutrition, under-nutrition or unbalanced nutrition is considered a major cause of ill-health worldwide. Nutrition during early development is associated with the offspring’s growth, organ development, body composition and body functions The response of the fetus to these insults in the environment during the prenatal period has short-term survival advantages, but may lead to long-term disadvantages This is because it is associated with increased susceptibility of the offspring to cardiovascular disease, hypertension, type 2 DM and obesity [9]. The composition of the diet during pregnancy modifies certain maternal risk factors (e.g. IGT, IR, hyperlipidemia etc) and may decrease the risk of developing gestational DM (GDM) [17] It may inhibit early metabolic changes in the offspring, associated with abnormal leptin and insulin levels [18]. In this article we review the evidence linking periconceptional, pregnancy and lactating diet, in terms of dietary carbohydrate, and the metabolic effects on the offspring’s health
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