Abstract
The purpose of this study was to determine the associations between amount and type of dietary protein intake and insulin sensitivity in late pregnancy, in normal weight and overweight women (29.8 ± 0.2 weeks gestation, n = 173). A 100-g oral glucose tolerance test (OGTT) was administered following an overnight fast to estimate the metabolic clearance rate of glucose (MCR, mg·kg−1·min−1) using four different equations accounting for the availability of blood samples. Total (TP), animal (AP), and plant (PP) protein intakes were assessed using a 3-day food record. Two linear models with MCR as the response variable were fitted to the data to estimate the relationship of protein intake to insulin sensitivity either unadjusted or adjusted for early pregnancy body mass index (BMI) because of the potential of BMI to influence this relationship. There was a positive association between TP (β = 1.37, p = 0.002) and PP (β = 4.44, p < 0.001) intake in the last trimester of pregnancy and insulin sensitivity that weakened when accounting for early pregnancy BMI. However, there was no relationship between AP intake and insulin sensitivity (β = 0.95, p = 0.08). Therefore, early pregnancy BMI may be a better predictor of insulin sensitivity than dietary protein intake in late pregnancy.
Highlights
Over half of women of child-bearing age in the United States are overweight or obese [1] and approximately 10% of pregnant women will develop gestational diabetes mellitus (GDM) during pregnancy [2]
We did not separate participants based on early pregnancy body mass index (BMI) status for statistical analysis, we used early pregnancy BMI as a confounder; Table 1 shows the descriptive data of the participants both combined and based on early pregnancy BMI
BMI, fasting insulin, fasting glucose, and HOMA2-IR were higher in OW and OB compared to NW
Summary
Over half of women of child-bearing age in the United States are overweight or obese [1] and approximately 10% of pregnant women will develop gestational diabetes mellitus (GDM) during pregnancy [2]. Dietary protein recommendations during pregnancy (0.88–1.1·g kg−1 ·d−1 ) are based on factorial estimates of current recommendations for healthy, non-pregnant populations as outlined by the Estimated Average Requirement (EAR, 0.60 g kg−1 ·d−1 ) and the Recommended Dietary Allowance (RDA, 0.8 g kg−1 ·d−1 ) for healthy adults. These static guidelines are potentially worrisome because adequate protein intake during pregnancy is critical to support the increase in total protein accretion [4] and without adequate dietary protein intake, growth and development of maternal and fetal tissues may be compromised [6,7]
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