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Purpose Today, coronavirus disease-19 (COVID-19) treatment is an evolving process, and synbiotic administration has been suggested as a new therapeutic strategy. This study aims to investigate the effect of synbiotic supplementation in COVID-19 patients. Design/methodology/approach In this placebo-controlled trial, 80 patients were randomized to receive oral synbiotic capsule (containing fructooligosaccharide and seven bacterial strains; Lactobacillus (L) casei, L. rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, L. acidophilus, Bifidobacterium longum, L. bulgaricus, each one 109 colony-forming units) or placebo for two months. Inflammatory markers (Interleukin-6 [IL-6], C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) and white blood cell (WBC) count were evaluated at two timepoints (baseline, two months later). The measured variables were adjusted for confounders and analyzed by SPSS v21.0. Findings All 80 enrolled patients completed the study. The study adherence was good (approximately 70%). The mean changes for IL-6 were not significant (Δ = −0.6 ± 10.4 pg/mL vs Δ = +11.2 ± 50.3 pg/mL, p > 0.05). There were no significant improvements for CRP, ESR and WBC. Originality/value Administration of synbiotics for two months did not improve inflammatory markers in COVID-19 patients.

BACKGROUND: Some researchers suggested a positive effect of Alpha-Lipoic Acid (ALA) on Blood Pressure (BP) and lipid profile. OBJECTIVE: The aim of this study was to determine the efficacy of ALA for improving BP and lipid profile in critically ill patients. METHODS: In the present study, eighty patients (aged 18–80 years old) were randomly assigned to receive daily either ALA (600 mg/day) or placebo for eight weeks. Systolic BP (SBP), Diastolic BP (DBP), Triglyceride (TG), Total cholesterol (TC), Low Density Lipoprotein (LDL), and High Density Lipoprotein (HDL) were measured before and after intervention. RESULTS: LDL decreased significantly in the ALA group (110.6±34.9 vs. 107.9±33.4 mg/dl; P

BACKGROUND: There is overwhelming scientific evidence that dietary modifications is beneficial in neurodegenerative diseases like Multiple Sclerosis (MS). OBJECTIVE: The goal of this study was to explore the effects of modified Mediterranean Diet (mMeD) on systemic inflammation, anthropometric indices, and relapse rate in MS patients. METHODS: This single-center, randomized controlled trial compared mMeD and traditional Iranian diet (as control) during six months in 180 Relapsing-Remitting MS (RRMS) patients. Serum high sensitivity C Reactive Protein (hs-CRP), body weight, Body Mass Index (BMI), percent body fat, and relapse rate were evaluated at baseline, and 3 and 6 months later. Multivariate analysis of covariance test (MANCOVA; conducted by SPSS 24) was adjusted for age, gender, family history, duration of MS and education level. RESULTS: Of 261 screened patients (July 2018-February 2019), 180 patients were eligible; 68/90 as mMeD and 79/90 as control group completed the study. Self-reported adherence was excellent (95%). The mean change on the relapse rate was –0.54±0.9 compared to –0.03±0.4 for control group (P = 0.004). In addition, hs-CRP levels decreased in the mMeD group (–2.9±3.3 mg/L; P

Current evidence has demonstrated that patients with Multiple Sclerosis (MS) have dysbiotic gut microbiomes, and anti-inflammatory nutritional interventions can normalize this status. Therefore, we aimed to investigate the effects of dietary intervention in patients with progressive forms of MS.Seventy patients with three forms of progressive MS (primary-progressive, secondary-progressive, and progressive-relapsing) were randomly assigned into intervention (daily synbiotics capsule plus anti-inflammatory-antioxidant rich diet) or control (placebo capsule plus dietary recommendations) groups for four months. Faecal calprotectin level, Impact of Vision Impairment (IVI), Gastrointestinal Symptom Rating Scale (GSRS), and anthropometric measurements were evaluated at baseline and trial cessation. Analysis of covariance was conducted and adjusted for age, gender, education level, family historyduration of MS, type of progressive MS, type of main drug, and physical activity.Sixty-nine participants were included in the final analysis (n of intervention = 34; n of control = 35). Synbiotics and dietary intervention significantly reduced Faecal calprotectin level after six months (110.5 ± 75.9-44.7 ± 49.3 ɥg/g,Synbiotics supplementation and adherence to an anti-inflammatory-antioxidant-rich diet reduced intestinal inflammation and improved clinical manifestations in progressive forms of MS.

Background: Probiotics can improve immune function leading to the prevention and management of viral infections like SARS-CoV-2 infection (COVID-19 disease). Methods: We searched PubMed, EMBASE, Google Scholar, Science Direct, Scopus, and Web of Science up to May 2020 to identify interventional & observational studies documenting the effects of probiotics on incidence, severity, duration, and other clinical manifestations of viral infections, especially SARS-CoV-2-induced. Results: From a total of 91 records, 24 studies were obtained and classified into three domains based on the efficacy of probiotics on 1) shortening the period and severity of infections (n=9), 2) incidence (n=6), and 3) other clinical complications that may be followed by viral disorders (n=9). Identified probiotics have positive effects on the mentioned domains. Conclusion: Based on the evidence, some probiotic strains may be useful in SARS-CoV-2 infection; randomized trials are needed to show the facts.

Background:Current evidence suggests that adherence to the Mediterranean diet (MeD) can reduce inflammation in chronic diseases; however, studies pertaining to relapsing-remitting multiple sclerosis (RRMS) are limited. Therefore, the aim of this study was to investigate the potential of the modified MeD (mMeD) in improving Dietary Inflammatory Index (DII) scores, disability and fatigue severity, compared with traditional Iranian diet (TID), in RRMS patients.Results:Of the 180 patients enrolled, 147 participants were included in the final analysis (n of mMeD = 68; n of TID = 79). Self-reported adherence was good (˜81 %). Dietary intakes of forty-five food parameters were assessed through the FFQ. The mMeD significantly reduced DII scores after 6 months (2·38 ± 0·21 to −1·87 ± 0·86, P < 0·001), but TID did not elicit any changes (2·21 ± 0·44 to 2·14 ± 1·01, P = 0·771). Additionally, Modified Fatigue Impact Scale (MFIS) total score decreased significantly (72·4 ± 17·2 to 63·9 ± 14·2, P < 0·001), whereas there was no considerable improvement for Expanded Disability Status Scale (EDSS) in the mMeD group.Methods:After initial screening (n 261), 180 RRMS patients were randomised to receive mMeD or TID (as control) for 6 months. DII score, EDSS and twenty-one-item MFIS were evaluated at baseline and trial cessation. Multivariate ANCOVA was conducted and adjusted for age, gender, body weight, BMI, education level, supplement use, family history and duration of MS.Conclusion:Adherence to mMeD, for 6 months, improved dietary inflammatory status and fatigue severity in RRMS patients; however, the TID did not positively impact dietary inflammation and MFIS score.

Background and Aims: This study was designed to make a systematic review and meta-analysis on randomized controlled trials (RCTs) assessing the effect of cinnamon on blood pressure (BP). Methods: A systematic computerized literature search of PubMed, Scopus, Web of Science, Cochrane Library and Google Scholar databases were conducted up to August 2019. All RCTs using cinnamon supplements in adults were included in this systematic review and meta-analysis. Results: Out of 927 records, 8 trials that enrolled 582 participants were included. The pooled effect size showed that SBP did not change following cinnamon supplementation. (WMD: -0.61mmHg; 95% CI: -1.36, 0.14, P= 0.111). Also cinnamon supplementation in long-duration (≥ 8weeks) had a significant effect on SBP (WMD: -1.25 mmHg; 95% CI: -2.22, -0.28, P= 0.012). Pooled analysis showed that cinnamon had a significant effect on DBP (WMD: -0.93mmHg, 95% CI: -1.55 to -0.32, P= 0.003). In addition, results from both duration subsets and high dose (>1500 mg/day) of cinnamon supplementation were significant. Conclusion: Our findings revealed that cinnamon supplementation has favorable effects on DBP although results about SBP were not the same. Nonetheless, further studies are required.

PURPOSE: Recent trials have demonstrated the possible improvements in lipid profile & anthropometric indices after probiotics supplementation. We aimed to reanalyze the related literature to explore the efficacy of probiotics in Diabetic Nephropathy (DN) patients. METHODS: PubMed, Embase, Web of science, google scholar, Scopus, and Cochrane Library databases were systematically searched to find the related data on diabetic nephropathy population. All Randomized controlled trials (RCTs) that investigated the effect of probiotics on serum lipid markers (High-Density Lipoprotein [HDL], Triglyceride, Total Cholesterol, TC-to-HDL ratio, Low-Density Lipoprotein, Very Low-Density Lipoprotein) and anthropometric indices (Body Weight, Body Mass Index, waist-to-hip ratio) were included (PROSPERO No.CRD42020186189). Meta-analysis was performed using the random-effect model. RESULTS: Of 156 studies, seven were eligible for inclusion. Lipid biomarkers had a marginal reduction (except for HDL; WMD = 2.59 mg/dl; 95% CI = -0.28, 5.47; P = 0.077); whereas anthropometric indices increased in a non-significant manner. CONCLUSION: There is limited evidence to support the efficacy of probiotics for the modulation of lipid profile and anthropometric indices in DN patients. GRAPHICAL ABSTRACT: [Figure: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00765-8.

Background: Human milk potentially includes probiotic Lactobacillales, an order of gram-positive bacteria that have the ability to ferment sugars to lactic acid. These bioactive agents may be affec...

PurposePatients with chronic obstructive pulmonary disease (COPD) suffer from many health problems including poor sleep. This paper aims to evaluate the relationship between diet quality indices (DQIs) and sleep quality in COPD.Design/methodology/approachThe current cross-sectional study was carried on 121 COPD patients. Subjective quality of sleep was determined by Pittsburgh Sleep Quality Index (PSQI) and categorized into “poor” and “good” sleep quality. Dietary history was assessed by the DQIs. Disease status was categorized according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines.FindingsIn total, 103 men and 18 women with a mean age of 66.1 ±10.9 were studied. The subjects were categorized into four groups based on GOLD; 3.3% of subjects were at Stage 1, 38% in Stage 2, 38% in Stage 3 and 20.7% in Stage 4. In total, 38% of subjects were good, and 62% were bad sleepers according to PSQI score. There was no significant relationship between the severity of COPD and PSQI score. We observed a significant inverse relation between PSQI total score and Mediterranean diet (MED) scale, Healthy Eating Index (HEI)-2010 and HEI-2005 (p= 0.024, 0.037 and 0.024, respectively) in males.Originality/valueThis study showed a high prevalence of poor quality of sleep and sleep disturbances among COPD patients. There was an inverse association between PSQI and sleep disorders and DQIs scores in COPD patients. Regardless of the severity of airflow obstruction, poor diet quality may constitute a risk factor for sleep quality.

Background: Parkinson’s disease (PD) as one of the most common neurodegenerative disorders may be affected by healthy dietary pattern. The aim of this study was to investigate the effects of the Me...

Purpose Heavy metals constitute one of the most hazardous substances that could be accumulated in biota coming from human activities such as agricultural and industrial wastes. This paper aims to study the levels of some of the most common heavy metals in muscles of the fish caught in the Karun River (Ahvaz, Iran) and to assess the health risks associated with their consumption. Design/methodology/approach In present study, the concentrations of three heavy metals (Pb, Cd and Cu) in the muscle of highly consumed fish species Ctenopharyngodon Idella (Cyprinidae) collected from three selected markets (Khoram Kooshk, Ahvaz-e Qadim and Padad Shahr; total number of samples was 45) in Ahvaz city and human health risk associated with their consumption were detected by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Findings The results indicated that the highest and lowest accumulated metal concentrations were related to Cu (20.36 ± 0.84) and Cd (0.53 ± 0.02), respectively. In addition, the mean difference for Pb and Cu across two pairwise of sampling sites were significant (Ahvaz-e Qadim and Khoram Kooshk, P for Pb = 0.025, P for Cu = 0.033; Ahvaz-e Qadim and Padad Shahr, p for Pb = 0.018, p for Cu = 0.039). The estimated daily intake of all metals in muscles of fish in this study were below the legal limit, and mean differences were not statistically significant among the sampling sites, except for Cu (Ahvaz-e Qadim and Khoram Kooshk, p = 0.048; Ahvaz-e Qadim and Padad Shahr, p = 0.041). Target hazard quotient values were also all below 1. Originality/value It can be concluded that the fishes from Ahvaz city markets are comparatively clean and do not constitute a risk for human health.

Dietary modification may improve quality of life and fatigue severity in Multiple Sclerosis (MS) patients. Given this, there is a growing interest in healthy diets, especially Mediterranean based. The goal of this study was to explore the effects of a modified Mediterranean (mMeD) dietary intervention in Quality Of Life (QOL), and severity of fatigue in MS participants. About 180 Relapsing-Remitting MS patients randomly assigned to follow/not follow the mMeD for 6 months. Primary endpoints were related to dietary adherence and study completion. Clinical endpoints were evaluated Multiple Sclerosis Quality Of Life-54 items, Fatigue Severity Scale (FSS-9), and Visual Analog Fatigue Scale. Data were analyzed by SPSS 24. Of 261 screened patients (July 2018–February 2019), 180 were eligible and willing to commit. 68/90 as mMeD and 79/90 as control group completed the study. Self-reported adherence was excellent (95%). The majority of mean changes for QOL were statistically significant (P

The effect of probiotics fermented milk (PFM) supplementation on blood pressure (BP) is conflicting. This review aimed to summarize available evidence from human trials evaluating the effects of PFM supplementation on BP in adults. Online databases, including PubMed, Scopus, EMBASE, and Cochran were searched for relevant studies published up to December 2019, using relevant keywords. All randomized controlled trials (RCTs) investigating the PFM supplementation on BP were included. The quality of this study was evaluated using the Cochrane Collaboration Risk of Bias Assessment tool. Meta-analysis was done using the random-effects model. Heterogeneity and publication bias were assessed in selected studies. Sensitivity analysis and subgroup analysis were conducted to examine potential heterogeneity. Meta-analysis of 24 (31 arms) randomized placebo-controlled trials involving 2102 participants showed that PFM supplementation did not change in systolic BP (SBP) (WMD: −2.17 mmHg; 95% CI: −4.5, 0.16, P = .068) as well in diastolic BP (DBP) (WMD: −1.04, 95% CI: −2.51 to 0.44, P = .167) subgroup analyses based on baseline SBP and DBP, duration of intervention, baseline BMI, mean age, and health status suggested a large significant decreasing effect on systolic and diastolic BP in prehypertensive (pre-HTN) and hypertensive (HTN) subset (P

BACKGROUND Probiotics may have a promising role in chronic autoinflammatory diseases. The current systematic review and meta-analysis investigated the effects of probiotics on disease progression, depression, general health, and anthropometric measurements in Relapsing-Remitting Multiple Sclerosis (RRMS) patients. METHODS The English literature search was performed using PubMed, Scopus, Web of Science, and the Central Cochrane Library through January 2021. Random effect models were used to synthesise quantitative data by STATA14 . RESULTS From a total of 152 identified entries, four trials were included in quantitative synthesis (n = 213; 106 as intervention, 107 as control). An additional six studies with the same structure and different markers were also systematically reviewed. The pooled effect size showed that Expanded Disability Status Scale (EDSS) (WMD = -0.43; 95% CI = -0.65, -0.20; P

Current evidence suggests that adherence to the Mediterranean diet (MeD) can reduce inflammation in chronic diseases; however, studies pertaining to relapsing-remitting multiple sclerosis (RRMS) are limited. Therefore, the aim of this study was to investigate the potential of the modified MeD (mMeD) in improving Dietary Inflammatory Index (DII) scores, disability and fatigue severity, compared with traditional Iranian diet (TID), in RRMS patients.Of the 180 patients enrolled, 147 participants were included in the final analysis (n of mMeD = 68;After initial screening (Adherence to mMeD, for 6 months, improved dietary inflammatory status and fatigue severity in RRMS patients; however, the TID did not positively impact dietary inflammation and MFIS score.

Purpose Dietary fiber and energy intakes seem to be related to disability and anthropometric indices in multiple sclerosis (MS), a chronic inflammatory disorder of the central nervous system. So, this study was designed to investigate the association between dietary fiber and energy intakes with systemic inflammation, disease severity and anthropometric measurements in MS subjects. Design/methodology/approach Four subtypes of 261 MS volunteers were recruited (female = 210, male = 51; mean age 38.9 ± 8.3). A 168-item food frequency questionnaire and nutritionist IV software were used to estimate the amounts of dietary, insoluble, soluble, crude fiber and energy intakes. Serum hs-CRP, extended disability status scale (EDSS), height, weight and Deurenberg equation were also used to evaluate systemic inflammation, disease severity, body mass index (BMI) and percentage body fat, respectively. Findings Mean differences among the three hs-CRP and EDSS subgroups for dietary fibers and energy intake were significant (p < 0.001). Dietary fiber intake (M = 19.9 ± 4.3 g/day) was a good predictor for EDSS (B = −0.196, p = 0.012), and insoluble fiber intake was introduced as the best predictor of hs-CRP (B = −3.293, p < 0.001). Energy intake predicted both BMI (B = 0.007, p < 0.001) and percentage body fat (B = 0.015, p < 0.001). Originality/value Hypocaloric and high prebiotic fiber diet may suppress systemic inflammation and thereby modulate disease severity, as well as control anthropometric indices.

This systematic review and meta-analysis was performed to evaluate the effect of probiotics on serum high sensitivity-C reactive protein (hs-CRP) and oxidative stress biomarkers among patients with Diabetic Nephropathy (DN). Electronic databases were searched through May 10, 2020. Seven trials that included 340 patients were identified for analysis. Meta-analysis indicated that probiotics significantly reduced hs-CRP (WMD = -1.53 mg/L; 95% CI = -2.38, -0.69; P < 0.001) and Malondialdehyde (MDA) (WMD = -0.62 ɥmol/L; 95% CI = -1.18, -0.06; P = 0.030) levels in DN patients, whereas they increased Glutathione (GSH) (WMD = 73.84 ɥmol/L; 95% CI = 24.3, 123.29; P = 0.003) and Total Antioxidant Capacity (TAC) (WMD = 26.54 mmol/L; 95% CI = 6.23, 46.85; P = 0.010). Therefore, probiotics may improve hs-CRP and oxidative stress biomarkers in DN population., Probiotics; Oxidative Stress; C-Reactive Protein; Diabetic Nephropathies; Meta-Analysis

Aim: COVID-19, a newly discovered virus disease, can be affected by probiotics. So, we tried to review the possible effects and associations of probiotics on viral infections focusing on SARS-CoV-2. Methods: We searched on PubMed, EMBASE, Google Scholar, Science Direct, Scopus and Web of Science up to May 2020 to identify interventional & observational studies documenting the effects of probiotics strains on interleukins, virus titres, and antibody production with a focus on confirmed diagnosis of SARS-CoV-2 infection. Results: From a total of 93 records, 21 studies were obtained and classified into three domains based on the efficacy of probiotics on 1)the level of interleukins (n=7), 2)virus titres reduction (n=2), and 3)antibody production (n=12). The suppuration of proinflammatory interleukins and type I interferon (IFN) production seemed to be the main anti-viral strategy of probiotics. Conclusion: Based on evidence, some probiotic strains may be useful in SARS-CoV-2 infection; randomized trials are needed to confirm these findings.

Today synbiotics are considered as immunomodulatory agents. The current systematic review and meta-analysis investigated the effect of synbiotics and probiotics on inflammatory and oxidative stress markers in autoimmune disease.The English literature search was performed using PubMed, Scopus, Web of Science, and the Central Cochrane Library through March 2020. Random effects models and generic inverse variance methods were used to synthesize quantitative data by STATAFrom a total of 623 entries identified via searches, ten RCTs (n = 440; 216 as intervention, 224 as controls) were included. An additional eleven studies with same intervention and different markers were also explained systematically. The pooled effect size showed that Interleukin (IL)-6 (WMD = -7.79 pg/ml; 95% CI = -13.81, -1.77, P = 0.011), Tumor Necrosis Factor (TNF)-α (WMD = -1.05 pg/ml; 95% CI = -2.01, -0.10, P = 0.030), high sensitivity C-Reactive Protein (hs-CRP) (SMD = -0.58; 95% CI = -0.79, -0.37, P 0.001), Malondialdehyde (MDA) (SMD = -0.36; 95% CI = -0.68, -0.04; P = 0.026), Homeostasis Model of Assessment-estimated Insulin Resistance (HOMA-IR) (WMD = -0.71; 95% CI = -1.05, -0.37, P 0.001), and beta cell function (HOMA-β) (WMD = -15.18; 95% CI = -22.08, -8.28, P 0.001) changed following probiotics (or synbiotics) supplementation. Also supplementation with doses more than 2 billion CFU could reduce IL-10 concentrations (WMD = -1.84; 95% CI = -2.23, 1.87; P 0.001). Glutathione (GSH) and Total Antioxidant Capacity (TAC) levels did not influence by synbiotics and probiotics; insignificancy was remained after subgrouping for participants' age, study duration, and disease duration.Our findings revealed that synbiotics and probiotics supplementation has significant effect on some inflammatory and oxidative stress markers; although, the number of trials was too small to powerful conclusion and further investigations may be needed.

BACKGROUND To relieve the signs and symptoms of anterior uveitis (AU), an ocular manifestation of Behcet's syndrome, we prescribed a synbiotic supplementation (probiotics and prebiotics) for a 49-year-old woman. CASE REPORT Seven strains of bacteria - Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium longum, and Lactobacillus bulgaricus, each 10⁸ colony-forming units (CFU) - and fructo-oligosaccharide (FOS; 100 mg) were given as a capsule 2 times per day. After 7-month treatment, AU was improved and serum inflammatory markers - C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), and estimated sedimentation rate (ESR) - were suppressed. Now, if a mild AU attack occurs, the problem is resolved by treatment with 1 gtt (from the Latin "guttae", meaning drops) eye drop (prednisolone 1%) for 1 week. CONCLUSIONS Synbiotic supplementation may contribute to treating AU, which is one of the most disastrous manifestations of BS, by controlling the proinflammatory processes.

Osteoarthritis is the most common articular disease that can lead to chronic pain and severe disability. Curcumin-an effective ingredient in turmeric with anti inflammatory property-plays an important role in protecting the joints against destructive factors. Gingerols and piperine, are the effective ingredients of ginger and black pepper, which may potentially enhance and sustain the effect of curcumin in this direction. To determine the effect of cosupplementation with turmeric extract, black pepper, and ginger on prostaglandin E2 (PGE2 ) in patients with chronic knee osteoarthritis, compared with Naproxen. Sixty patients with two different levels of knee osteoarthritis (Grade 2 and 3) were studied. Individuals were randomly assigned to receive daily turmeric extract, ginger, and black pepper together or Naproxen capsule for 4 weeks. PGE2 was evaluated by ELISA method. 24-hr recall was also assessed. All of participants completed the study. PGE2 decreased significantly in both groups (p < .001), but there was no significant differences between groups. The results of this study indicated that intake of the selected herbs twice a day for 4 weeks may improve the PGE2 levels in patients with chronic knee osteoarthritis similar to Naproxen drug.

Background: Multiple sclerosis (MS) is associated with changes in quality of life, disability, fatigue and anthropometric measurements. The important relationship of dietary patterns with such clin...

Maternal nutritional status during pregnancy will affect the outcomes for the mother and the newborn. Maternal diet was assessed in 150 pregnant women during the first trimester of pregnancy by a 168-item food frequency questionnaire. Dietary patterns were explored by Factor analysis, and association of patterns with maternal and neonatal outcomes such as gestational diabetes mellitus (GDM), anemia and anthropometric indices were determined by analysis of variance and linear regression analysis. Three major dietary patterns were identified: 1) High Carbohydrate-Lower Fat (mean age, 27.67 ± 6.1; n = 34), 2) High Carbohydrate-Higher Fat (27.70 ± 4.1; n = 55), and 3) High Fiber (29.27 ± 5.8; n = 61). A significant difference was observed between maternal dietary patterns (p < 0.01) for GDM, while it was not significant for anemia. Also, the number of preterm and low birth weight (LBM) infants as well as mean weight, height and head circumference of the infants did not differ significantly between patterns, but there was a significant difference between the maternal dietary patterns about the number of macrosomic babies, which was higher in the second (n = 9) and third (n = 9) dietary patterns (p < 0.01). After adjusting for mothers' age, disease history, disease status, and energy intake, High Carbohydrate-Lower Fat dietary pattern was more associated with GDM than crude model (p = 0.01 vs. p = 0.02). The present study indicated a significant relationship between maternal dietary patterns before pregnancy and GDM and fetal macrosomia.