Anti-inflammatory Diets to Reduce Gestational Problems Caused by Obesity, Metabolic Syndrome, and Diabetes

Abstract

The master switch that turns on the expression of inflammatory gene products is the nuclear factor kappaB (NF-κB). Its activating factor includes oxidative stress from excess calories, hormones derived from arachidonic acid, saturated fatty acids, advanced glycosylated end products (AGE), and inflammatory cytokines from nearby cells. The core message from this molecular world is that the innate immune system is under considerable dietary control that can pound either on the pro-inflammatory or anti-inflammatory balance. The balance between the two arms of the scale allows to “burn out” damages and “repair.” In acute conditions, both arms are part of defense-and-healing process. Although virtually every chronic disease can be connected with unbalanced cellular inflammation, the three that are most germane to pregnancy are obesity, metabolic syndrome, and diabetes. Reducing the potential problems derived by “inflammation” during pregnancy is best accomplished by first identifying high-risk populations with existing metabolic dysfunction caused by diet-induced inflammation, and then working with such populations to reduce cellular inflammation by the use of an anti-inflammatory diet. There are various time points at which such dietary interventions might be contemplated. Peri-conception – The best time to prepare for the dramatic hormonal changes caused by pregnancy is lower cellular inflammation prior to conception. This is true for both parents. The rise in IVF treatments is an indication of the increasing difficulty of successful conception. Pregnancy – It is known that the maternal diet can have significant effect on fetal programming with dramatic influence on the future health of the child (Yajnik, Diabetes Care 33(5):1146–1148, 2010; Ravelli et al., Am J Clin Nutr 70(5):811–816, 1999; Hanbauer et al., Cardiovasc Psychiatry Neurol 2009:867041, 2009; Alvheim et al., Lipids 9(1):59–69, 2014; Alvheim et al., Obesity 20(10):1984–1994, 2012; Muhlhausler and Ailhaud, Curr Opin Endocrinol Diabetes Obes 20(1):56–61, 2013; Skinner, Mol Cell Endocrinol S1872–8057, 2014; Schneider et al. Horm Behav 66(1):104–119, 2014). The more closely a mother follows an anti-inflammatory diet, the better the future outcome for the child. Postnatal – After birth, the brain is the most rapidly growing organ in the body of the child. Reducing cellular inflammation throughout the newborn’s body with an anti-inflammatory diet is perhaps the best insurance policy for long-term metabolic health of the child. This is especially true as it is estimated that one-third of the children born in the United States after the year 2000 will develop diabetes (Olshansky et al., N Engl J Med 352(11):1138–1145, 2005). Anti-inflammatory diets are ultimately based on new breakthroughs in molecular biology that support the ability of such a dietary strategy to reduce inflammation, increase resolution, and alter gene expression. The more quickly such diets are implemented in high-risk populations, the less the likelihood of long-term negative metabolic consequences for the offspring.