Applied nutritional investigation Nutrient intake of women with and without gestational diabetes with a specific focus on fatty acids Beverley Thomas, M.Phil. a, *, Kebreab Ghebremeskel, Ph.D. a , Clara Lowy, M.D., Ph.D. b , Michael Crawford, Ph.D., F.R.C.Path. a , and Bridget Offley-Shore, R.N. b a Institute of Brain Chemistry and Human Nutrition, London Metropolitan University, London, United Kingdom b Endocrine and Diabetic Day Centre, Guy’s and St. Thomas’ Hospital Trust, London, United Kingdom Manuscript received March 17, 2005; accepted July 15, 2005. Abstract Objective: Diet therapy is the cornerstone for the management of gestational diabetes mellitus (GDM). Women with GDM are commonly given dietary advice that broadly focuses on a reduction of total energy and fat consumption. We compared nutrient intake and specifically fatty acids of women with GDM who had received individualized nutritional counseling with those of non- diabetic women who did not. Method: Women with GDM (n = 44) and healthy pregnant women (n = 44) with uncomplicated singleton pregnancies were recruited during the third trimester. Women with GDM were given consultation on diet, health, and macronutrient content of foods commonly consumed by the individual. The non-diabetic group did not receive any dietary advice. Both groups were asked to keep a detailed record of all of foods and fluid consumed over a 4-d period. Results: After dietary counseling, the GDM group had lower intakes of energy (P  0.05), refined sugar (P  0.0001), total and saturated fats (P  0.0001), and monounsaturated (P  0.01) and trans (P  0.0001) fatty acids and higher levels of docosahexaenoic acid and fiber (P  0.05) compared with the non-diabetic group. Conclusions: Individualized dietary advice was associated with a lower consumption of the target nutrients in women with GDM. Another benefit of the advice was a slight increase in intake of eicosapentaenoic and docosahexaenoic acids, although consumption of -3 fatty acids by both groups was well below the recommendations for pregnancy. There is evidence that docosahexaenoic acid modulates insulin resistance and that it is vital for neurovisual development. We suggest that dietary management for women with GDM should foster the current recommendations for essential fatty acids in pregnancy. © 2006 Elsevier Inc. All rights reserved. Keywords: Gestational diabetes mellitus; Nutrients; Dietary fatty acids Introduction Gestational diabetes mellitus (GDM) is one of the com- monest metabolic disorders of pregnancy [1]. In the United Kingdom, 3% to 5% of pregnant women develop GDM [2]. However, the prevalence is two and four times higher in women of African and Asian origin, respectively, compared with Caucasians [3–5]. The disorder is characterized by increased insulin resistance [6,7], impaired insulin secretion [8], or a combination [9]. The etiology of GDM is not well understood, but it is thought to be due to a non-immune, functional defect of pancreatic -cells and failure to com- pensate for the normal insulin resistance of pregnancy [10]. Gestational diabetes mellitus is associated with increased risk of maternal morbidity and adverse perinatal outcomes [11–16]. Women with a history of GDM [17,18] and their offspring [13,19] have a higher risk of developing type 2 diabetes later in life. Nutritional management is the main treatment option for GDM [20,21]. Those who do not respond are given insulin This study was supported by Diabetes UK, the March of Dimes Birth Defect Foundation, the Mother and Child Foundation, and Shida Kanzume Co. Ltd. * Corresponding author. Fax: +44-0207-133-2453. (B. Thomas). E-mail address: b.thomas@londonmet.ac.uk Nutrition 22 (2006) 230 –236 www.elsevier.com/locate/nut 0899-9007/06/$ – see front matter © 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.nut.2005.07.017