Dietary Patterns during Pregnancy Are Associated with the Risk of Gestational Diabetes Mellitus: Evidence from a Chinese Prospective Birth Cohort Study.

Jiajin Hu,Deliang Wen,Ming Gao,Yanan Ma,Xiaotong Wei,Ning Ding,Emily Oken,Pi-I Lin,Izzuddin Aris

doi:10.3390/nu11020405

Abstract

Dietary patterns during pregnancy have been shown to influence the development of gestational diabetes mellitus (GDM). However, evidence from Asian populations is limited and inconsistent. We conducted a prospective cohort study in China to assess the relationship between dietary patterns and GDM. We administered three-day food diaries (TFD) and food frequency questionnaires (FFQ) at the second trimester. GDM was diagnosed with a 75 g 2-h oral glucose tolerance test at 24–28 weeks of gestation. We identified dietary patterns using principal components analysis and used multivariable logistic regression to investigate associations of dietary patterns with GDM. Of the 1014 participants, 23.5% were diagnosed with GDM. Both the TFD and FFQ identified a “traditional pattern”, consisting of high vegetable, fruit, and rice intake, which was associated with a lower GDM risk (odds ratio (OR) for quartile 4 versus quartile 1: 0.40, 95% CI: 0.23–0.71 for traditional pattern (TFD); OR: 0.44, CI: 0.27–0.70 for traditional pattern (FFQ)). The protective associations were more pronounced among women ≥35 years old. A whole grain–seafood TFD pattern was associated with higher risk of GDM (OR: 1.73, 95% CI: 1.10–2.74). These findings may provide evidence for making dietary guidelines among pregnant women in Chinese populations to prevent GDM.

Highlights

Gestational diabetes mellitus (GDM), which is the onset of diabetes or glucose intolerance first recognized during pregnancy [1], is a common medical disorder with short- and long-term adverse outcomes for both mothers and children [2,3,4,5]
There were no significant differences for age, ethnicity, and parity between the women who participated in the cohort study (n = 1338) and women did not respond (n = 730)
Women who participated in the present study reported a higher rate of educational attainment of college and above

Summary

Introduction

Gestational diabetes mellitus (GDM), which is the onset of diabetes or glucose intolerance first recognized during pregnancy [1], is a common medical disorder with short- and long-term adverse outcomes for both mothers and children [2,3,4,5]. In China, there was a rapid increase in the prevalence of GDM during the last decades, and the reported prevalence currently ranges from 9.3% to 18.9%, depending on the region [8,9]. Increasing evidence suggests that dietary intake has an important role in the development of GDM [10,11,12,13,14,15,16,17,18]. Most studies have examined the role of individual macronutrients or micronutrients on the subsequent risk of GDM [19,20,21,22]. Instead of looking at individual nutrients or foods, examining the effects of overall dietary patterns, which represent a broader picture of food and nutrient consumption, may be more relevant and useful for predicting future disease risk [23]

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