Effect Of Pistachio Intake On Postprandial Glycemic Response In Pregnant Woman:a Randomized,Controlled,Cross-over Study

OBJECTIVES:?1?This study focuses on the problems in choice of snack on pregnant women and to provide a theoretical basis and reference for improving the suitable dietary pattern and targeted education.?2?The author found the effect of pistachio and bread intake on blood glucose and related indexes of women who are with impaired glucose tolerance and gestational diabetes mellitus.METHODS:?1?According to the results of 50g glucose challenge test at 24-28 weeks,pregnant women were divided into"normal blood glucosegroup"and"abnormal glucose tolerance group".The questionnaire on snacks habits,physical activity and sleep quality they finished was to analyze the correlation between snacks and blood sugar.?2?Among those who didn't pass the 50g glucose challenge test,they were divided into"Gestational Impaired Glucose Tolerance?GIGT?group"and"Gestational Diabetes Mellitus?GDM?group"according to the result of 75g oral glucose tolerance test.Two groups women consumed isocaloric 42g pistachio or 100g whole-wheat bread in a random order after overnight fasting.The washout between the two snacks was 7 days.Blood glucose,insulin and incretin were measured every 30 minutes up to120 minutes.RESULTS:1?snacks habit questionnaire of pregnant women?1?According to the results of the questionnaire,the daily energy and three major nutrients from snack in"normal glucose tolerance group"and"abnormal glucose tolerance group"were in no difference,p>0.05.?2?In the choice of the types of snacks,women in"abnormal glucose tolerance group"were more likely to choose the cake[37.4%vs.20.6%],glutinous rice[17.4%vs.4.1%],and dried fruit[13.0%vs.4.1%],p<0.05.?3?In the choice of the types of snacks,women in"normal blood glucosegroup"were more likely to choose nuts[64.5%vs.47.8%]and vegetables[28.9%vs.11.6%],p<0.05.2?the effect of pistachio on blood glucose of pregnant women?1?In"GIGT group",the blood glucoses after consuming pistachio were significantly lower than whole-wheat bread at 30min[3.86±0.51 vs.4.56±0.73mmol/l],60min[3.98±0.57 vs.6.18±0.94mmol/l],90min[4.03±0.49 vs.6.24±0.96mmol/l],120min[4.21±0.48 vs.5.60±0.79mmol/l]?p<0.01?.The AUC_glu120minof bread and pistachio are[10.80±1.09 vs.7.92±0.92]?p<0.01?.?2?In"GIGT group",the insulin after consuming pistachio were significantly lower than whole-wheat bread at 30min[8.42±4.30 vs.31.08±31.05 mU/l],60min[10.07±6.53 vs.74.94±48.61 mU/l],90min[8.56±5.60 vs.77.55±47.86 mU/l],120min[6.29±3.90 vs 49.92±36.29 mU/l]?p<0.01?.The AUC_ins120minof bread and pistachio are[106.91±64.09hr·mU/Lvs.16.96±8.55hr·mU/L]?p<0.01?.?3?In"GIGT group",the glucagon-like peptide-1?GLP-1?after consuming pistachio were significantly higher than whole-wheat bread at 60 min[5.07±4.66 vs.3.30±2.67pm]?P<0.05?,90 min[5.53±4.75 vs.2.88±2.37pm]?p<0.01?,120 min[4.22±4.25 vs.2.61±3.11pm]?p<0.05??4?In"GDM group",the blood glucose after consuming pistachio were significantly lower than whole-wheat bread at 30min[4.23±0.58 vs.5.38±1.14mmol/l],60min[4.38±0.59 vs.7.49±1.43mmol/l],90min[4.53±0.51 vs.7.74±1.26mmol/l],120min[4.58±0.49 vs.6.86±1.21mmol/l]?p<0.01?.The AUC_glu120minof bread and pistachio are[13.04±1.90hr·mmol/L vs.8.75±1.01hr·mmol/L]?p<0.01?.?5?In"GDM group",the insulin after consuming pistachio were significantly lower than whole-wheat bread at 30min[10.99±4.99 vs.32.56±17.75 mU/l],60min[12.14±6.32 vs.68.01±27.41 mU/l],90min[9.20±4.14 vs.69.11±28.16 mU/l],120min[7.13±4.39 vs.47.60±28.58 mU/l]?p<0.01?.The AUC_ins120minof bread and pistachio are[98.87±29.6hr·mU/L vs.20.04±7.93hr·mU/L]?p<0.01?.?6?In"GDM group",the GLP-1 after consuming pistachio were significantly higher than whole-wheat bread at 90 min[6.86±2.69 vs.4.49±2.85pm]?p<0.01?,120 min[6.30±2.59 vs.3.78±2.77pm]?p<0.01?CONCLUSION:?1?Both normal and abnormal glucose tolerance pregnant women have the same energy intake but different choice of type of food during the between-meal snacks.?2?Normalwomen are more likely to choose high nutrient density and low glycemic index food,such as nuts and vegetables.?3?Pistachios makes smaller fluctuations in postprandial blood glucose than bread in both"GIGT group"and"GDM group".?4?Pistachio promotes more secretion of GLP-1in both"GIGT group"and"GDM group".