Abstract
ABSTRACTOBJECTIVE To investigate the relationship between the dietary patterns of pregnant women with maternal excessive body weight and gestational diabetes mellitus.METHODS A cross-sectional study conducted with a convenience sample of 785 adult pregnant women attended by the Unified Health System of Ribeirão Preto, state of São Paulo, between 2011 and 2012. Two 24-hour dietary recalls, corrected by the multiple source method, were employed . For the classification of the body mass index and the diagnosis of gestational diabetes mellitus, the criteria by Atalah and the World Health Organization were used, respectively. Dietary patterns were obtained by principal component analysis using the Varimax rotation method. The relationship between adherence to patterns, overweight and obesity was analyzed by multinomial logistic regression models and the relationship with gestational diabetes mellitus by adjusted unconditional logistic regression models.RESULTS We identified four dietary patterns: “traditional Brazilian”; “snacks”; “coffee” and “healthy”. Women with a higher adherence to the “Healthy” (OR = 0.52; 95%CI 0.33–0.83) and “Brazilian Traditional” patterns (OR = 0.61; 95%CI 0.38–0.96) presented a lower chance of obesity, when compared to women with lower adherence, regardless of confounding factors. After adjustment for maternal excessive body weight, there was no association between dietary patterns and gestational diabetes mellitus.CONCLUSIONS Among the pregnant women, greater adherence to “traditional Brazilian” and “healthy” patterns was inversely associated with obesity, but no relationship was identified with gestational diabetes mellitus after adjusting for excessive body weight. Prospective studies are recommended to investigate the relationship between dietary patterns, overweight and gestational diabetes mellitus, reducing the chance of reverse causality.
Highlights
Gestational diabetes mellitus (GDM), a hyperglycemia diagnosed for the first time during pregnancy, is the most common metabolic problem during pregnancy[1]
After adjustment for maternal excessive body weight, there was no association between dietary patterns and gestational diabetes mellitus
Among the pregnant women, greater adherence to “traditional Brazilian” and “healthy” patterns was inversely associated with obesity, but no relationship was identified with gestational diabetes mellitus after adjusting for excessive body weight
Summary
Gestational diabetes mellitus (GDM), a hyperglycemia diagnosed for the first time during pregnancy, is the most common metabolic problem during pregnancy[1]. The GDM can trigger the development of obstetric complications and losses to maternal and child health in the short and long term[4,5]. The identification of modifiable risk factors related to the genesis of the disease is extremely relevant. Certain studies indicate that both nutrient and food intake alone and adherence to dietary patterns are directly related to the health of the mother-child binomial[3,6]. The approach of eating patterns is recognized as more comprehensive, considering the synergistic and inhibitory action of the simultaneous consumption of different foods and their relationship with health outcomes[7,8]
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