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      Effects of Fish Oil Supplementation on Gestational Diabetes Mellitus (GDM): A Systematic Review

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          Abstract

          Context

          One of the most common complications of pregnancy is gestational diabetes mellitus (GDM), which is increasing worldwide. Experimental and epidemiological studies have shown that higher intake of n-3 long-chain polyunsaturated fatty acids may decrease the risk of various diseases such as diabetes. The objective of this study was to assess the effect of fish oil supplementation on the prevention and treatment of GDM.

          Evidence Acquisition

          This systematic review was performed by searching several databases, including PubMed, Scopus, Google Scholar, the Cochrane Library, ProQuest, Science Direct SID, Magiran and IranMedex since 1983. The researchers also searched for references in reviewed clinical trial articles in which fish oil supplementation was compared with placebo or no supplementation.

          Results

          Only two published and in-press articles are included in this review. Based on these studies, docosahexaenoic acid (DHA)-enriched fish oil (800 mg/d) had no effect on prevention of GDM [0.97 (95% CI: 0.74, 1.27)]. Furthermore, omega-3 fatty acid supplementation containing 180 mg of eicosapentaenoic acid (EPA) and 120 mg DHA had beneficial effects on insulin resistance in women with GDM (change from baseline: 1.5 ± 7.5 vs ‏3.5 ± 8.5 mIU/mL, P = 0.02) but did not influence fasting plasma glucose, homeostatic model assessment-Beta cell function (HOMA-B), the quantitative insulin sensitivity check index (QUICKI), or lipid profiles (P > 0.05).

          Conclusions

          There is not enough evidence to support or refute the routine use of fish oil supplements during pregnancy for the prevention or treatment of diabetes. It is suggested that further randomized controlled trials be conducted to evaluate the role of fish oil supplementation in pregnancy.

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          Most cited references40

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          Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association.

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            Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus.

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              Conversion of alpha-linolenic acid to longer-chain polyunsaturated fatty acids in human adults.

              The principal biological role of alpha-linolenic acid (alphaLNA; 18:3n-3) appears to be as a precursor for the synthesis of longer chain n-3 polyunsaturated fatty acids (PUFA). Increasing alphaLNA intake for a period of weeks to months results in an increase in the proportion of eicosapentaenoic acid (EPA; 20:5n-3) in plasma lipids, in erythrocytes, leukocytes, platelets and in breast milk but there is no increase in docosahexaenoic acid (DHA; 22:6n-3), which may even decline in some pools at high alphaLNA intakes. Stable isotope tracer studies indicate that conversion of alphaLNA to EPA occurs but is limited in men and that further transformation to DHA is very low. The fractional conversion of alphaLNA to the longer chain n-3 PUFA is greater in women which may be due to a regulatory effect of oestrogen. A lower proportion of alphaLNA is used for beta-oxidation in women compared with men. Overall, alphaLNA appears to be a limited source of longer chain n-3 PUFA in humans. Thus, adequate intakes of preformed long chain n-3 PUFA, in particular DHA, may be important for maintaining optimal tissue function. Capacity to up-regulate alphaLNA conversion in women may be important for meeting the demands of the fetus and neonate for DHA.
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                Author and article information

                Journal
                Iran Red Crescent Med J
                Iran Red Crescent Med J
                10.5812/ircmj
                Kowsar
                Iranian Red Crescent Medical Journal
                Kowsar
                2074-1804
                2074-1812
                02 July 2016
                November 2016
                : 18
                : 11
                : e24690
                Affiliations
                [1 ]Nutrition Research Center, Health Services Management Research Centre, Tabriz University of Medical Sciences, Tabriz, IR Iran
                [2 ]Department of Midwifery, Faculty of Nursing and Midwifery, Research Center of Social Determinants of Health, Tabriz University of Medical Sciences, Tabriz, IR Iran
                [3 ]Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
                [4 ]DVM, Faculty of Veterinary Medicine, Tabriz Branch, Islamic Azad University, Tabriz, IR Iran
                [5 ]Health Center, Tabriz University of Medical Sciences, Tabriz , IR Iran
                [6 ]Tabriz Health Services Management Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
                Author notes
                [* ]Corresponding Author: Azizeh Farshbaf-Khalili, Health Services Management Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4134796770, Fax: +98-4134796969, E-mail: azizeh_farshbafkhalili@ 123456yahoo.com
                Article
                10.5812/ircmj.24690
                5292136
                8db49f16-16fa-41ce-a630-d351e39fee89
                Copyright © 2016, Iranian Red Crescent Medical Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                : 20 October 2014
                : 01 March 2015
                : 04 April 2015
                Categories
                Review Article

                Medicine
                gdm,fish oil,supplementation,randomized controlled trials
                Medicine
                gdm, fish oil, supplementation, randomized controlled trials

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