The overall plant-based diet index during pregnancy and risk of gestational diabetes mellitus: a prospective cohort study in China

Abstract

The high overall plant-based diet index (PDI) is considered to protect against type 2 diabetes in the general population. However, whether the PDI affects gestational diabetes mellitus (GDM) risk among pregnant women is still unclear. We evaluated the association between PDI and GDM risk based on a Chinese large prospective cohort - Tongji Maternal and Child Health Cohort. Dietary data were collected at 13-28 weeks of pregnancy by a validated semi-quantitative food frequency questionnaire. The PDI was obtained by assigning plant food groups positive scores while assigning animal food groups to reverse scores. GDM was diagnosed by a 75g 2-h oral glucose tolerance test at 24-28 weeks of gestation. Logistic regression models were fitted to estimate odds ratios (ORs) of GDM, with associated 95% confidence intervals (CIs), comparing women in different PDI quartiles. Among the total 2,099 participants, 169 (8.1%) were diagnosed with GDM. The PDI ranged from 21.0 to 52.0 with a median (IQR, interquartile range) as 36.0 (33.0-39.0). After adjusting for social-demographic characteristics and lifestyle factors etc., the participants with the highest quartile of PDI were associated with 57% reduced odds of GDM compared with women in the lowest quartile of PDI (Adjusted OR 0.43; 95% CI, 0.24-0.77; P for trend = 0.005). An IQR increment in PDI was associated with 29% decreased odds of GDM (Adjusted OR 0.71; 95% CI, 0.56-0.90). Findings suggest that adopting a plant-based diet during pregnancy could reduce GDM risk among Chinese women, which may be valuable for dietary counseling during pregnancy.

The health effects of soy: A reference guide for health professionals

“…Finally, Schiattarella et al (365) recently concluded there is some evidence a vegetarian diet as well as a plant-based diet reduces risk of developing GDM and/or some symptoms of this condition. This conclusion aligns with recent work by Wang et al (366), who found that among 2,099 Chinese women participating in the Tongji Maternal and Child Health Cohort, after adjusting for social-demographic characteristics and lifestyle factors, women in the highest quartile of plantbased dietary index (PDI) were less than half as likely to develop GDM. Soy products typically comprise a large part of the bean intake category, which represents a significant portion of the PDI.…”

The effect of diet quality on the risk of developing gestational diabetes mellitus: A systematic review and meta-analysis

“…The eligible studies included 15 cohort studies and four case-control studies. Eleven studies had a low risk of bias [10 cohort studies ( 31 – 36 , 39 , 40 , 44 , 48 ) and one case-control study ( 45 )], and eight studies had a moderate risk of bias [five cohort studies ( 30 , 37 , 38 , 46 , 47 ) and three case-control studies ( 41 – 43 )] ( Figure 2 ).…”

“…The 19 included studies were published between 2012 and 2022 and included 108,084 study participants. Six studies were conducted in the United States (30)(31)(32)(33)(34)(35), five in China (36)(37)(38)(39)(40), three in Iran (41-43), and the remaining in Japan (44), Spain (45), Iceland (46), Australia (47), and Finland (48). Six studies included pre-pregnancy (30,31,34,44,45,47), and the remaining were pregnancy.…”

Prepregnancy Protein Source and BCAA Intake Are Associated with Gestational Diabetes Mellitus in the CARDIA Study

“…Similarly, large-scale studies have found higher pregnancy intake of animal-based fat, heme iron and fried foods [ 20 , 24 ] to be associated with GDM. Conversely, dietary patterns characterized by a higher consumption plant-based food products in the prepregnancy period were associated with a lower risk for developing GDM [ 25 , 26 ]. Non-pregnant young adults also were less likely to develop diabetes in middle age if they transitioned to a more plant-centered dietary pattern, as assessed by the plant-centered A Priori Diet Quality Score (APDQS) in CARDIA [ 27 ].…”