Pregnant women taking folic acid dietary supplements in the first trimester can cause gestational diabetes | 孕妇在怀孕前期服用叶酸膳食补充剂可以导致妊娠糖尿病

Many dietary supplements may be beneficial. But some, especially when used in high doses, can cause some side effects. A Chinese study showed that the consumption of synthetic folic acid before and after pregnancy may increase the risk of gestational diabetes. Folic acid is recommended as a supplement to prevent neural tube defects. It is effective, but the synthetic form of folic acid can greatly increase the risk of gestational diabetes.

The study analyzed data from the China-Anhui birth cohort study, involving 3474 pregnant women. Participants took a glucose test at 28 weeks of gestation and took 75 grams of oral glucose to test the pregnant women’s glucose tolerance to see if they had diabetes.

The study found that the rate of gestational diabetes was 12.8%. The study found that daily supplementation during the first trimester is associated with a 125% diabetes risk. For women with a pregnant body mass index greater than or equal to 25 kg/m2, the risk of taking folic acid supplements in the first trimester increased by 463%. In pregnant women with a body mass index of less than 25kg/m2 and not taking folic acid supplements, using folic acid alone or using folic acid only in the second trimester did not significantly increase the risk of gestational diabetes.

Early studies have shown that high plasma folic acid in pregnant women can increase the risk of insulin resistance in children and gestational diabetes patients. Animal studies also pointed out that high-fat food supplements high folic acid can promote glucose intolerance or insulin resistance in male offspring. Other side effects of folic acid include cleft mouth and palate deformity, asthma/respiratory tract infections, and increased cancer risk.

The mechanism behind the risk of gestational diabetes is unclear. But the researchers provided two explanations. The first is that high folic acid intake leads to an imbalance between vitamin B12 and folic acid. High folic acid intake may aggravate vitamin B12 deficiency, which is related to diabetes. The second explanation is that unused plasma folic acid may cause some harmful effects. It can reduce the cellular activity of natural killer cells, which is known to be involved in the pathogenesis of gestational diabetes.

Folic acid is high in vegetables. When folic acid is used as a nutrient to fortify flour, consumers may mistakenly think that they no longer need to eat vegetables. Folic acid fortified flour may also have a negative impact on the health of other flour consumers. But like anything else, when used in high doses, pure nutrients such as folic acid may cause some imbalances and cause some health problems.

Editor’s comment: A new report on diabetes care suggests that supplementation of folic acid used in early pregnancy can increase the risk of gestational diabetes. Pregnant women usually use folic acid supplements to prevent birth defects. Because of this benefit, the government even requires that folic acid be added to flour as a nutritional fortifier. The report once again reminded people of the potential risks of folic acid supplementation.

Folic acid found in food and nutritional fortifiers in food are synthetic chemicals. In addition to the increased risk of gestational diabetes, synthetic folic acid supplementation is associated with an increased risk of breast cancer. When folic acid supplements are used as a source of nutrition, we should proceed with caution.

Folic acid is not the only thing that may promote gestational diabetes. Some foods and food ingredients, such as fast food, red meat, and higher intake of iron supplements, are also associated with an increased risk of gestational diabetes. The possible problem with red meat is the iron in its heme. Iron, especially heme iron found in high concentrations of red meat, can promote lipid peroxidation, which can lead to a range of health conditions, including diabetes.

It should be noted that the natural folic acid found in vegetables has nothing to do with any adverse effects or health conditions. (Dr. Lu)

许多膳食补充剂可能是有益的。但有些特别是高剂量使用时，会导致一些副作用。中国的一项研究表明，合成叶酸作为怀孕前后怀孕叶酸的消费可能会增加妊娠糖尿病的风险。推荐叶酸作为补充剂，以防止神经管缺陷。它是有效的，但合成形式的叶酸可以大大提高妊娠糖尿病的风险。

该研究分析了中国 – 安徽出生队列研究的数据，涉及3474名孕妇。参与者在妊娠28周时接受葡萄糖试验，服用75克口服葡萄糖以测试孕妇的葡萄糖耐受性，看她们是否患有糖尿病。

研究发现妊娠期糖尿病率为12.8％。该研究发现，在妊娠前期的每日补充与125％的糖尿病风险相关。对于孕妇身体质量指数大于或等于25 kg / m2的妇女，孕早期服用叶酸补充剂的风险增加了463％。而在身体质量指数低于25kg / m2并没有服用叶酸补充剂的孕妇中，在单独使用叶酸或仅在妊娠中期仅使用叶酸没有明显提高妊娠糖尿病风险。

早期的研究已经表明，高孕妇血浆叶酸可增加儿童和妊娠期糖尿病患者的胰岛素抵抗风险。动物研究还指出，高脂肪食物补充物质高叶酸可促进雄性后代的葡萄糖不耐受或胰岛素抵抗性。叶酸的其他多种副作用包括口腔腭裂畸形，哮喘/呼吸道感染，和癌症风险增加。

妊娠糖尿病风险背后的机制还不清楚。但研究人员提供了两个解释。首先是高叶酸摄入导致维生素B12与叶酸之间的不平衡。高叶酸摄入可能会加重维生素B12的缺乏症，这与糖尿病有关。第二个解释是未使用的血浆叶酸可能会造成一些有害影响。它可以减少自然杀伤细胞的细胞活性，这已知是参与妊娠糖尿病的发病机制。

叶酸在蔬菜中含量很高。叶酸作为一种营养素被用来强化面粉时，消费者可能误以为他们可以不再需要吃蔬菜了。叶酸强化了的面粉还可能对其它面粉消费者的健康产生不好的影响。但像其他任何事情一样，当高剂量使用时，纯净营养物质如叶酸可能会造成一些不平衡，并导致一些健康问题。

编者评论：关于糖尿病护理的新报告表明，怀孕早期使用的补充叶酸可增加妊娠期糖尿病的风险。孕妇通常使用叶酸补充剂来预防出生缺陷。由于这个好处，政府甚至要求将叶酸作为营养强化剂加入到面粉中。该报告再次提醒人们补充叶酸的潜在风险。

在食物中发现的叶酸和食物中的营养强化剂是合成化学品。除了与妊娠糖尿病风险增加的关系外，合成叶酸补充与乳腺癌风险增加有关。当叶酸补充剂作为一种营养来源被使用时，我们应谨慎行事。

叶酸不是唯一可能促进妊娠期糖尿病的。一些食物和食物成分，如快餐，红肉和补充铁摄入量较高，与妊娠期糖尿病风险增加也有关。红肉的可能问题是它的血红素中的铁。铁，特别是在高浓度红肉中发现的血红素铁可以促进脂质过氧化，这可导致一系列健康状况，包括糖尿病。

应该指出，蔬菜中发现的天然叶酸与任何不利影响或健康状况无关。(陆博士)