Combining probiotics with perinatal dietary counselling could help reduce the risk of diabetes in mothers and provide a “safe and cost-effective” tool in addressing obesity in children, according to a new study from Finland.
Published in the British Journal of Nutrition, the study found that probiotic-supplemented dietary counselling could help reduce the risk of diabetes during pregnancy, improve blood glucose control and improve child health.
“Taken together, long-term health benefits for mothers and children may be conferred by balanced maternal nutrition during pregnancy and lactation and by promoting the healthy gut microbiota in the mother and the child. The results of the present study add weight to the argument that the continuing burden of Western lifestyle diseases is modifiable,” write the researchers.
Methods
Initiated in 2002, the study included 256 women, who were randomized during their first trimester of pregnancy into a control and a dietary intervention group.
The women, none of whom had any chronic diseases, all received dietary counselling provided by welfare clinics according to a national program.
The intervention group received additionally intensive dietary counselling at every study visit provided by a nutritionist, the aim being a dietary intake complying with current recommendations, combined with conventional food products with favourable fat and fibre contents for use at home, said the researchers.
The intervention group was further randomised at baseline in a double-blind manner to receive either placebo capsules or probiotics (Lactobacillus rhamnosus GG supplied by Valio, and Bifidobacterium lactis Bb12 supplied by Chr. Hansen) at a dose of 1010 colony-forming units/d each.
The capsules were taken once per day, and the intervention period extended from the first trimester of pregnancy to the end of exclusive breast-feeding.
Results
The researchers evaluated pregnancy outcome and fetal and infant growth during the 24 months’ follow-up.
All pregnancies were of normal duration, and there were no adverse events noted in mothers or in children, which confirms the safety of this approach, said the researchers.
They noted that those women who had taken probiotics had a reduced frequency of gestational diabetes mellitus (GDM): 13 percent for the diet/probiotics group, compared to 36 percent for the diet/placebo group and 34 percent for the control group.
In addition, the dietary counselling during pregnancy reduced the risk of fetal overgrowth, which is thought to predispose to later obesity.
“Probiotic intervention reduced the risk of GDM and dietary intervention diminished the risk of larger birth size in affected cases,” wrote the researchers. “The results of the present study show that probiotic-supplemented perinatal dietary counselling could be a safe and cost-effective tool in addressing the metabolic epidemic. In view of the fact that birth size is a risk marker for later obesity, the present results are of significance for public health in demonstrating that this risk is modifiable.”
Source: Impact of maternal probiotic-supplemented dietary counselling on pregnancy outcome and prenatal and postnatal growth: a double-blind, placebo-controlled study
British Journal of Nutrition (2010)
doi:10.1017/S0007114509993898
Authors: Raakel Luoto, Kirsi Laitinen, Merja Nermes and Erika Isolauri
Coffee is one of the most pervasive beverages globally. It speaks the same language, and bears the same love no matter what country you’re in. It has been touted for its many health benefits, and well as frowned upon for its acidic nature and effect on blood pressure. But researchers continue to delve into its potential, never-ending benefits and questionable effects. Italian researchers recently reported caffeinated coffee acutely induced unfavorable cardiovascular effects, especially on endothelial function; and during the fasting state, insulin secretion was reduced after caffeinated coffee ingestion (Eu J Clin Nutr. 2010;64:483–489).
A total of 20 (10 males and 10 females) healthy non-obese subjects underwent a double blind, crossover study. Subjects ingested one cup of caffeinated and one cup of decaffeinated Italian espresso coffee in random order at five- to seven-day intervals. Following caffeinated ingestion, brachial artery flow-mediated dilation (FMD) decreased progressively and significantly, but it did not significantly increase after decaffeinated ingestion. Similarly, caffeinated coffee significantly increased both systolic and diastolic blood pressure; this effect was not observed after decaffeinated ingestion. Blood glucose concentrations remained unchanged after ingestion of both caffeinated and decaffeinated, but insulin and C-peptide blood concentrations decreased significantly only after caffeinated ingestion.
Vitamin D may inhibit the build-up of cholesterol in blood vessels, says a new study that support calls for vitamin D supplements to improve heart health of diabetics.
According to new findings published in Circulation, diabetics – a population group at higher risk of heart disease – with low vitamin D levels displayed difficulties in processing cholesterol, putting them at an increased risk of heart attack and stroke.
“Vitamin D inhibits the uptake of cholesterol by cells called macrophages,” explained lead researcher Carlos Bernal-Mizrachi, MD. “When people are deficient in vitamin D, the macrophage cells eat more cholesterol, and they can’t get rid of it. The macrophages get clogged with cholesterol and become what scientists call foam cells, which are one of the earliest markers of atherosclerosis.”
Macrophage activation is higher in people with disease such as diabetes, and when found in combination with low vitamin D levels, the macrophages become loaded with cholesterol and eventually stiffen blood vessels and block blood flow.
“Cholesterol is transported through the blood attached to lipoproteins such as LDL, the ‘bad’ cholesterol,” he said. “As it is stimulated by oxygen radicals in the vessel wall, LDL becomes oxidated, and macrophages eat it uncontrollably. LDL cholesterol then clogs the macrophages, and that’s how atherosclerosis begins.”
And the problem may be solved by simply ensuring adequate vitamin D status via supplements, say researchers from Washington University in St Louis.
“There is debate about whether any amount of sun exposure is safe, so oral vitamin D supplements may work best,” said Bernal-Mizrachi.
Vitamin D refers to two biologically inactive precursors – D3, also known as cholecalciferol, and D2, also known as ergocalciferol. The former, produced in the skin on exposure to UVB radiation (290 to 320 nm), is said to be more bioactive. The latter is derived from plants and only enters the body via the diet, from consumption of foods such as oily fish, egg yolk and liver.
Both D3 and D2 precursors are hydroxylated in the liver and kidneys to form 25- hydroxyvitamin D (25(OH)D), the non-active ‘storage’ form, and 1,25-dihydroxyvitamin D (1,25(OH)2D), the biologically active form that is tightly controlled by the body.
In adults, it is said vitamin D deficiency may precipitate or exacerbate osteopenia, osteoporosis, muscle weakness, fractures, common cancers, autoimmune diseases, infectious diseases and cardiovascular diseases. There is also some evidence that the vitamin may reduce the incidence of several types of cancer and type-1 diabetes.
Study details
Bernal-Mizrachi and his co-workers obtained macrophage cells from diabetics and non-diabetics, with and without vitamin D deficiency. When the cells were exposed cells to cholesterol and low vitamin D levels, they found that low vitamin D levels in the culture dish resulted in fewer macrophages becoming foam cells.
On the other hand, when the human macrophages were placed in a vitamin D-rich environment, the uptake of cholesterol was suppressed, and they don’t become foam cells, said Bernal-Mizrachi.
The researchers noted that it may be possible to delay or reverse the development of atherosclerosis in diabetics by helping them regain adequate vitamin D levels.
The next stage in the research is to look at vitamin D-deficient diabetics who also high blood pressure. Bernal-Mizrachi said he wants to learn whether replacing vitamin D will lower blood pressure and improve blood flow.
Diabetic stats
An estimated 19 million people are affected by diabetes in the EU 25, equal to four per cent of the total population. This figure is projected to increase to 26 million by 2030.
In the US, there are almost 24 million people with diabetes, equal to 8 per cent of the population. The total costs are thought to be as much as $174 billion, with $116 billion being direct costs from medication, according to 2005-2007 American Diabetes Association figures.
Source: Circulation
Volume 120, Number 8, Pages 687-698, doi:10.1161/CIRCULATIONAHA.109.856070
“1,25 (OH) vitamin D inhibits foam cell formation and suppresses macrophage cholesterol uptake in patients with type 2 diabetes mellitus”
Authors: J. Oh, S. Weng, S.K. Felton, S. Bhandare, A. Riek, B. Butler, B.M. Proctor, M. Petty, Z. Chen, K.B. Schechtman, L. Bernal-Mizrach, C. Bernal-Mizrachi