Preconception Dietary Inflammatory Index and Risk of Gestational Diabetes Mellitus Based on Maternal Body Mass Index: Findings from a Japanese Birth Cohort Study

Abstract

We aimed to examine the impact of a preconception pro-inflammatory diet on gestational diabetes mellitus (GDM) using singleton pregnancy data from the Japan Environment and Children’s Study involving live births from 2011 to 2014. Individual meal patterns before pregnancy were used to calculate the dietary inflammatory index (DII). Participants were categorized according to DII quartiles 1–4 (Q1 and Q4 had the most pro-inflammatory and anti-inflammatory diets, respectively). The participants were stratified into five groups by pre-pregnancy body mass index (BMI): G1 to G5 (<18.5 kg/m2, 18.5 to <20.0 kg/m2, 20.0 to <23.0 kg/m2, 23.0 to <25.0 kg/m2, and ≥25.0 kg/m2, respectively). A multiple logistic regression model was used to estimate the effect of the anti-inflammatory diet on GDM, early diagnosed (Ed)-GDM, and late diagnosed (Ld)-GDM in each BMI group. Trend analysis showed that the risk of GDM, Ed-GDM, and Ld-GDM increased with increased pre-pregnancy BMI values. In the G4 group, the risk of Ed-GDM increased in Q2 and Q4. This study suggests that, although higher maternal BMI increases the risk of GDM, the effect of a preconception pro-inflammatory diet on the occurrence of GDM depends on pre-pregnancy BMI. This result may facilitate personalized preconception counseling based on maternal BMI.

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 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. 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 ).…”

“…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 ).…”

Early life programming of neurodevelopment and growth: understanding nutritional, inflammatory, and placental contributions in complex pregnancies

“…These findings are consistent with research reporting a reduced risk of fetal NTDs in pregnant people adhering to more healthful diets (i.e., a diet higher in fruits and vegetables, fish, and whole grains), compared to other dietary patterns [503][504][505] , even after adjusting for folic acid intake 504 . Mothers of cases also had diets with higher inflammatory potential than controls, which may increase maternal inflammatory load, oxidative stress, risk of pregnancy disorders, and low birth weight [506][507][508][509] . Understanding whether a preconception diet with more anti-inflammatory potential could reduce the risk of fetal NTDs, or improve outcomes in affected pregnancies, could be evaluated in larger cohorts that have collected the required data, such as the US National Birth Defects Prevention Study 510 .…”