Davis Jaimie N, Shearrer Grace E, Tao Wei, Hurston Shanta R, Gunderson Erica P
Department of Nutritional Sciences, University of Texas at Austin, 103 24 street, Building PAI 3.24, Austin, TX 78712 USA.
Kaiser Permanente Northern California, Division of Research, Oakland, California USA.
BMC Obes. 2017 Aug 3;4:31. doi: 10.1186/s40608-017-0166-0. eCollection 2017.
An understanding of the dietary behaviors linked to substantial postpartum weight retention, particularly in women diagnosed with gestational diabetes (GDM), is warranted to focus intervention efforts to prevent future type 2 diabetes. This study evaluates the relationship between dietary food intake at 6-9 weeks postpartum (baseline) and odds of substantial postpartum weight retention (≥ 5 kg) at 1-year in women with GDM.
The Study of Women, Infant Feeding and Type 2 Diabetes after GDM pregnancy (SWIFT) is a prospective multi-ethnic cohort (75% minority) of 1035 women (aged 20-45 years) with recent GDM who delivered a singleton, live birth (≥35 weeks gestation) and underwent 2-h 75 g OGTTs, anthropometric measurements and other assessments at 6-9 weeks postpartum (baseline) and annually thereafter. Eight hundred and eighty-eight women without diabetes at baseline completed the 18-item PrimeScreen to assess dietary intake and the 13-item Caffeine Survey to assess beverage intake, and completed 1-year follow-up. Average postpartum weight retention was calculated (1-year postpartum weight minus pre-pregnancy weight). Multivariable logistic regression models that estimated baseline dietary intake and odds of substantial postpartum weight retention (SPPWR ≥5 kg above pre-pregnancy weight) versus not SPPWR adjusted for numerous clinical, sociodemographic and behavioral covariates.
Compared to eating no fried foods, women who reported eating fried foods ≥5 servings/wk. ( = 32) and 2-4 serv/wk. ( = 208), respectively, had a three-fold and two-fold higher odds of SPPWR (OR = 3.38, 95% CI:1.36-8.38, = 0.009; OR = 1.99, 95% CI:1.30-3.03, = 0.02), after adjustment for covariates and other foods and soda intake. Soda intake ≥2 serv/wk. versus none was associated with higher odds of SPPWR (OR = 1.95, 95% CI:1.22-3.11, = 0.005) adjusted for fried foods and covariates, but was attenuated (OR = 1.61,95% CI:0.98-2.66, = 0.06) after addition of whole eggs and processed meats.
These findings indicate that interventions should focus on reducing fried foods and soda intake during early postpartum periods to reduce substantial postpartum weight retention in high-risk women with GDM.
NCT01967030; October 2013, Eunice Kennedy Shriver National Institute of Health and Human Development (NICHD).
了解与产后大量体重滞留相关的饮食行为，尤其是被诊断为妊娠期糖尿病（GDM）的女性，对于集中干预措施以预防未来的2型糖尿病很有必要。本研究评估产后6 - 9周（基线）的饮食摄入量与GDM女性产后1年大量体重滞留（≥5kg）几率之间的关系。
妊娠期糖尿病妊娠后妇女、婴儿喂养与2型糖尿病研究（SWIFT）是一项前瞻性多民族队列研究（75%为少数族裔），共有1035名年龄在20 - 45岁之间、近期患有GDM且单胎活产（妊娠≥35周）的女性，她们在产后6 - 9周（基线）及此后每年接受2小时75g口服葡萄糖耐量试验、人体测量及其他评估。888名基线时无糖尿病的女性完成了18项PrimeScreen以评估饮食摄入量，完成了13项咖啡因调查问卷以评估饮料摄入量，并完成了1年的随访。计算平均产后体重滞留量（产后1年体重减去孕前体重）。多变量逻辑回归模型估计基线饮食摄入量以及产后大量体重滞留（产后体重比孕前体重增加≥5kg）与未大量体重滞留的几率，并针对众多临床、社会人口学和行为协变量进行了调整。
与不吃油炸食品的女性相比，报告每周食用油炸食品≥5份（n = 32）和2 - 4份（n = 208）的女性，在调整协变量以及其他食物和汽水摄入量后，产后大量体重滞留的几率分别高出三倍和两倍（OR = 3.38，95%CI：1.36 - 8.38，P = 0.009；OR = 1.99，95%CI：1.30 - 3.03，P = 0.02）。每周饮用汽水≥2份与不饮用相比，在调整油炸食品和协变量后，产后大量体重滞留的几率更高（OR = 1.95，95%CI：1.22 - 3.11，P = 0.005），但在加入全蛋和加工肉类后，该几率有所降低（OR = 1.61，95%CI：0.98 - 2.66，P = 0.06）。
这些发现表明，干预措施应侧重于在产后早期减少油炸食品和汽水的摄入量，以降低GDM高危女性产后大量体重滞留的情况。
NCT01967030；2013年10月，尤妮斯·肯尼迪·施赖弗国家儿童健康与人类发展研究所（NICHD）。
