Fast food consumption and gestational diabetes incidence in the SUN project

Abstract

Background: Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates.

Methods: The prospective dynamic "Seguimiento Universidad de Navarra" (SUN) cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency questionnaire. Fast food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food were established: low (0-3 servings/month), intermediate (>3 servings/month and ≤2 servings/week) and high (>2 servings/week). Non-conditional logistic regression models were used to adjust for potential confounders.

Results: We identified 159 incident cases of gestational diabetes during follow-up. After adjusting for age, baseline body mass index, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at baseline, parity, adherence to Mediterranean dietary pattern, alcohol intake, fiber intake, and sugar-sweetened soft drinks consumption, fast food consumption was significantly associated with a higher risk of incident gestational diabetes, with multivariate adjusted OR of 1.31 (95% conficence interval [CI]:0.81-2.13) and 1.86 (95% CI: 1.13-3.06) for the intermediate and high categories, respectively, versus the lowest category of baseline fast food consumption (p for linear trend: 0.007).

Conclusion: Our results suggest that pre-pregnancy higher consumption of fast food is an independent risk factor for gestational diabetes.

Figure 1. Flow chart depicting the selection process among participants of the SUN project to be included in the present analyses.

Figure 2. Odds ratio (OR) and 95% confidence interval (CI) for incident gestational diabetes according to frequency of fast food consumption in the SUN project (n = 3,048 pregnant women).

Respective numbers (gestational diabetes incidence) for fast food intake of 0–3 times per month (low), >3 times a month and ≤2 times per week (intermediate), and >2 times per week (high) were 616 (24), 1,461 (70), 971 (65). Results represent fully adjusted model (age, baseline BMI, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at baseline, parity, adherence to Mediterranean dietary pattern, fiber intake, alcohol intake, and sugar-sweetened soft drinks consumption).