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Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing gestational diabetes: the Australian Longitudinal Study on Women's Health

Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing gestational diabetes: the Australian Longitudinal Study on Women's Health
Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing gestational diabetes: the Australian Longitudinal Study on Women's Health

Carbohydrate quantity and quality affect postprandial glucose response, glucose metabolism and risk of type 2 diabetes. The aim of this study was to examine the association of pre-pregnancy dietary carbohydrate quantity and quality with the risk of developing gestational diabetes mellitus (GDM). We used data from the Australian Longitudinal Study on Women's Health that included 3607 women aged 25-30 years without diabetes who were followed up between 2003 and 2015. We examined carbohydrate quantity (total carbohydrate intake and a low-carbohydrate diet (LCD) score) and carbohydrate subtypes indicating quality (fibre, total sugar intake, glycaemic index, glycaemic load and intake of carbohydrate-rich food groups). Relative risks (RR) for development of GDM were estimated using multivariable regression models with generalised estimating equations. During 12 years of follow-up, 285 cases of GDM were documented in 6263 pregnancies (4·6 %). The LCD score, reflecting relatively high fat and protein intake and low carbohydrate intake, was positively associated with GDM risk (RR 1·54; 95 % CI 1·10, 2·15), highest quartile v. lowest quartile). Women in the quartile with highest fibre intake had a 33 % lower risk of GDM (RR 0·67; 95 % CI 0·45, 0·96)). Higher intakes of fruit (0·95 per 50 g/d; 95 % CI 0·90, 0·99) and fruit juice (0·89 per 100 g/d; 95 % CI 0·80, 1·00)) were inversely associated with GDM, whereas cereal intake was associated with a higher risk of GDM (RR 1·05 per 20 g/d; 95 % CI 1·01, 1·07)). Thus, a relatively low carbohydrate and high fat and protein intake may increase the risk of GDM, whereas higher fibre intake could decrease the risk of GDM. It is especially important to take the source of carbohydrates into account.

Adolescent, Adult, Australia, Carbohydrates, Diabetes Mellitus, Type 2/diagnosis, Diabetes, Gestational/diagnosis, Diet, Diet, Carbohydrate-Restricted, Dietary Carbohydrates/administration & dosage, Female, Glycemic Index, Glycemic Load, Humans, Longitudinal Studies, Multivariate Analysis, Nutrition Assessment, Pregnancy, Prospective Studies, Risk, Women's Health, Young Adult
0007-1145
435-444
Looman, Moniek
41b07ae4-350b-4a57-96be-9cabcd04d26f
Schoenaker, Danielle A.J.M.
84b96b87-4070-45a5-9777-5a1e4e45e818
Soedamah-Muthu, Sabita S.
a92e78f0-b28c-44f3-be86-e744fd004ff4
Geelen, Anouk
a1ccaee8-a603-462e-bbbf-57e16b9af3d5
Feskens, Edith J.M.
8b8d5834-dc2e-40d1-9301-2df15e12ec22
Mishra, Gita D.
02143b82-e536-4915-9b30-3c86cbe1a1fe
Looman, Moniek
41b07ae4-350b-4a57-96be-9cabcd04d26f
Schoenaker, Danielle A.J.M.
84b96b87-4070-45a5-9777-5a1e4e45e818
Soedamah-Muthu, Sabita S.
a92e78f0-b28c-44f3-be86-e744fd004ff4
Geelen, Anouk
a1ccaee8-a603-462e-bbbf-57e16b9af3d5
Feskens, Edith J.M.
8b8d5834-dc2e-40d1-9301-2df15e12ec22
Mishra, Gita D.
02143b82-e536-4915-9b30-3c86cbe1a1fe

Looman, Moniek, Schoenaker, Danielle A.J.M., Soedamah-Muthu, Sabita S., Geelen, Anouk, Feskens, Edith J.M. and Mishra, Gita D. (2018) Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing gestational diabetes: the Australian Longitudinal Study on Women's Health. British Journal of Nutrition, 120 (4), 435-444. (doi:10.1017/S0007114518001277).

Record type: Article

Abstract

Carbohydrate quantity and quality affect postprandial glucose response, glucose metabolism and risk of type 2 diabetes. The aim of this study was to examine the association of pre-pregnancy dietary carbohydrate quantity and quality with the risk of developing gestational diabetes mellitus (GDM). We used data from the Australian Longitudinal Study on Women's Health that included 3607 women aged 25-30 years without diabetes who were followed up between 2003 and 2015. We examined carbohydrate quantity (total carbohydrate intake and a low-carbohydrate diet (LCD) score) and carbohydrate subtypes indicating quality (fibre, total sugar intake, glycaemic index, glycaemic load and intake of carbohydrate-rich food groups). Relative risks (RR) for development of GDM were estimated using multivariable regression models with generalised estimating equations. During 12 years of follow-up, 285 cases of GDM were documented in 6263 pregnancies (4·6 %). The LCD score, reflecting relatively high fat and protein intake and low carbohydrate intake, was positively associated with GDM risk (RR 1·54; 95 % CI 1·10, 2·15), highest quartile v. lowest quartile). Women in the quartile with highest fibre intake had a 33 % lower risk of GDM (RR 0·67; 95 % CI 0·45, 0·96)). Higher intakes of fruit (0·95 per 50 g/d; 95 % CI 0·90, 0·99) and fruit juice (0·89 per 100 g/d; 95 % CI 0·80, 1·00)) were inversely associated with GDM, whereas cereal intake was associated with a higher risk of GDM (RR 1·05 per 20 g/d; 95 % CI 1·01, 1·07)). Thus, a relatively low carbohydrate and high fat and protein intake may increase the risk of GDM, whereas higher fibre intake could decrease the risk of GDM. It is especially important to take the source of carbohydrates into account.

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More information

e-pub ahead of print date: 22 May 2018
Published date: August 2018
Keywords: Adolescent, Adult, Australia, Carbohydrates, Diabetes Mellitus, Type 2/diagnosis, Diabetes, Gestational/diagnosis, Diet, Diet, Carbohydrate-Restricted, Dietary Carbohydrates/administration & dosage, Female, Glycemic Index, Glycemic Load, Humans, Longitudinal Studies, Multivariate Analysis, Nutrition Assessment, Pregnancy, Prospective Studies, Risk, Women's Health, Young Adult

Identifiers

Local EPrints ID: 441333
URI: http://eprints.soton.ac.uk/id/eprint/441333
ISSN: 0007-1145
PURE UUID: b6c9145d-b447-4abc-a51a-1fc5db773c8c
ORCID for Danielle A.J.M. Schoenaker: ORCID iD orcid.org/0000-0002-7652-990X

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Date deposited: 10 Jun 2020 16:30
Last modified: 17 Mar 2024 04:01

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Contributors

Author: Moniek Looman
Author: Sabita S. Soedamah-Muthu
Author: Anouk Geelen
Author: Edith J.M. Feskens
Author: Gita D. Mishra

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