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J Nutr. 2017 Apr;147(4):653-660. doi: 10.3945/jn.116.243881. Epub 2017 Mar 8.

Higher Maternal Dietary Protein Intake Is Associated with a Higher Risk of Gestational Diabetes Mellitus in a Multiethnic Asian Cohort.

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Departments of Obstetrics and Gynaecology.
Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.
Paediatrics, and.
Departments of Nutrition and Dietetics and.
Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore.
Khoo Teck Puat-National University Children's Medical Institute.
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Liggins Institute, University of Auckland, Auckland, New Zealand.
Medical Research Council Lifecourse Epidemiology Unit, Southampton, United Kingdom; and.
National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom.
Medicine, Yong Loo Lin School of Medicine,
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore;


Background: Dietary protein may affect glucose metabolism through several mechanisms, but results from studies on dietary protein intake and risk of gestational diabetes mellitus (GDM) have been inconsistent.Objective: We examined the cross-sectional associations of dietary protein intake from different food sources during pregnancy with the risk of GDM in a multiethnic Asian population.Methods: We included 980 participants with singleton pregnancies from the Growing Up in Singapore Toward healthy Outcomes (GUSTO) cohort. Protein intake was ascertained from 24-h dietary recall and 3-d food diaries at 26-28 wk gestation. GDM was defined as fasting glucose ≥7.0 mmol/L and/or 2-h postload glucose ≥7.8 mmol/L at 26-28 wk gestation. We evaluated the association of dietary protein intake with GDM risk by substituting carbohydrate with protein in an isocaloric model with the use of multivariable logistic regression analysis.Results: The prevalence of GDM was 17.9% among our participants. After adjustment for potential confounders, a higher total dietary protein intake was associated with a higher risk of GDM; the OR comparing the highest with the lowest quartile of intake was 2.15 (95% CI: 1.27, 3.62; P-trend = 0.016). Higher intake levels of both animal protein (OR: 2.87; 95% CI: 1.58, 5.20; P-trend = 0.001) and vegetable protein (OR: 1.78; 95% CI: 0.99, 3.20; P-trend = 0.009) were associated with a higher risk of GDM. Among the animal protein sources, higher intake levels of seafood protein (OR: 2.17; 95% CI: 1.26, 3.72; P-trend = 0.023) and dairy protein (OR: 1.87; 95% CI: 1.11, 3.15; P-trend = 0.017) were significantly associated with a higher GDM risk.Conclusion: Higher intake levels of both animal and vegetable protein were associated with a higher risk of GDM in Asian women. This trial was registered at as NCT01174875.


Asian; animal protein; dietary protein; gestational diabetes mellitus; vegetable protein

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