Specific fruit but not total fruit intake during early pregnancy is inversely associated with gestational diabetes mellitus risk: a prospective cohort study

Abstract

Objectives: Fruit intake may influence gestational diabetes mellitus (GDM) risk. However, prospective evidence remains controversial and limited. The current study aimed to investigate whether total fruit and specific fruit intake influence GDM risk. Design: A prospective cohort study was conducted. Dietary information was collected by a 3-d 24-h dietary recall. All participants underwent a standard 75-g oral glucose tolerance test at 24–28 gestational weeks. Log-binomial models were used to estimate the association between fruit intake and GDM risk, and the results are presented as relative risks (RR) and 95 % CI. Setting: Southwest China. Participants: Totally, 1453 healthy pregnant women in 2017. Results: Total fruit intake was not associated with lower GDM risk (RR of 1·03 (95 % CI 0·83, 1·27) (Ptrend = 0·789)). The RR of GDM risk was 0·73 for the highest anthocyanin-rich fruit intake quartile compared with the lowest quartile (95 % CI 0·56, 0·93; Ptrend = 0·015). A higher grape intake had a linear inverse association with GDM risk (Q4 v. Q1: RR = 0·65; 95 % CI 0·43, 0·98; Ptrend = 0·044), and after further adjustment for anthocyanin intake, the inverse association tended to be non-linear (Q4 v. Q1: RR = 0·65; 95 % CI 0·44, 0·98; Ptrend = 0·079). However, we did not find an association between glycaemic index-grouped fruit, glycaemic load-grouped fruit or other fruit subtype intake and GDM risk. Conclusions: In conclusion, specific fruit intake (particularly anthocyanin-rich fruit and grapes) but not total fruit intake was inversely associated with GDM risk.

Association of Polyphenols Consumption with Risk for Gestational Diabetes Mellitus and Preeclampsia: A Systematic Review and Meta-Analysis

“…In studies assessing the association between polyphenol consumption and the risk of GDM, women were recruited from hospitals [ 24 , 26 , 27 , 30 , 31 ] or national cohort studies [ 25 , 28 , 29 ]. In articles assessing the risk of PE, three studies were hospital or care practices based [ 20 , 21 , 22 ] and one was a national cohort study [ 23 ].…”

“…From the studies selected to evaluate the association of polyphenol-rich food consumption and GDM risk [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ], the same population was evaluated in Dong et al (2019), [ 28 ] and Dong et al (2021) [ 29 ]. Therefore, two different metanalyses were performed including chocolate and soy isoflavone consumption, respectively ( Figure 2 A,B).…”

“…In both cases, the analysis included a total of 162,443 individuals. All eight studies were cohort and corresponded to self-administrated questionnaires [ 24 , 26 , 28 , 29 ] or in-person/telephone interviews to apply questionnaires [ 25 , 27 , 30 , 31 ]. The majority of these studies were conducted in Asia [ 27 , 28 , 29 , 30 , 31 ], followed by Europe [ 25 , 26 ] and North America [ 24 ].…”

“…All eight studies were cohort and corresponded to self-administrated questionnaires [ 24 , 26 , 28 , 29 ] or in-person/telephone interviews to apply questionnaires [ 25 , 27 , 30 , 31 ]. The majority of these studies were conducted in Asia [ 27 , 28 , 29 , 30 , 31 ], followed by Europe [ 25 , 26 ] and North America [ 24 ]. In addition, we analyzed separately studies that quantified total polyphenol intake or their subclasses ( Supplementary Figure S1A–C ).…”

“…In addition, we analyzed separately studies that quantified total polyphenol intake or their subclasses ( Supplementary Figure S1A–C ). Polyphenol-rich food intake was estimated by using a food frequency questionnaire [ 24 , 28 , 29 , 30 ], 3-day 24 h dietary records or 4-day weighed food records [ 26 , 27 , 31 ], and other types of questionnaire [ 25 ]. Those articles that measured 3-day 24-h dietary records to estimate GDM risk evaluated the consumption of polyphenol-rich foods during each gestational trimester [ 27 , 31 ], whereas Tryggvadottir and co-authors [ 26 ] measured 4-day weighed food records during 19 to 24 gestational weeks.…”