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Nutrients. 2019 Feb 15;11(2). pii: E405. doi: 10.3390/nu11020405.

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

Hu J1,2, Oken E3,4, Aris IM5,6,7, Lin PD8,9,10, Ma Y11, Ding N12, Gao M13, Wei X14, Wen D15.

Author information

1
Department of Social Medicine, School of Public Health, China Medical University, Shenyang 110122, China. jjhu@cmu.edu.cn.
2
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA. jjhu@cmu.edu.cn.
3
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA. emily_oken@harvardpilgrim.org.
4
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02113, USA. emily_oken@harvardpilgrim.org.
5
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA. Izzuddin_Aris@harvardpilgrim.org.
6
Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore. Izzuddin_Aris@harvardpilgrim.org.
7
Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, Singapore 119228, Singapore. Izzuddin_Aris@harvardpilgrim.org.
8
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA. pil864@mail.harvard.edu.
9
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02113, USA. pil864@mail.harvard.edu.
10
Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80709, Taiwan. pil864@mail.harvard.edu.
11
Department of epidemiology and health statistics, School of Public Health, China Medical University, Shenyang 110122, China. ynma@cmu.edu.cn.
12
Department of Curriculum and Teaching Research, Research Center of Medical Education, China Medical University, Shenyang 110122, China. nding@cmu.edu.cn.
13
Department of Social Medicine, School of Public Health, China Medical University, Shenyang 110122, China. cmugaom@163.com.
14
Department of Social Medicine, School of Public Health, China Medical University, Shenyang 110122, China. xtwei@cmu.edu.cn.
15
Department of Social Medicine, School of Public Health, China Medical University, Shenyang 110122, China. dlwen@cmu.edu.cn.

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.

KEYWORDS:

Asia; dietary pattern; food frequency questionnaire; gestational diabetes mellitus; maternal nutrition; pregnancy; three-day food diary

PMID:
30769927
DOI:
10.3390/nu11020405
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