تأثیر رژیم غذایی بر اختلالات فشارخون و دیابت بارداری: مرور سیستماتیک

نوع مقاله : مروری

نویسندگان

1 استادیار گروه مامایی و بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 دانشجوی دکتری تخصصی بهداشت باروری، کمیته تحقیقات و فناوری دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: اختلالات فشارخون و دیابت بارداری، از مشکلات شایع دوران حاملگی هستند که سلامت مادر و جنین را تهدید می‌کنند. بارِ اسیدی رژیم غذایی، عامل مؤثری در بروز این عوارض شناخته شده است. مطالعه حاضر با هدف بررسی تأثیر رژیم غذایی بر اختلالات فشارخون و دیابت بارداری انجام شد.
روش‌کار: در مطالعه مرور نظام‌مند حاضر، پایگاه‌های اطلاعاتی PubMed، Web of Science، Scopus، Embase، SID و Magiran با کلیدواژه ­های مرتبط "بارِ اسیدی رژیم" (Dietary Acid Load)، "اسیدیتی" (Acidity)، "رژیم آلکالاین" (Alkaline diet)، "دیابت بارداری" (Gestational Diabetes) و " اختلالات فشارخون" (Hypertensive disorders) به زبان­های فارسی و انگلیسی تا جولای 2025 مورد جستجو قرار گرفتند. انتخاب مقالات بر اساس معیارهای ورود و خروج و ارزیابی کیفیت مقالات با مقیاس نیوکاسل اوتاوا انجام شد.
یافته­ ها: در نهایت 5 مطالعه مرتبط انتخاب و با حجم کلی 7869 زن باردار و غیرباردار بررسی شد. داده ­ها عمدتاً از پرسشنامه نیمه‌کمّی بسامد خوراک و شاخص­ های بارِ اسیدی مانند NEAP و PRAL استخراج و محاسبه شده بودند. بر اساس اکثر مطالعات، بارِ اسیدی بالای رژیم غذایی با افزایش معنی‌دار اختلالات فشارخون و دیابت بارداری همراه است. افزایش مصرف میوه ­ها و سبزیجات و کاهش مواد پروتئینی حیوانی، این خطرات را کاهش می‌دهد.
نتیجه ­گیری: علی‌رغم مطالعات محدود، تنظیم بارِ اسیدی رژیم غذایی با اصلاح الگوی تغذیه‌ای مادران در پیشگیری و کاهش اختلالات فشارخون و دیابت بارداری مؤثر است. انجام مطالعات آینده‌نگر و کارآزمایی های بالینی برای تأیید دقیق‌تر این ارتباط ضروری است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The Effect of Diet on Blood Pressure Disorders and Gestational Diabetes: A Systematic Review

نویسندگان [English]

  • Seideh Hanieh Alamolhoda 1
  • , Fatemeh Kermani 2
  • Fatemeh Alahverdi 2
  • Fatemeh Rashidi 2
  • Mojgan Zarei Salehabadei 2
1 Assistant Professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 PhD of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Blood pressure disorders and gestational diabetes are common problems during pregnancy that threaten the health of mother and fetus. The acidic load of the diet is known to be an effective factor in the occurrence of these complications. The present study was conducted with aim to investigate the effect of diet on blood pressure disorders and gestational diabetes.
Methods: In this systematic review, databases of PubMed, Web of Science, Scopus, Embase, SID and Magiran were searched using the related keywords "Dietary Acid Load", "Acidity", "Alkaline diet", "Gestational Diabetes" and "Hypertensive disorders" in Persian and English language until July 2025. The selection of articles was based on the inclusion and exclusion criteria and the quality of the articleswas assessed with the Newcastle-Ottawa scale.
Results: Finally, 5 relevant studies were selected and reviewed with a total volume of 7869 pregnant and non-pregnant women. The data were mainly extracted and calculated from the semi-quantitative food frequency questionnaire and acid load indices such as NEAP and PRAL. According to most studies, high dietary acid load is associated with a significant increase in blood pressure disorders and gestational diabetes. Increasing the consumption of fruits and vegetables and reducing animal protein can decrease these risks.
Conclusion: Despite limited studies, regulating dietary acid load by modifying maternal nutritional patterns is effective in preventing and reducing hypertension and gestational diabetes. Prospective studies and clinical trials are necessary to more accurately confirm this association.

کلیدواژه‌ها [English]

  • Diet
  • Gestational Diabetes
  • Hypertension
  • Pregnancy-Induced Hypertension

مراجع

  1. Ying W, Catov JM, Ouyang P. Hypertensive disorders of pregnancy and future maternal cardiovascular risk. Journal of the American Heart Association 2018; 7(17):e009382.
  2. Safarpour F, Shafaatdoost M, Naeimi R, Moini A, Pirjani R, Basirat Z, et al. Assessing the role of dietary acid load in the development of hypertensive disorders during pregnancy: uncovering the association through prospective cohort analysis. Nutrition Journal 2024; 23(1):122.
  3. Wang W, Xie X, Yuan T, Wang Y, Zhao F, Zhou Z, et al. Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population‐based study. BMC pregnancy and childbirth 2021; 21(1):364.
  4. Garovic VD, White WM, Vaughan L, Saiki M, Parashuram S, Garcia-Valencia O, et al. Incidence and long-term outcomes of hypertensive disorders of pregnancy. Journal of the American College of Cardiology 2020; 75(18):2323-34.
  5. Ghulmiyyah L, Sibai B. Maternal mortality from preeclampsia/eclampsia. InSeminars in perinatology 2012; 36(1):56-59.
  6. Roth H, Henry A, Roberts L, Hanley L, Homer CS. Exploring education preferences of Australian women regarding long-term health after hypertensive disorders of pregnancy: a qualitative perspective. BMC Women's Health 2021; 21(1):384.
  7. Giorgione V, Ridder A, Kalafat E, Khalil A, Thilaganathan B. Incidence of postpartum hypertension within 2 years of a pregnancy complicated by pre‐eclampsia: a systematic review and meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology 2021; 128(3):495-503.
  8. Riise HK, Sulo G, Tell GS, Igland J, NygAard O, Iversen AC, et al. Association between gestational hypertension and risk of cardiovascular disease among 617 589 Norwegian women. Journal of the American Heart Association 2018; 7(10):e008337.
  9. Umesawa M, Kobashi G. Epidemiology of hypertensive disorders in pregnancy: prevalence, risk factors, predictors and prognosis. Hypertension Research 2017; 40(3):213-20.
  10. Kinshella ML, Omar S, Scherbinsky K, Vidler M, Magee LA, Von Dadelszen P, et al. Maternal dietary patterns and pregnancy hypertension in low-and middle-income countries: a systematic review and meta-analysis. Advances in Nutrition 2021; 12(6):2387-400.
  11. American Diabetes Association. Gestational diabetes mellitus. Diabetes Care 2004; 27 Suppl 1:S88-90.
  12. Koivusalo SB, Rönö K, Klemetti MM, Roine RP, Lindström J, Erkkola M, et al. Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish Gestational Diabetes Prevention Study (RADIEL) a randomized controlled trial. Diabetes care 2016; 39(1):24-30.
  13. Al-Rifai RH, Abdo NM, Paulo MS, Saha S, Ahmed LA. Prevalence of gestational diabetes mellitus in the middle east and North Africa, 2000–2019: A Systematic Review, Meta-Analysis, and Meta-Regression. Frontiers in endocrinology 2021; 12:668447.
  14. Zhu Y, Zhang C. Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective. Current diabetes reports 2016; 16(1):7.
  15. Jafari-Shobeiri M, Ghojazadeh M, Azami-Aghdash S, Naghavi-Behzad M, Piri R, Pourali-Akbar Y, et al. Prevalence and risk factors of gestational diabetes in Iran: a systematic review and meta-analysis. Iranian journal of public health 2015; 44(8):1036.
  16. Tieu J, McPhee AJ, Crowther CA, Middleton P, Shepherd E. Screening for gestational diabetes mellitus based on different risk profiles and settings for improving maternal and infant health. Cochrane Database of Systematic Reviews 2017(8).
  17. Li M, Grewal J, Hinkle SN, Yisahak SF, Grobman WA, Newman RB, et al. Healthy dietary patterns and common pregnancy complications: a prospective and longitudinal study. The American journal of clinical nutrition 2021; 114(3):1229-37.
  18. Pasand M, Eslamian G, Noura P, Akbarzadeh N, Sadatinejad M. The effects of low carbohydrate diet on the outcomes of gestational diabetes: A systematic review. The Iranian Journal of Obstetrics, Gynecology and Infertility 2023; 26(4):101-17.
  19. Remer T, Dimitriou T, Manz F. Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents. The American journal of clinical nutrition 2003; 77(5):1255-60.
  20. Scialla JJ, Anderson CA. Dietary acid load: a novel nutritional target in chronic kidney disease?. Advances in chronic kidney disease 2013; 20(2):141-9.
  21. Carnauba RA, Baptistella AB, Paschoal V, Hübscher GH. Diet-induced low-grade metabolic acidosis and clinical outcomes: a review. Nutrients 2017; 9(6):538.
  22. Osuna-Padilla IA, Leal-Escobar G, Garza-García CA, Rodríguez-Castellanos FE. Dietary acid load: mechanisms and evidence of its health repercussions. Nefrología (English Edition) 2019; 39(4):343-54.
  23. Parohan M, Sadeghi A, Nasiri M, Maleki V, Khodadost M, Pirouzi A, et al. Dietary acid load and risk of hypertension: a systematic review and dose-response meta-analysis of observational studies. Nutrition, Metabolism and Cardiovascular Diseases 2019; 29(7):665-75.
  24. Williams RS, Kozan P, Samocha-Bonet D. The role of dietary acid load and mild metabolic acidosis in insulin resistance in humans. Biochimie 2016; 124:171-7.
  25. Jayedi A, Shab-Bidar S. Dietary acid load and risk of type 2 diabetes: a systematic review and dose–response meta-analysis of prospective observational studies. Clinical nutrition ESPEN 2018; 23:10-8.
  26. Bühlmeier J, Harris C, Koletzko S, Lehmann I, Bauer CP, Schikowski T, et al. Dietary acid load and mental health outcomes in children and adolescents: results from the GINIplus and LISA birth cohort studies. Nutrients 2018; 10(5):582.
  27. Crews DC, Banerjee T, Wesson DE, Morgenstern H, Saran R, Burrows NR, et al. Race/ethnicity, dietary acid load, and risk of end-stage renal disease among US adults with chronic kidney disease. American journal of nephrology 2018; 47(3):174-81.
  28. Moghadam SK, Bahadoran Z, Mirmiran P, Tohidi M, Azizi F. Association between dietary acid load and insulin resistance: Tehran Lipid and Glucose Study. Preventive nutrition and food science 2016; 21(2):104.
  29. Akter S, Eguchi M, Kurotani K, Kochi T, Pham NM, Ito R, et al. High dietary acid load is associated with increased prevalence of hypertension: the Furukawa Nutrition and Health Study. Nutrition 2015; 31(2):298-303.
  30. Dehghan P, Abbasalizad Farhangi M. Dietary acid load, blood pressure, fasting blood sugar and biomarkers of insulin resistance among adults: findings from an updated systematic review and meta‐analysis. International journal of clinical practice 2020; 74(4):e13471.
  31. Lee KW, Shin D. Positive association between dietary acid load and future insulin resistance risk: findings from the Korean Genome and Epidemiology Study. Nutrition journal 2020; 19(1):137.
  32. Saraf-Bank S, Tehrani H, Haghighatdoost F, Moosavian SP, Azadbakht L. The acidity of early pregnancy diet and risk of gestational diabetes mellitus. Clinical Nutrition 2018; 37(6):2054-9.
  33. Tielemans MJ, Erler NS, Franco OH, Jaddoe VW, Steegers EA. Dietary acid load and blood pressure development in pregnancy: The Generation R Study. Clinical Nutrition 2018; 37(2):597-603.
  34. Zhao R, Zhou L, Lei G, Wang S, Li Y, Yang X, et al. Dietary acid load is positively associated with risk of gestational diabetes mellitus in a prospective cohort of Chinese pregnant women. Frontiers in Nutrition 2022; 9:892698.
  35. Hajianfar H, Mollaghasemi N, Jahan Mihan A, Arab A. Association between maternal dietary acid load during the early pregnancy and pregnancy-related complications. International Journal of Food Properties 2020; 23(1):1568-78.
  36. Pirkle CM, de Albuquerque Sousa AC, Alvarado B, Zunzunegui MV, IMIAS Research Group. Early maternal age at first birth is associated with chronic diseases and poor physical performance in older age: cross-sectional analysis from the International Mobility in Aging Study. BMC public health 2014; 14(1):293.
  37. Haddy FJ, Vanhoutte PM, Feletou M. Role of potassium in regulating blood flow and blood pressure. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 2006; 290(3):R546-52.
  38. Adam TC, Hasson RE, Ventura EE, Toledo-Corral C, Le KA, Mahurkar S, et al. Cortisol is negatively associated with insulin sensitivity in overweight Latino youth. The Journal of Clinical Endocrinology & Metabolism 2010; 95(10):4729-35.
مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 11
بهمن 1404
صفحه 68-79

فایل ها

هم رسانی

ارجاع به این مقاله

آمار