Temporal Trends in Maternal Food Intake Frequencies and Associations with Gestational Diabetes: The Cambridge Baby Growth Study

Abstract

Previous studies have suggested that in the first decade of this century the incidence of gestational diabetes (GDM) in pregnancy rose worldwide. In the Cambridge Baby Growth Study cohort we observed that this temporal trend was associated with an index of multiple deprivation and reductions in indices of insulin secretion. Deprivation level was not directly associated with GDM, suggesting that the temporal trend may relate more to other factors linked to it, such as dietary composition. In this study we investigated temporal trends in perceived food intake frequencies, derived from a qualitative, short questionnaire, in 865 pregnant Cambridge Baby Growth Study (CBGS) recruits. A number of food frequency ranks showed both temporal trends and associations with GDM, but of note is the frequency of egg consumption (negative temporal trend p = 0.03, slope = −6.2 ranks/year; negative association with GDM p = 3.0 × 10−8, slope = −0.002 increased risk/rank) as it was also positively associated with the insulin disposition index (p = 1.17 × 10−3, slope = 0.42 ranks. L/mmoL). These results are consistent with a potential protective effect of factors related to the frequency of egg consumption in pregnancy. Such factors may have contributed to the observed temporal trend in GDM risk but the overall detectable effect appears to have been small.

Multiple Micronutrient Supplementation during Pregnancy and Increased Birth Weight and Skinfold Thicknesses in the Offspring: The Cambridge Baby Growth Study

“…Each of the pregnant women were given an extensive questionnaire at recruitment to fill in as pregnancy progressed (with assistance from trained research nurses if required) [ 9 ]. These questionnaires were collected by the research nurses after the birth of the babies.…”

“…Food frequency intakes were also collected from the pregnancy questionnaires [ 9 ]. As part of a section of the questionnaire about lifestyle, there was a short (specific) food frequency questionnaire which covered most of the major food and drink types.…”

“…This cohort came from a high-income country, and indeed, the participants were generally less deprived than the national average for this country [ 8 ]. The maternal participants also appeared to consume varied diets [ 9 ]. In the absence of having detailed records of the nutritional status for this cohort, it should be noted that, in the UK as a whole, at the start of recruitment in this cohort, younger adults (particularly women with low socioeconomic statuses) showed relative trends for low micronutrient intakes [ 10 ].…”

Nutrition for Gestational Diabetes—Progress and Potential

“…that contributed the most to the differences in the composition of the gut microbiota in ketonuric women was Methanobrevibacter , which, when assessing metagenomic linkage groups, in a previously published metagenome-wide association study of GDM was found to be enriched in healthy controls [ 18 ]. The third paper in this Special Issue, predominantly related to the time in pregnancy before any diagnosis of GDM, was from Cambridge Baby Growth Study investigators [ 19 ]. In their contemporary birth and infancy growth cohort they, like many investigators in other studies, had noticed a temporal trend in the incidence of GDM [ 20 ].…”

“…Using a food frequency questionnaire, with all its inherent limitations [ 21 ], they found that the food type most consistently tracking the previously observed trends was eggs. In fact, egg consumption appeared to be protective against GDM, although the effect size was small [ 19 ]. Egg consumption in isolation may not totally explain the associations; however, principal component analysis suggested that in this cohort it was positively linked to the consumption of fresh fruit and green vegetables, salad, yogurt and tap water, i.e., a “healthy” diet.…”