The impact of nutrigenomics in pregnancy

Abstract

Nutrigenomics studies the nutrients that modulate genome expression through epigenetic, transcriptional, and post-transcriptional mechanisms. DNA methylation, post-translational histone modifications, and microRNA production are all regulated by various nutrients, such as folates and polyphenols. Transcription factors, such as the vitamin D receptor and PPARs, are activated by their respective ligands: vitamin D and unsaturated fatty acids (MUFAs and PUFAs).

During pregnancy, nutrigenomic intervention with folates is a standard practice for the prevention of congenital malformations. Folates, choline, and vitamin B12 are all involved in the production of S-adenosylmethionine, the main methyl donor in DNA and histone methylation processes. Diabetes induces epigenomic dysregulation, both due to the energy requirements of epigenetic processes and due to increased oxidative stress, which disrupts these processes. In women with gestational diabetes, there is evidence of epigenetic alterations in the mother, the placenta, the umbilical cord and the offspring.

Experimental models of diabetes and pregnancy demonstrate that diets enriched in MUFAs and PUFAs can regulate PPAR nuclear receptors, modulate microRNA production, and reduce embryonic, fetal, placental, and postnatal complications. Diets enriched in extra virgin olive oil, provided to women with gestational diabetes, regulate the pro-inflammatory environment in the placenta and placental PPAR pathways in relation to microRNA regulation. Furthermore, the multicentre OLIDIAG study demonstrates the ability of diets enriched in extra virgin olive oil to reduce insulin requirements, maternal triglyceride levels, and neonatal complications in women with gestational diabetes.

A better understanding of the nutrigenomic impact on diabetes and pregnancy could improve key epigenetic processes in development, thereby improving the health of both the mother and her offspring.