Diabetes in pregnancy (DIP) impairs fetal and placental development and leads to the programming of metabolic and cardiovascular diseases in the offspring. A prooxidant and proinflammatory intrauterine environment is involved in these developmental alterations. Peroxisome proliferator activated receptors (PPARs) are ligand activated transcription factors with key regulatory functions in developmental, metabolic and anti-inflammatory processes. PPARs can be activated by nutrients, being unsaturated fatty acids their natural ligands. Studies in our laboratory have addressed the effect of diets enriched in PUFAs and MUFAs, capable of activating PPARs, in experimental models of diabetes and pregnancy and in patients with GDM.
Using experimental models of pregestational diabetes, we provided evidence of the capacity of diets enriched in PUFAs in the F0 generation to improve decidual function and feto-placental development in the F0 generation and to ameliorate antioxidant and anti-inflammatory pathways in the placenta of the F1 generation. Besides, diets enriched extra virgin olive oil (EVOO), enriched in MUFAs, provided in the F0 generation, reduce prooxidant, proinflammatory and apoptotic markers in the offspring´s heart and prevent the reduced beta cell number in the offspring´s pancreas. When the EVOO enriched diet is provided to the F1 females that develop GDM we found regulation of PPAR pathways and microRNAs that regulate PPARs, prevention of lipid accretion in the fetal liver and reduction of prooxidant and proinflammatory markers in the placenta. Translational studies performed in GDM patients provided evidence of the capacity of EVOO supplementation to prevent maternal hypertriglyceridemia, to regulate placental PPAR pathways and to reduce placental proinflammatory markers. Our results suggest that diets enriched in unsaturated fatty acids that activate PPARs may be beneficial for the mothers, the placentas and the offspring in pregnancies complicated by maternal diabetes.