title: Higher Maternal Dietary Protein Intake Is Associated with a Higher Risk of Gestational Diabetes Mellitus in a Multiethnic Asian Cohort.
abstract: Background:Dietary protein may affect glucose metabolism through several mechanisms, but results from studies on dietary protein intake and risk of gestational diabetes mellitus (GDM) have been inconsistent.Objective:We examined the cross-sectional associations of dietary protein intake from different food sources during pregnancy with the risk of GDM in a multiethnic Asian population.Methods:We included 980 participants with singleton pregnancies from the Growing Up in Singapore Toward healthy Outcomes (GUSTO) cohort. Protein intake was ascertained from 24-h dietary recall and 3-d food diaries at 26-28 wk gestation. GDM was defined as fasting glucose ≥7.0 mmol/L and/or 2-h postload glucose ≥7.8 mmol/L at 26-28 wk gestation. We evaluated the association of dietary protein intake with GDM risk by substituting carbohydrate with protein in an isocaloric model with the use of multivariable logistic regression analysis.Results:The prevalence of GDM was 17.9% among our participants. After adjustment for potential confounders, a higher total dietary protein intake was associated with a higher risk of GDM; the OR comparing the highest with the lowest quartile of intake was 2.15 (95% CI: 1.27, 3.62;P-trend = 0.016). Higher intake levels of both animal protein (OR: 2.87; 95% CI: 1.58, 5.20;P-trend = 0.001) and vegetable protein (OR: 1.78; 95% CI: 0.99, 3.20;P-trend = 0.009) were associated with a higher risk of GDM. Among the animal protein sources, higher intake levels of seafood protein (OR: 2.17; 95% CI: 1.26, 3.72;P-trend = 0.023) and dairy protein (OR: 1.87; 95% CI: 1.11, 3.15;P-trend = 0.017) were significantly associated with a higher GDM risk.Conclusion:Higher intake levels of both animal and vegetable protein were associated with a higher risk of GDM in Asian women. This trial was registered at clinicaltrials.gov as NCT01174875.
authors.affiliation: Departments of Obstetrics and Gynaecology.
authors.forename: Wei Wei
authors.initials: WW
authors.lastname: Pang
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.
authors.forename: Marjorelee
authors.initials: M
authors.lastname: Colega
authors.affiliation: Departments of Obstetrics and Gynaecology.
authors.forename: Shirong
authors.initials: S
authors.lastname: Cai
authors.affiliation: Biostatistics.
authors.forename: Yiong Huak
authors.initials: YH
authors.lastname: Chan
authors.affiliation: Departments of Obstetrics and Gynaecology.
authors.forename: Natarajan
authors.initials: N
authors.lastname: Padmapriya
authors.affiliation: Paediatrics, and.
authors.forename: Ling-Wei
authors.initials: LW
authors.lastname: Chen
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.
authors.forename: Shu-E
authors.initials: SE
authors.lastname: Soh
authors.affiliation: Departments of Nutrition and Dietetics and.
authors.forename: Wee Meng
authors.initials: WM
authors.lastname: Han
authors.affiliation: Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: Kok Hian
authors.initials: KH
authors.lastname: Tan
authors.affiliation: Paediatrics, and.|Khoo Teck Puat-National University Children's Medical Institute.|Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.|Liggins Institute, University of Auckland, Auckland, New Zealand.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit, Southampton, United Kingdom; and.|National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Departments of Obstetrics and Gynaecology.|Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Medicine, Yong Loo Lin School of Medicine, rob.van.dam@nus.edu.sg ephmcff@nus.edu.sg.|Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore; rob.van.dam@nus.edu.sg ephmcff@nus.edu.sg.|Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.
authors.forename: Mary Ff
authors.initials: MF
authors.lastname: Chong
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D016640:Diabetes, Gestational / Q000208:ethnology / Q000209:etiology*; D004044:Dietary Proteins / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004044:Dietary Proteins
keywords: Asian; animal protein; dietary protein; gestational diabetes mellitus; vegetable protein