Maternal Dietary Patterns and Gestational Diabetes Mellitus in a Multi-Ethnic Asian Cohort: The GUSTO Study

Abstract

Gestational Diabetes Mellitus (GDM) is associated with an increased risk of perinatal morbidity and long term health issues for both the mother and offspring. Previous research has demonstrated associations between maternal diet and GDM development, but evidence in Asian populations is limited. The objective of our study was to examine the cross-sectional relationship between maternal dietary patterns during pregnancy and the risk of GDM in a multi-ethnic Asian cohort. Maternal diet was ascertained using 24-h dietary recalls from participants in the Growing up in Singapore towards healthy outcomes (GUSTO) study—a prospective mother-offspring cohort, and GDM was diagnosed according to 1999 World Health Organisation guidelines. Dietary patterns were identified using factor analysis, and multivariate regression analyses performed to assess the association with GDM. Of 909 participants, 17.6% were diagnosed with GDM. Three dietary patterns were identified: a vegetable-fruit-rice-based-diet, a seafood-noodle-based-diet and a pasta-cheese-processed-meat-diet. After adjusting for confounding variables, the seafood-noodle-based-diet was associated with a lower likelihood of GDM (Odds Ratio (95% Confidence Interval)) = 0.74 (0.59, 0.93). The dietary pattern found to be associated with GDM in our study was substantially different to those reported previously in Western populations.

Adherence to a healthy eating index for pregnant women is associated with lower neonatal adiposity in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study

“…However, sensitivity analyses in participants who completed a 3-d food diary produced similar estimates, albeit wider CIs (but not with abdominal adiposity measures, which might be due to the reduced sample size). In addition, we also showed that our 24-h recall is moderately valid and has good reproducibility in previously published results (27,29,30,52,62). Second, maternal diet was only assessed during 26-28 wk of gestation, which may not be representative of a diet followed throughout pregnancy.…”

Prevalence of gestational diabetes mellitus evaluated by universal screening with a 75‐g, 2‐hour oral glucose tolerance test and IADPSG criteria

“…Studies have been done in several countries to determine the prevalence of GDM in accordance with the new IADPSG criteria. The prevalence of GDM diagnosed by IADPSG criteria has been reported as 17.6%, 4.2%, 11.8%, 9.5%, 23.3%, 8.6%, and 45% in Singapore, Greenland, Switzerland, South Korea, Sri Lanka, Sub‐Saharan Africa, and the United Arab Emirates, respectively. By contrast, a two‐step approach for diagnosis determined a GDM prevalence of 3.3% in Switzerland and 12% in the United Arab Emirates .…”

Maternal dietary pattern characterised by high protein and low carbohydrate intake in pregnancy is associated with a higher risk of gestational diabetes mellitus in Chinese women: a prospective cohort study

“…Only a few studies have examined the association between dietary patterns during pregnancy and risk of GDM ( 17 – 21 ) . Results from these studies provided an evidence base for dietary recommendation to prevent GDM, but the findings were compromised by either relatively small sample size ( 17 , 18 ) or variance in study design ( 19 ) , dietary assessment tools ( 20 , 21 ) and diagnostic criteria for GDM ( 20 , 21 ) .…”