title: Association between pre-pregnancy consumption of meat, iron intake, and the risk of gestational diabetes: the SUN project.
abstract: OBJECTIVE
  We assessed the association of total meat, processed, and unprocessed red meat and iron intake with the risk of developing gestational diabetes mellitus (GDM) in pregnant women.
  
  
  METHODS
  We conducted a prospective study among 3298 disease-free Spanish women participants of the SUN cohort who reported at least one pregnancy between December 1999 and March 2012. Meat consumption and iron intake were assessed at baseline through a validated, 136-item semi-quantitative, food frequency questionnaire. We categorized total, red, and processed meat consumption and iron intake into quartiles. Logistic regression models were used to adjust for potential confounders.
  
  
  RESULTS
  We identified 172 incident cases of GDM. In the fully adjusted analysis, total meat consumption was significantly associated with a higher risk of GDM [OR = 1.67 (95% CI 1.06-2.63, p-trend 0.010)] for the highest versus the lowest quartile of consumption. The observed associations were particularly strong for red meat consumption [OR = 2.37 (95% CI 1.49-3.78, p-trend < 0.001)] and processed meat consumption [OR = 2.01 (95% CI 1.26-3.21, p-trend 0.003)]. Heme iron intake was also directly associated with GDM [OR = 2.21 (95% CI 1.37-3.58, p-trend 0.003)], although the association was attenuated and lost its statistical significance when we adjusted for red meat consumption [OR = 1.57 (95% CI 0.91-2.70, p-trend 0.213)]. No association was observed for non-heme and total iron intake, including supplements.
  
  
  CONCLUSIONS
  Our overall findings suggest that higher pre-pregnancy consumption of total meat, especially red and processed meat, and heme iron intake, are significantly associated with an increased GDM risk in a Mediterranean cohort of university graduates.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.|Division of Nutrition, Department of Endocrinology and Nutrition, Hospital de Navarra, Pamplona, Spain.
authors.forename: Amelia
authors.initials: A
authors.lastname: Marí-Sanchis
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
authors.forename: Ginette
authors.initials: G
authors.lastname: Díaz-Jurado
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.|Department of Internal Medicine (Endocrinology), Hospital Reina Sofia, Tudela, Spain.
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Basterra-Gortari
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.|Navarra Institute for Health Research (IDISNA), Pamplona, Spain.|Biomedical Research Center Network on Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: de la Fuente-Arrillaga
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.|Navarra Institute for Health Research (IDISNA), Pamplona, Spain.|Biomedical Research Center Network on Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martínez-González
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain. mbes@unav.es.|Navarra Institute for Health Research (IDISNA), Pamplona, Spain. mbes@unav.es.|Biomedical Research Center Network on Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain. mbes@unav.es.
authors.forename: Maira
authors.identifier: http://orcid.org/0000-0002-9139-4206
authors.initials: M
authors.lastname: Bes-Rastrollo
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000517:prevention & control; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D019587:Dietary Supplements / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006418:Heme / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D019266:Iron, Dietary / Q000009:adverse effects*; D039382:Maternal Nutritional Physiological Phenomena / Q000208:ethnology; D008460:Meat / Q000009:adverse effects*; D008461:Meat Products / Q000009:adverse effects*; D016742:Preconception Care; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012648:Self Care; D057566:Self Report; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019266:Iron, Dietary; D006418:Heme
keywords: Gestational diabetes mellitus; Heme iron intake; Mediterranean population; Red and processed meat; Total meat