Abstract
This study investigated the dietary intake of pregnant women with gestational diabetes mellitus (GDM) and their beliefs relating to the consumption of fruits and vegetables (F&V) and sugary foods and drinks. A cross-sectional study was conducted on 239 pregnant women with GDM in Cape Town. Dietary intake was assessed using a quantified Food Frequency Questionnaire and beliefs relating to food choices were assessed using the Theory of Planned Behaviour (TPB). The mean energy intake was 7268 KJ, carbohydrate was 220 (±104.5) g, protein 60.3 (±27.5) g and fat 67.7 (±44.2) g. The macronutrient distribution was 55% carbohydrates, 14.5% protein and 30.5% fat of total energy. The majority of the sample had inadequate intakes of vitamin D (87.4%), folate (96.5%) and iron (91.3%). The median (IQR) amount of added table sugar and sugar sweetened beverages (SSBs) was 4.0 (0.00–12.5) g and 17.9 (0.0–132.8) mL per day, respectively. Only 31.4% met the recommendation (400 g per day) for F&V. Beliefs that it was not easy to exclude sugary foods/drinks and that knowing how to control cravings for sugary foods/drinks are areas to target messages on the sugar content of SSBs. In conclusion, the dietary intake of these women was not optimal and fell short of several nutritional guidelines for pregnant women with hyperglycaemia. The strongly held beliefs regarding sugary foods/drinks may contribute to poor adherence to nutritional guidelines among pregnant women with GDM in South Africa.
Highlights
Pregnancies complicated by hyperglycaemia are classified as pre-existing diabetes or hyperglycaemia first detected in pregnancy, which includes both gestational diabetes mellitus (GDM)and overt diabetes [1,2]
This study found that the macronutrient distribution in pregnant women with GDM in Cape Town did not meet the dietary guidelines of local and international associations as carbohydrate intake are high and protein and fat intakes are low
We recommend that interventions be developed and tested for women with GDM in Cape Town to: (1) establish the macronutrient distribution required for optimal glucose control, (2) meet the recommendations of 400 g/d for fruits and vegetables (F&V) and 28 g/d for fibre, (3) limit intake of added table sugar and sugar sweetened beverages (SSBs) and (4) improve the nutrient density of the diet so that adequate intakes of micronutrients are ensured
Summary
Pregnancies complicated by hyperglycaemia are classified as pre-existing diabetes or hyperglycaemia first detected in pregnancy, which includes both gestational diabetes mellitus (GDM)and overt diabetes [1,2]. The prevalence of hyperglycaemia in pregnancy has been increasing worldwide. The estimated global prevalence is 16.2%, with the vast majority being due to GDM diagnosed in women living in low and middle-income countries [3]. Nutrients 2018, 10, 1183 increase in the prevalence of hyperglycaemia first detected in pregnancy in sub-Saharan Africa over the last 50 years. The prevalence of GDM in South Africa was estimated to be as high as 25.6%. Using the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria [5]. The rise in number of women with hyperglycaemia in pregnancy is likely to be due to changes in lifestyle associated with urbanisation, including a Western style diet and sedentary lifestyle, which lead to overweight and obesity [6]
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