Sociodemographic Factors Associated with Adherence to Dietary Guidelines in Women with Gestational Diabetes: A Cohort Study.

Sara Mustafa,Clare Wall,Jane Harding,Caroline Crowther

doi:10.3390/nu13061884

Sara Mustafa, Clare Wall + Show 2 more

Open Access

https://doi.org/10.3390/nu13061884

Copy DOI

Journal: Nutrients	Publication Date: May 31, 2021
Citations: 7	License type: CC BY 4.0

Affiliation: University of Auckland

Abstract

Dietary advice is the cornerstone of care for women with gestational diabetes mellitus (GDM). However, adherence to this advice is variable. We aimed to identify the proportion of women with GDM who adhere to the New Zealand nutrition guideline recommendations and assess the sociodemographic factors linked to dietary adherence. We assessed dietary intake at 36 weeks’ gestation in a cohort of 313 women with GDM and compared this with the dietary recommendations for the management of GDM. Associations between maternal characteristics and dietary adherence were assessed using ANOVA, chi square, logistic regression, and linear regression tests. Women with GDM had an average adherence score of 6.17 out of 10 to dietary recommendations, but no one adhered to all the recommendations. Adherence to recommendations was lowest for saturated fat, and wholegrain breads and cereals. While 85% visited a dietitian, only 28% of women achieved their recommended weight gain. Maternal factors associated with lower dietary adherence were primiparity, no previous history of GDM, being underweight, and smoking. Adherence to the dietary recommendations by women with GDM in New Zealand for the management could be improved. Further research is needed to identify ways for women with GDM to improve their dietary adherence.

Highlights

Gestational diabetes mellitus (GDM) is glucose intolerance first recognised in pregnancy and is managed by providing dietary and lifestyle advice, together with pharmacological support, such as oral hypoglycaemics and/or insulin when needed [1]
This study aimed to assess the proportion of women with GDM who adhere to the dietary recommendations in New Zealand and the sociodemographic factors associated with adherence
Women with a singleton pregnancy were eligible for this cohort study if they participated in the TARGET Trial, completed a food frequency questionnaire (FFQ) [11] in late pregnancy, and data were available for at least one of the following maternal and sociodemographic characteristics: maternal age, maternal history of GDM, family history of diabetes, parity, body mass index (BMI), ethnicity, smoking status, gestational age at trial entry and New Zealand Deprivation Index (NZDep 2013) [12]

Summary

Introduction

Gestational diabetes mellitus (GDM) is glucose intolerance first recognised in pregnancy and is managed by providing dietary and lifestyle advice, together with pharmacological support, such as oral hypoglycaemics and/or insulin when needed [1]. Dietary therapy alone has been reported to be effective in controlling maternal blood glucose concentrations in 70% of women [3], reducing the need for pharmacological treatments, such as insulin or oral hypoglycaemics [4]. As dietary advice is recognised worldwide as the first line treatment in the management of GDM, assessment of dietary adherence in women with GDM and factors that may influence this is key when evaluating care practices [5]. Recognising factors that influence dietary adherence by women with GDM to clinical practice guideline recommendations may help identify ways to improve and maintain adherence in high-risk populations [9]

Objectives

Methods

Results

Discussion

Conclusion