Lancet Diabetes Endocrinol
August 2025
Background: The mechanistic basis underlying the remission of prediabetes (ie, the return to normoglycaemia) has been suggested to be amelioration of insulin resistance without improvement of β-cell function. We aimed to characterise the relative contributions of changes in insulin sensitivity and β-cell function to the remission of prediabetes.
Methods: In this prospective cohort study, conducted at Mount Sinai Hospital (Toronto, ON, Canada), we screened pregnant women for gestational diabetes, aiming to recruit participants with varying degrees of dysglycaemia and conduct serial postpartum metabolic evaluations.
Adipose tissue (AT) inflammation is a topic of increasing interest given its role in initiating systemic subclinical inflammation. Evidence from preclinical studies suggests that n-3 polyunsaturated fatty acids (PUFAs) may ameliorate AT inflammation through various pathways. However, fewer data are available from humans, and existing studies are heterogeneous in design and findings.
View Article and Find Full Text PDFDiabetes Obes Metab
September 2025
Aims: Women with gestational diabetes (GDM) are advised to undergo an oral glucose tolerance test (OGTT) within 6 months postpartum, owing to their elevated risk of developing pre-diabetes/diabetes. However, the optimal approach to glycemic surveillance in the years thereafter is unclear. We thus sought to compare OGTT, fasting glucose and A1c for chronic monitoring of women with previous GDM.
View Article and Find Full Text PDFBackground: Objective biomarkers of diet, such as metabolomics, may improve dietary assessment and provide additional insight into how diet influences disease risk. The portfolio diet, a cholesterol-lowering plant-based diet, is recommended for lowering low-density lipoprotein cholesterol (LDL-C). This diet is low in saturated fat and includes nuts, plant protein (legumes), viscous fiber, and phytosterols.
View Article and Find Full Text PDFAlthough both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discovered 22 novel gene-sleep duration interaction loci for blood pressure, mapped to 23 genes.
View Article and Find Full Text PDFBackground: Aboriginal and Torres Strait Islander women experience a disproportionate burden of hyperglycaemia in pregnancy. A multi-component health systems intervention aiming to improve antenatal and postpartum care was implemented across Australia's Northern Territory (NT) and Far North Queensland (FNQ) between 2016 and 2019. Components included clinician education, improving recall systems, enhancing policies and guidelines, and embedding Diabetes in Pregnancy (DIP) Clinical Registers in systems of care.
View Article and Find Full Text PDFObjective: The International Diabetes Federation recently endorsed a 1-h oral glucose tolerance test (OGTT) as more convenient than the conventional 2-h OGTT. In practice, women with hyperglycemia in pregnancy are advised to undergo a 2-h OGTT within 6 months after delivery, but this test is often not completed, partly owing to its inconvenience for busy mothers. Recognizing the potential advantage of the 1-h OGTT in this setting, we sought to compare 1-h and 2-h OGTT glucose measurements at 3 months postpartum as predictors of dysglycemia (prediabetes/diabetes) over the first 5 years postpartum.
View Article and Find Full Text PDFInt J Behav Med
January 2025
Background: World Health Organization (WHO) growth standards, including weight-for-length, are used to monitor infant size. Excessive infant weight-for-length at or above the 85th percentile is a risk for childhood overweight. Although antenatal interventions like the nutrition and exercise lifestyle intervention program (NELIP) have successfully prevented excessive gestational weight gain, strategies to improve the intervention remain of interest.
View Article and Find Full Text PDFAppl Physiol Nutr Metab
January 2025
Global public health recommendations for optimal infant nutrition include exclusive breastfeeding for the first 6 months of life. Breastfeeding has several benefits; however, breastfeeding initiation rates and duration remain below recommendations in Northwestern Ontario, Canada. Sandy Lake First Nation is particularly interested in understanding infant feeding experiences of community members to support increased breastfeeding initiation and duration.
View Article and Find Full Text PDFJ Clin Endocrinol Metab
June 2025
Context: Lactation is associated with lower future risk of cardiovascular disease (CVD) in women but the mechanism(s) underlying this relationship remain unclear.
Objective: We sought to characterize the relationship between duration of exclusive breastfeeding and CV risk factors over the first 5 years post partum.
Methods: In this prospective cohort study, 328 women underwent serial cardiometabolic characterization (anthropometry, blood pressure [BP], lipids, fasting glucose, adiponectin, C-reactive protein [CRP]) at 1 year, 3 years, and 5 years post partum.
Objectives: Although preclinical studies have shown a beneficial impact of omega-3 (n-3) polyunsaturated fatty acids (PUFAs) on adipose tissue (AT) inflammation, the current literature from human studies is limited. Therefore, we aimed to evaluate the longitudinal associations of circulating levels of n-3 PUFAs with biomarkers of AT inflammation.
Methods: Longitudinal data from participants in the PROMISE cohort (n = 474) were used.
Background: The cumulative effect of postpartum weight retention from each pregnancy in a woman's life may contribute to her risk of ultimately developing type 2 diabetes and cardiovascular disease. However, there is limited direct evidence supporting this hypothesis. Thus, we sought to characterize the impact of postpartum weight retention on the trajectories of cardiovascular risk factors over the first 5-years after pregnancy.
View Article and Find Full Text PDFAlthough both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discover 22 novel gene-sleep duration interaction loci for blood pressure, mapped to genes involved in neurological, thyroidal, bone metabolism, and hematopoietic pathways.
View Article and Find Full Text PDFContext: Recent studies have reported elevated urinary vitamin D binding protein (uVDBP) concentrations in patients with diabetic kidney disease, although the utility of uVDBP to predict deterioration of kidney function over time has not been examined.
Objective: Our objective was to assess the association of uVDBP with longitudinal changes in kidney function.
Methods: Adults at-risk for type 2 diabetes from the Prospective Metabolism and Islet Cell Evaluation (PROMISE) study had 3 assessments over 6 years (n = 727).
Background: The cardiometabolic implications of postprandial hyperinsulinemia are unclear with recent studies suggesting both adverse and beneficial associations. We aimed to evaluate the longitudinal cardiometabolic implications of the post-challenge insulin secretory response over 4-years follow-up.
Methods: In this prospective cohort study, conducted in Toronto (Ontario, Canada), women comprising the full range of antepartum glucose tolerance were recruited in pregnancy (at the time of glucose tolerance screening, late in the second trimester) to undergo cardiometabolic testing in the years thereafter.
Diabetes Obes Metab
April 2024
Aim: The diagnosis of gestational diabetes (GDM) identifies women who are at future risk of developing type 2 diabetes. However, it is unclear if diagnosing GDM thus motivates women to increase physical activity after pregnancy or if this medicalization has the opposite effect of decreasing activity, possibly reflecting assumption of a sick role. We thus sought to evaluate the impact of diagnosing GDM on changes in maternal physical activity after pregnancy.
View Article and Find Full Text PDFAims/hypothesis: Excess adiposity, insulin resistance and beta cell dysfunction each contribute to the development of prediabetes (impaired glucose tolerance and/or impaired fasting glucose)/diabetes but their comparative impact in relation to one another remains uncertain. We thus ranked their contributions to incident dysglycaemia over the first 5 years postpartum in women reflecting the full spectrum of gestational glucose tolerance (spanning normoglycaemia to gestational diabetes) and hence a range of future diabetic risk.
Methods: In this study, 302 women with normal glucose tolerance (NGT) on OGTT at 3 months postpartum underwent repeat OGTT at 1 year, 3 years and 5 years, enabling serial assessment of glucose tolerance, insulin sensitivity/resistance (Matsuda index, HOMA-IR) and beta cell function (insulin secretion-sensitivity index-2 [ISSI-2], insulinogenic index [IGI]/HOMA-IR).
Diabetes
November 2023
A unique group of circulating very-long-chain saturated fatty acids (VLCSFAs), including arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0), have been associated with a lower risk of type 2 diabetes, although associations with early metabolic risk phenotypes preceding type 2 diabetes have received limited study. We aimed to examine the associations of VLCSFAs with longitudinal changes in insulin sensitivity and β-cell function in a cohort at risk for type 2 diabetes. VLCSFAs in the four main serum pools (phospholipid, triacylglycerol, cholesteryl ester, and nonesterified fatty acid) were extracted from fasting baseline samples (n = 467).
View Article and Find Full Text PDFAnn Epidemiol
September 2023
Purpose: In adults, cardiometabolic conditions manifest differently by ethnicity with South Asians particularly predisposed. Whether these differences arise in childhood remains narrowly explored. To address this evidence gap, we examined whether children of different ethnicities display differences in cardiometabolic risk (CMR).
View Article and Find Full Text PDFBranched chain fatty acids (BCFAs) are mainly saturated fatty acids with a methyl branch on the penultimate or antepenultimate carbon atom. While BCFAs are endogenously produced via the catabolism of branched chain amino acids, the primary exogenous source of BCFAs in the human body is via the diet, including dairy products. Recently, BCFAs have been identified as having a potentially protective role in the etiology of cardiometabolic disorders although current literature is limited.
View Article and Find Full Text PDFNutrients
February 2023
Background: Health authorities are near universal in their recommendation to replace sugar-sweetened beverages (SSBs) with water. Non-nutritive sweetened beverages (NSBs) are not as widely recommended as a replacement strategy due to a lack of established benefits and concerns they may induce glucose intolerance through changes in the gut microbiome. The STOP Sugars NOW trial aims to assess the effect of the substitution of NSBs (the "intended substitution") versus water (the "standard of care substitution") for SSBs on glucose tolerance and microbiota diversity.
View Article and Find Full Text PDFRecent observational studies have documented inverse associations of circulating very long-chain saturated fatty acids (VLCSFAs), namely arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0), with cardiometabolic outcomes. In addition to their endogenous production, it has been suggested that dietary intake or an overall healthier lifestyle may influence VLCSFA concentrations; however, a systematic review of the modifiable lifestyle contributors to circulating VLCSFAs is lacking. Therefore, this review aimed to systematically assess the effects of diet, physical activity, and smoking on circulating VLCSFAs.
View Article and Find Full Text PDFBackground: A large part of the existential threat associated with climate change is the result of current human feeding patterns. Over the last decade, research evaluating the diet-related environmental impacts of plant-based diets has emerged, and a synthesis of the available data is now due.
Objectives: The objectives of the study were as follows: 1) to compile and summarize the literature on diet-related environmental impacts of plant-based dietary patterns; 2) to assess the nature of the data on impacts of plant-based dietary patterns on both environmental parameters and health (e.
Am J Clin Nutr
January 2023
Background: Sugar-sweetened beverages (SSBs) have been implicated in fueling the obesity epidemic.
Objectives: This study aimed to update a synthesis of the evidence on SSBs and weight gain in children and adults.
Methods: MEDLINE, Embase, and Cochrane databases were searched through September 8, 2022, for prospective cohort studies and randomized controlled trials (RCTs) that evaluated intake of SSBs in relation to BMI and body weight in children and adults, respectively.