Dietary Patterns during Pregnancy Are Associated with the Risk of Gestational Diabetes Mellitus: Evidence from a Chinese Prospective Birth Cohort Study

Abstract

Dietary patterns during pregnancy have been shown to influence the development of gestational diabetes mellitus (GDM). However, evidence from Asian populations is limited and inconsistent. We conducted a prospective cohort study in China to assess the relationship between dietary patterns and GDM. We administered three-day food diaries (TFD) and food frequency questionnaires (FFQ) at the second trimester. GDM was diagnosed with a 75 g 2-h oral glucose tolerance test at 24⁻28 weeks of gestation. We identified dietary patterns using principal components analysis and used multivariable logistic regression to investigate associations of dietary patterns with GDM. Of the 1014 participants, 23.5% were diagnosed with GDM. Both the TFD and FFQ identified a "traditional pattern", consisting of high vegetable, fruit, and rice intake, which was associated with a lower GDM risk (odds ratio (OR) for quartile 4 versus quartile 1: 0.40, 95% CI: 0.23⁻0.71 for traditional pattern (TFD); OR: 0.44, CI: 0.27⁻0.70 for traditional pattern (FFQ)). The protective associations were more pronounced among women ≥35 years old. A whole grain⁻seafood TFD pattern was associated with higher risk of GDM (OR: 1.73, 95% CI: 1.10⁻2.74). These findings may provide evidence for making dietary guidelines among pregnant women in Chinese populations to prevent GDM.

Keywords: Asia; dietary pattern; food frequency questionnaire; gestational diabetes mellitus; maternal nutrition; pregnancy; three-day food diary.

Figure 1

Associations between “Traditional pattern (TFD)” and “Traditional pattern (FFQ)” score quantiles and the risk of gestational diabetes mellitus, stratified by maternal age (<35 vs. ≥35). Adjusted for other dietary patterns derived from the same dietary assessment tool (TFD or FFQ), pre-pregnancy body mass index (BMI), age, parity, family income, education level, ethnicity, smoking status, total energy intake from three-day food diaries, and physical activity. TFD: three-day food diaries; FFQ: food frequency questionnaire.