The association between dietary patterns before and in early pregnancy and the risk of gestational diabetes mellitus (GDM): Data from the Malaysian SECOST cohort

Yong, Heng Yaw; Shariff, Zalilah Mohd; Yusof, Barakatun Nisak Mohd; Rejali, Zulida; Appannah, Geeta; Bindels, Jacques; Tee, Yvonne Yee Siang; Beek, Eline M. van der

doi:10.1371/journal.pone.0227246

Cited by 16 publications

(27 citation statements)

References 55 publications

(69 reference statements)

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“…Poor dietary habits are also a risk factor for GDM among Southeast Asian women [57]. A higher intake level of seafood protein [58,59] and less fiber [60] in daily meals has been reported to increase the risk of GDM during pregnancy.…”

Section: Risk Factorsmentioning

confidence: 99%

Gestational Diabetes Mellitus in Southeast Asia: A Scoping Review

Kunasegaran

Balasubramaniam

Arasoo

et al. 2021

IJERPH

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A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute’s methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.

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Section: Risk Factorsmentioning

confidence: 99%

Gestational Diabetes Mellitus in Southeast Asia: A Scoping Review

Kunasegaran

Balasubramaniam

Arasoo

et al. 2021

IJERPH

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“…In contrast, a Mediterranean pattern and a healthy dietary pattern characterized with vegetables, rye bread, fruits and berries, and fish are associated with a decreased risk of GDM [18][19][20]. Again, some other investigators have not found any links between dietary patterns and the risk of GDM [21,22]. The most recent suggestion has been that the inflammatory potential of the diet may be associated with various diseases [23] including GDM [24].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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.

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“…A further stratified analysis of BMI at first prenatal visit and GWG at the second trimester revealed that particularly women with height < 150 cm, OW/OB and excessive GWG at the end of the second trimester were significantly at higher risk for developing GDM. The associations between higher pre-pregnancy BMI and excessive GWG with the risk of GDM have not only been established in previous studies [ 35 , 36 ] but also in previously reported data of a prospective cohort study in Malaysia (SECOST) [ 30 , 37 , 38 ]. It is possible that women with short stature and higher pre-pregnancy BMI have limited muscle and higher fat mass [ 39 ].…”

Section: Discussionmentioning

confidence: 81%

Early pregnancy body mass index and gestational weight gain: A mediating or moderating factor for short stature and risk of gestational diabetes mellitus?

et al. 2022

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This study examined the association between height and the risk of Gestational Diabetes Mellitus (GDM), and whether this association was mediated or moderated by early pregnancy body mass index (BMI) and gestational weight gain (GWG) that are known independent risk factors for GDM. Data of a retrospective cohort of pregnant women (N = 1,945) were extracted from antenatal clinic cards. The cut-off values of height in relation to risk of GDM were identified using receiver operating characteristic analysis and four categories of height were derived: < 150 cm, 150–155 cm, 156–160 cm, and > 160cm. Mediation analysis was performed using the Preacher and Hayes bootstrapping method while the moderation effect was tested with multiple regression analysis with interaction terms. Although there was no mediation effect of BMI and GWG on the association between height and risk of GDM, both factors moderated this association with a significant association between shorter height and risk of GDM was observed in overweight / obese women (height < 150 cm: AOR = 1.41, 95% CI = 1.03–2.44; height 156–160 cm: AOR = 1.48, 95% CI = 1.03–2.14). Overweight / obese women with height < 150 cm and excessive GWG at the end of the second trimester (AOR = 2.25, 95% CI = 1.45–4.17) had significantly higher risk of GDM than those without these factors. Short stature (< 150 cm) was significantly associated with GDM risk among OW/OB women with excessive gestational weight gain at the end of second trimester. This finding underscores the importance of maintaining a healthy BMI during reproductive age and gaining weight in recommended range during pregnancy.

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The association between dietary patterns before and in early pregnancy and the risk of gestational diabetes mellitus (GDM): Data from the Malaysian SECOST cohort

Cited by 16 publications

References 55 publications

Gestational Diabetes Mellitus in Southeast Asia: A Scoping Review

Gestational Diabetes Mellitus in Southeast Asia: A Scoping Review

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

Early pregnancy body mass index and gestational weight gain: A mediating or moderating factor for short stature and risk of gestational diabetes mellitus?

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