The effect of diet quality on the risk of developing gestational diabetes mellitus: A systematic review and meta-analysis

Abstract

ObjectiveTo examine the effect of diet quality on the risk of gestational diabetes mellitus.MethodsThis review included cohort and case-control studies reporting an association between diet quality and gestational diabetes mellitus. We searched PubMed, Cochrane Library, Web of Science, Embase, PsycINFO, CINAHL Complete, Chinese Periodical Full-text Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and China Wanfang Database for studies published from inception to November 18, 2022. The Newcastle-Ottawa Scale was used for quality assessment, and the overall quality of evidence was assessed using the GRADEpro GDT.ResultsA total of 19 studies (15 cohort, four case-control) with 108,084 participants were included. We found that better higher diet quality before or during pregnancy reduced the risk of developing gestational diabetes mellitus, including a higher Mediterranean diet (OR: 0.51; 95% CI: 0.30–0.86), dietary approaches to stop hypertension (OR: 0.66; 95% CI: 0.44–0.97), Alternate Healthy Eating Index (OR: 0.61; 95% CI: 0.44–0.83), overall plant-based diet index (OR: 0.57; 95% CI: 0.41–0.78), and adherence to national dietary guidelines (OR: 0.39; 95% CI:0.31–0.48). However, poorer diet quality increased the risk of gestational diabetes mellitus, including a higher dietary inflammatory index (OR: 1.37; 95% CI: 1.21–1.57) and overall low-carbohydrate diets (OR: 1.41; 95% CI: 1.22–1.64). After meta-regression, subgroup, and sensitivity analyses, the results remained statistically significant.ConclusionsBefore and during pregnancy, higher diet quality reduced the risk of developing gestational diabetes mellitus, whereas poorer diet quality increased this risk.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022372488.

Multigenerational diabetes mellitus

“…For example, meta-analysis has demonstrated an 18% reduction in the risk of GDM with lifestyle intervention, with increased effect size (22%) when intervention was initiated earlier (before 15 weeks gestation) ( 140 ). Furthermore, pre-pregnancy adherence to Mediterranean diet also decreases the risk of developing GDM, regardless of weight and other risk factors, in particular, avoidance of pre-conception consumption of processed and fatty meats ( 141 , 142 ). “Before the Beginning”, an RCT of preconception lifestyle intervention that is currently ongoing, is examining the effect of time-restricted eating and exercise on maternal glucose tolerance at 28 weeks gestation ( 143 ).Time-restricted eating has been demonstrated to be a feasible lifestyle intervention in those with obesity and T2D outside of pregnancy ( 144 ), however adherence in pregnancy may be more challenging outside of the more intensive support offered during an RCT.…”

Relationship between gut microbiota and the pathogenesis of gestational diabetes mellitus: a systematic review

“…High-quality diets before and during pregnancy reduce the risk of developing gestational diabetes, whereas poorer diet quality increases the risk of developing gestational diabetes ( Gao et al., 2023 ). Vitamin B12 deficiency is associated with an increased risk of developing GDM, and attention needs to be paid to the balance of vitamin B12 and folate ( He et al., 2020 ).…”

Exploring Lifestyle and Dietary Patterns in Pregnancy and Their Impact on Health: A Comparative Analysis of Two Distinct Groups 10 Years Apart

“…Concerning the mother, inadequate nutrition can alter the course of pregnancy by increasing the risk of pre-eclampsia [1], gestational diabetes [2,3], and cesarean section [4]. In terms of fetal health, inadequate nutrition may result in neural tube defects [5,6], altered neurodevelopment [7,8], intra-uterine growth restriction [9], macrosomia [10], as well as neonatal hypoglycemia [11].…”