Prepregnancy low-carbohydrate dietary pattern and risk of gestational diabetes mellitus: a prospective cohort study: a prospective cohort study

Wei Bao, Katherine Bowers, Deirdre K Tobias, Sjurdur F Olsen, Jorge Chavarro, Allan Vaag, Michele Kiely, Cuilin Zhang

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109 Citations (Scopus)

Abstract

BACKGROUND: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown.

OBJECTIVE: We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.

DESIGN: We included 21,411 singleton pregnancies in the Nurses' Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal fat; and a vegetable LCD score on the basis of intakes of carbohydrate, vegetable protein, and vegetable fat. A higher score reflected a higher intake of fat and protein and a lower intake of carbohydrate, and it indicated closer adherence to a low-carbohydrate dietary pattern. RRs and 95% CIs were estimated by using generalized estimating equations with log-binomial models.

RESULTS: We documented 867 incident GDM pregnancies during 10 y follow-up. Multivariable-adjusted RRs (95% CIs) of GDM for comparisons of highest with lowest quartiles were 1.27 (1.06, 1.51) for the overall LCD score (P-trend = 0.03), 1.36 (1.13, 1.64) for the animal LCD score (P-trend = 0.003), and 0.84 (0.69, 1.03) for the vegetable LCD score (P-trend = 0.08). Associations between LCD scores and GDM risk were not significantly modified by age, parity, family history of diabetes, physical activity, or overweight status.

CONCLUSIONS: A prepregnancy low-carbohydrate dietary pattern with high protein and fat from animal-food sources is positively associated with GDM risk, whereas a prepregnancy low-carbohydrate dietary pattern with high protein and fat from vegetable food sources is not associated with the risk. Women of reproductive age who follow a low-carbohydrate dietary pattern may consider consuming vegetable rather than animal sources of protein and fat to minimize their risk of GDM.

Original languageEnglish
JournalThe American Journal of Clinical Nutrition
Volume99
Issue number6
Pages (from-to)1378-1384
Number of pages7
ISSN0002-9165
DOIs
Publication statusPublished - Jun 2014

Keywords

  • Adult
  • Cohort Studies
  • Diabetes, Gestational
  • Diet, Carbohydrate-Restricted
  • Diet, High-Fat
  • Diet, Reducing
  • Dietary Proteins
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Maternal Nutritional Physiological Phenomena
  • Meat
  • Nurses
  • Pregnancy
  • Prospective Studies
  • Risk Factors
  • Self Report
  • United States
  • Vegetable Proteins

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