Evidence map›Paper›PMID 36811561›Full record

ReviewThe American journal of clinical nutrition2023

Re-examination of the estimated average requirement for carbohydrate intake during pregnancy: Addition of placental glucose consumption.

Teri L Hernandez, Paul J Rozance

Open access · greenAbstract readReview
In one paragraph

Review in The American journal of clinical nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Article
  4. Review
  5. Observational
  6. Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Teri L HernandezCollege of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA; Children's Hospital Colorado, Anschutz Medical Campus, Aurora, CO, USA. Electronic address: teri.hernandez@cuanschutz.edu.
Paul J RozanceDepartment of Pediatrics, Perinatal Research Center, University of Colorado School of Medicine, Aurora, CO, USA.
Children's Hospital Colorado · USUniversity of Colorado Denver · US

Funding

PILOT STUDY--SUBSTRATE METABOLISM IN EXTREMELY LOW BIRTH WEIGHT INFANTSP30DK048520 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI JANINE A HIGGINS · 1995 to 2026
$32.6M
Nutrient Coordination of Pancreatic Vasculature and Beta-CellsR01DK088139 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI ROZANCE, PAUL JOSEPH · 2011 to 2020
$5.1M
Triglycerides as a Predictor of Newborn Subcutaneous and Liver Fat: Contributors to Fetal Fat Accretion in Obese PregnanciesR01HD102726 · NICHD · UNIVERSITY OF COLORADO DENVER · PI LINDA Anne BARBOUR, Teri L Hernandez · 2021 to 2026
$3.2M
Randomized Trial of Diet in GDM: Metabolic Consequences to Mother and OffspringR01DK101659 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI HERNANDEZ, TERI L · 2014 to 2018
$3.1M
Physiological Ramifications of Chorionic Somatomammotropin DeficiencyR01HD093701 · NICHD · UNIVERSITY OF COLORADO DENVER · PI ANTHONY, RUSSELL V, ROZANCE, PAUL JOSEPH · 2018 to 2022
$2.9M
NICHD NIH HHS R01 HD102726NIDDK NIH HHS P30 DK048520NIDDK NIH HHS R01 DK088139NIDDK NIH HHS R01 DK101659
6 · The paper itself

Abstract

Evidence-based dietary reference intakes for nutrients in healthy individuals were last set in 2005 by the Institute of Medicine. For the first time, these recommendations included a guideline for carbohydrate intake during pregnancy. The recommended dietary allowance (RDA) was set at ≥175 g/d or 45%-65% of total energy intake. In the decades since, carbohydrate intake has been declining in some populations, and many pregnant women consume carbohydrates below the RDA. The RDA was developed to account for both maternal brain and fetal brain glucose requirements. However, the placenta also requires glucose as its dominant energy substrate and is as dependent on maternal glucose as the brain. Prompted by the availability of evidence demonstrating the rate and quantity of human placental glucose consumption, we calculated a potential new estimated average requirement (EAR) for carbohydrate intake to account for placental glucose consumption. Further, by narrative review, we have re-examined the original RDA by applying contemporary measurements of adult brain and whole-body fetal glucose consumption. We also propose, using physiologic rationale, that placental glucose consumption be included in pregnancy nutrition considerations. Calculated from human in vivo placental glucose consumption data, we suggest that 36 g/d represents an EAR for adequate glucose to support placental metabolism without supplementation by other fuels. A potential new EAR of 171 g/d accounts for maternal (100 g) and fetal (35 g) brain, and now placental glucose utilization (36 g), and with extrapolation to meet the needs of nearly all healthy pregnant women, would result in a modified RDA of 220 g/d. Lower and upper safety thresholds for carbohydrate intake remain to be determined, of importance as preexisting and gestational diabetes continue to rise globally, and nutrition therapy remains the cornerstone of treatment.

Indexed as

Diabetes, GestationalPlacentaAdultCarbohydratesEnergy IntakeFemaleGlucoseHumansPregnancyCarbohydratesGlucosecarbohydrateglucoseplacentapregnancyRDA

Identifiers

PMID36811561
PMCPMC10196558
OpenAlexW4312054071

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.