Associations of Diet and Physical Activity with Risk for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Abstract

Rising rates of gestational diabetes mellitus (GDM) and related complications have prompted calls to identify potentially modifiable risk factors that are associated with gestational diabetes mellitus (GDM). We systematically reviewed the scientific literature for observational studies examining specific dietary and/or physical activity (PA) factors and risk of GDM. Our search included PubMed, Medline, CINAHL/EBSCO, Science Direct and EMBASE, and identified 1167 articles, of which 40 met our inclusion criteria (e.g., singleton pregnancy, reported diet or PA data during pre-pregnancy/early pregnancy and GDM as an outcome measure). Studies were assessed for quality using a modified Quality Criteria Checklist from American Dietetic Association. Of the final 40 studies, 72% obtained a positive quality rating and 28% were rated neutral. The final analysis incorporated data on 30,871 pregnant women. Dietary studies were categorised into either caffeine, carbohydrate, fat, protein, calcium, fast food and recognized dietary patterns. Diets such as Mediterranean Diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH) diet and Alternate Healthy Eating Index diet (AHEI) were associated with 15–38% reduced relative risk of GDM. In contrast, frequent consumption of potato, meat/processed meats, and protein (% energy) derived from animal sources was associated with an increased risk of GDM. Compared to no PA, any pre-pregnancy or early pregnancy PA was associated with 30% and 21% reduced odds of GDM, respectively. Engaging in >90 min/week of leisure time PA before pregnancy was associated with 46% decreased odds of GDM. We conclude that diets resembling MedDiet/DASH diet as well as higher PA levels before or in early pregnancy were associated with lower risks or odds of GDM respectively. The systematic review was registered at PROSPERO () as CRD42016027795.

How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses

“…Compared to no physical activity, any pre-pregnancy or early pregnancy physical activity was associated with a 30% (OR = 0.70, 95% CI 0.57, 0.85; p < 10 −3 ) and a 21% (OR = 0.79, 95% CI 0.64, 0.97; p = 0.03) reduced risk of GDM, respectively. Engaging in >90 min/week of leisure time physical activity before pregnancy was associated with a 46% decreased risk of GDM (OR = 0.54, 95% CI 0.34, 0.87; p = 0.01) [18]. These two studies did not report on neonatal outcome.…”

Dietary Protein Intake, Meat Consumption, and Dairy Consumption in the Year Preceding Pregnancy and During Pregnancy and Their Associations With the Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study in Southwest China

“…Physical activity is a well-established risk factor for the development of GDM ( 42 ). In present study, we were not surprised to find that with the increase of gestational age, the work of pregnant women was significantly reduced, and physical activity during pregnancy (especially in the first trimester) was also reduced.…”

The association between the rs4987105 of 5-lipoxygenase (ALOX5) gene and gestational glucose metabolism in Chinese population

“…Therefore for Asian pregnant women, BMI by itself should not be considered as a reliable indicator for GDM risk prediction. Aside from obesity, it has been shown that dietary patterns and physical activity significantly influence GDM risk [37][38][39][40]. Life-style changes such as more unhealthy fast food and more sedentary activities may underlie the globally escalating prevalence of the disease.…”