Association between healthy maternal dietary pattern and risk for gestational diabetes mellitus.
OBJECTIVE
Gestational diabetes mellitus (GDM) is associated with negative health effects for mother and child. The aim was to investigate the association between maternal dietary patterns and GDM.


METHODS
Prospective observational study including 168 pregnant women aged 18-40 years, recruited at routine 20-week ultrasound. All participants kept a 4-day weighed food record following recruitment (commencement: gestational weeks 19-24). Principal component analysis was used to extract dietary patterns from 29 food groups. A Healthy Eating Index (HEI) was constructed. All women underwent an oral glucose tolerance test in weeks 23-28.


RESULTS
One clear dietary pattern (Eigenvalue 2.4) was extracted with positive factor loadings for seafood; eggs; vegetables; fruits and berries; vegetable oils; nuts and seeds; pasta; breakfast cereals; and coffee, tea and cocoa powder, and negative factor loadings for soft drinks and French fries. This pattern was labeled a prudent dietary pattern. Explained variance was 8.2%. The prevalence of GDM was 2.3% among women of normal weight before pregnancy (n=86) and 18.3% among overweight/obese women (n=82). The prudent dietary pattern was associated with lower risk of GDM (OR: 0.54; 95% CI: 0.30, 0.98). When adjusting for age, parity, prepregnancy weight, energy intake, weekly weight gain and total metabolic equivalent of task the association remained (OR: 0.36; 95% CI: 0.14, 0.94). Similar results were found when only including overweight or obese women (OR: 0.31; 95% CI: 0.13, 0.75).


CONCLUSIONS
Adhering to a prudent dietary pattern in pregnancy was clearly associated with lower risk of GDM, especially among women already at higher risk because of overweight/obesity before pregnancy.
Unit for Nutrition Research, Landspitali National University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
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Tryggvadottir
Department of Obstetrics and Gynecology, Women's Clinic, Landspitali University Hospital/University of Iceland, Reykjavik, Iceland.
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Medek
Unit for Nutrition Research, Landspitali National University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
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Birgisdottir
Department of Obstetrics and Gynecology, Women's Clinic, Landspitali University Hospital/University of Iceland, Reykjavik, Iceland.
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Geirsson
Unit for Nutrition Research, Landspitali National University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
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Gunnarsdottir
D000293:Adolescent; D000328:Adult; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000209:etiology*; D004032:Diet / Q000009:adverse effects* / Q000379:methods; D015930:Diet Records; D002149:Energy Intake; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D015430:Weight Gain; D055815:Young Adult