The Association between Dietary Patterns and Pre-Pregnancy BMI with Gestational Weight Gain: The “Born in Shenyang” Cohort

Abstract

The reported associations of maternal dietary patterns during pregnancy with gestational weight gain are inconsistent, especially among the less studied Asian Chinese populations. In a prospective pre-birth cohort study conducted in northern China, we determined the associations between maternal dietary patterns and the probability of excess gestational weight gain (EGWG) among 1026 pregnant women. We used 3-day food diaries to assess maternal diet and performed principal component analysis to identify dietary patterns. Maternal adherence to a traditional pattern, which was characterized by a higher intake of tubers, vegetables, fruits, red meat, and rice, was associated with a higher probability of EGWG (quartile 3 vs. quartile 1, odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.10−2.38). This risk association was more pronounced among women who were overweight/obese before pregnancy (quartile 4 vs. quartile 1, OR = 5.17, 95% CI = 1.45–18.46; p for interaction < 0.01). Maternal adherence to a high protein pattern, which was characterized by a higher intake of fried foods, beans and bean products, dairy products, and fruits, was associated with a lower risk of EGWG (quartile 3 vs. quartile 1, OR = 0.56, 95% CI, 0.39−0.81). The protective association was more pronounced among non-overweight/obese women (p for interaction < 0.01). These findings may help to develop interventions and better define target populations for EGWG prevention.

Associations of Dietary Patterns during Pregnancy with Gestational Hypertension: The “Born in Shenyang” Cohort Study

“…In the present study, we observed evidence that the association between maternal dietary patterns and the development of GH is stratified by maternal pre-pregnancy weight status. Previous studies have indicated that the association between maternal prenatal dietary patterns and the risk of GDM [ 17 ] or gestational weight gain [ 18 ] is stratified by women’s BMI levels. To our knowledge, ours is the first study to report the effect of the interaction between maternal dietary patterns and pre-pregnancy weight status on maternal GH risk.…”

“…To assess the linear trend between dietary patterns and pregnant women’s blood pressure, we took the median score of each dietary pattern quartile as a continuous variable, and reported the p -for-trend in multivariable models. Previous studies have reported that associations between maternal diet and complications of pregnancy may be modified by women’s pre-pregnancy weight status [ 17 , 18 ]. Therefore, we further examined the potential effect modification of maternal pre-pregnancy BMI (overweight/obese [OwOb] [BMI < 24 kg/m 2 ] vs. non-OwOb [BMI ≥ 24 kg/m 2 ]) by including multiplicative interaction terms in the models.…”

“…In addition, previous studies have reported that the association between maternal diet and pregnancy complications, such as GDM [ 17 ] and excessive gestational weight gain [ 18 ], may be stratified by women’s pre-pregnancy body mass index (BMI). Possible mechanisms could be that the pre-pregnancy weight status represents the overall nutrient and metabolism background, and thus, may modify the influence of prenatal diets on women’s metabolic outcomes.…”

Dietary intake patterns during pregnancy and excessive gestational weight gain: a systematic review and meta-analysis

“…According to previous studies, we classified the dietary patterns in the included articles into three categories: healthy dietary patterns, [16][17][18][19]21,22,[24][25][26][27] unhealthy dietary patterns, [18][19][20][21][22]26,28,29 and mixed dietary patterns. [18][19][20][21][22][27][28][29][30] Healthy dietary patterns are characterized by high intake of fruits, vegetables, soy products, whole grains, fish, seafood, low-fat yogurt, olive oil, low-fat dairy, nuts, and legumes.…”

“…[18][19][20] This is in contrast to the results of a cohort study from Shenyang, China, where a negative association between sweet food patterns and EGWG was established. 21 Another study 22 failed to establish a significant association between a dietary pattern characterized by the higher intake of cake, coffee, sugary fizzy drinks, alcohol, sweets, and fast food and EGWG. A previous review paper 23 showed that neither healthy nor unhealthy dietary patterns are significantly associated with EGWG.…”