(04-08-12) Prepregnancy adherence to dietary patterns and lower risk of gestational diabetes mellitus

1,2,3
1. Deirdre K Tobias,
2. Cuilin Zhang,
3. Jorge Chavarro,
4. Katherine Bowers,
5. Janet Rich-Edwards,
6. Bernard Rosner,
7. Dariush Mozaffarian, and
8. Frank B Hu
+ Author Affiliations
1. 1From the Departments of Nutrition (DKT, JC, DM, and FBH), Epidemiology (DKT, JC, JR-E, DM, and FBH), and Biostatistics (BR), Harvard School of Public Health, Boston, MA; the Epidemiology Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Development, Bethesda, MD (CZ and KB); and the Channing Laboratory (JC, JR-E, BR, DM, and FBH) and Connors Center for Women's Health and Gender Biology (JR-E), Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA
+ Author Notes
? ↵2 Supported by grants DK58845, CA50385, and P30 DK46200-18. CZ and KB were supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH.
? ↵3 Address correspondence to DK Tobias, Harvard School of Public Health, Department of Nutrition, 665 Huntington Avenue, Boston, MA 02115. E-mail: [email protected]; and C Zhang, 6100 Executive Boulevard, Room 7B03, MSC 7510, Bethesda, MD 20892-7510. E-mail: [email protected].
Abstract
Background: Previous studies observed inverse associations of adherence to the alternate Mediterranean (aMED), Dietary Approaches to Stop Hypertension (DASH), and alternate Healthy Eating Index (aHEI) dietary patterns with risk of type 2 diabetes; however, their associations with gestational diabetes mellitus (GDM) risk are unknown.
Objective: This study aimed to assess usual prepregnancy adherence to well-known dietary patterns and GDM risk.
Design: Our study included 21,376 singleton live births reported from 15,254 participants of the Nurses? Health Study II cohort between 1991 and 2001. Pregnancies were free of prepregnancy chronic disease or previous GDM. Prepregnancy dietary pattern adherence scores were computed based on participants? usual intake of the patterns? components, assessed with a validated food-frequency questionnaire. Multivariable logistic regressions with generalized estimating equations were used to estimate the RRs and 95% CIs.
Results: Incident first-time GDM was reported in 872 pregnancies. All 3 scores were inversely associated with GDM risk after adjustment for several covariables. In a comparison of the multivariable risk of GDM in participants in the fourth and first quartiles of dietary pattern adherence scores, aMED was associated with a 24% lower risk (RR: 0.76; 95% CI: 0.60, 0.95; P-trend = 0.004), DASH with a 34% lower risk (RR: 0.66; 95% CI: 0.53, 0.82; P-trend = 0.0005), and aHEI with a 46% lower risk (RR: 0.54; 95% CI: 0.43, 0.68; P-trend < 0.0001).
Conclusion: Prepregnancy adherence to healthful dietary patterns is significantly associated with a lower risk of GDM.


Source: Am J Clin Nutr August 2012 vol. 96 no. 2 289-295

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