Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity

Abstract

The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.

Keywords: cardio-diabesity; inflammation; nutraceuticals; oxidative stress; plant foods.

Figure 1

COVID-19, diabesity, and MedDiet interactions. ACE: Angiotensin-Converting Enzyme; COVID-19: Coronavirus Disease 2019, CVD: cardiovascular disease; GDM: Gestational Diabetes Mellitus; KEAP1: Kelch-Like ECH-Associated Protein 1; I-κB: Kappa b inhibitor; IL: interleukin; Nrf2: Nuclear Factor Erythroid-Derived 2-Like; SCFA: Short-Chain Fatty Acids.