A healthy dietary pattern with a low inflammatory potential reduces the risk of gestational diabetes mellitus

Abstract

Purpose An optimal diet for lowering the risk of gestational diabetes mellitus (GDM) is still to be defined, but may comprise of nutrient intakes, dietary patterns, diet quality, and eating frequency. This study was designed to investigate the contribution of diet in developing GDM in a comprehensive way. Methods The dietary intake of overweight or obese women, a risk group for GDM (n = 351), was assessed using 3-day food diaries and diet quality questionnaires in early pregnancy. Eating frequency and nutrient intakes were calculated, and dietary patterns identified using principal component analysis. The inflammatory potential of the diet was determined by calculating the dietary inflammatory index (DII®) and energy-adjusted DII (E-DII™). GDM was diagnosed with an oral glucose tolerance test at 24–28 gestational weeks. Results Higher adherence to ‘healthier dietary pattern’ characterized by consumptions of vegetables and rye bread associated with a reduced risk of GDM (adjusted OR 0.27, 95% CI 0.11–0.70). Higher E-DII score, indicating pro-inflammatory diet, was associated with a 27% higher risk of GDM (adjusted OR 1.27; 95% CI 1.08–1.49) for each E-DII point. In the evaluation of nutrient intakes, total fat, saturated fatty acids (SFAs), and trans fatty acids were higher and fiber lower in women developing GDM compared to women not developing GDM (all p < 0.05). Intakes of total fat, SFAs, and trans fatty acids were also significant predictors for GDM (all p < 0.05). Conclusions The results emphasize the importance of an overall healthy diet and limitation of foods with SFAs, and other nutrients with a high inflammatory potential in reducing the risk of GDM. Trial registration ClinicalTrials.gov Identifier: NCT01922791, August 14, 2013.

The effect of diet quality on the risk of developing gestational diabetes mellitus: A systematic review and meta-analysis

“…The 19 included studies were published between 2012 and 2022 and included 108,084 study participants. Six studies were conducted in the United States ( 30 – 35 ), five in China ( 36 – 40 ), three in Iran ( 41 – 43 ), and the remaining in Japan ( 44 ), Spain ( 45 ), Iceland ( 46 ), Australia ( 47 ), and Finland ( 48 ). Six studies included pre-pregnancy ( 30 , 31 , 34 , 44 , 45 , 47 ), and the remaining were pregnancy.…”

“…Six studies included pre-pregnancy ( 30 , 31 , 34 , 44 , 45 , 47 ), and the remaining were pregnancy. The reported GDM diagnostic methods included a 100 g ( n = 3) ( 34 , 42 , 45 ) and 75 g ( n = 8) ( 36 – 40 , 44 , 46 , 48 ) oral glucose tolerance test (OGTT), a combination of these ( n = 5) ( 32 , 35 , 41 , 43 , 47 ), or were extrapolated from medical records ( n = 3) ( 30 , 31 , 33 ).…”

“…The eligible studies included 15 cohort studies and four case-control studies. Eleven studies had a low risk of bias [10 cohort studies ( 31 – 36 , 39 , 40 , 44 , 48 ) and one case-control study ( 45 )], and eight studies had a moderate risk of bias [five cohort studies ( 30 , 37 , 38 , 46 , 47 ) and three case-control studies ( 41 – 43 )] ( Figure 2 ).…”

The effect of dietary fiber supplement on prevention of gestational diabetes mellitus in women with pre-pregnancy overweight/obesity: A randomized controlled trial

“…Moreover, pregnant women with pre-pregnancy overweight/obesity have decreased insulin sensitivity as compared with lean or normal-weight women, which puts them at a higher risk of GDM( Johns et al, 2018 ). Dietary fiber has previously been associated with a reduced risk of GDM by several evidences ( Goletzke et al, 2021 ; Pajunen et al, 2022 ). In our study, the incidence of GDM in women randomized to the fiber supplement group was significantly lower than in the control group.…”

Fish Oil And/Or Probiotics Intervention in Overweight/Obese Pregnant Women and Overweight Risk in 24-Month-Old Children

“…Two study visits were arranged during pregnancy and 4 after delivery (3, 6, 12, and 24 months). The women filled in 3-day food diaries in early pregnancy, from which dietary patterns, a healthier and an unhealthier (data not shown), were identified as described previously ( 23 ). The study was carried out according to the guidelines laid down in the Declaration of Helsinki.…”