Dietary variables associated with substantial postpartum weight retention at 1-year among women with GDM pregnancy.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

TRIAL REGISTRATION

NCT01967030; October 2013, Eunice Kennedy Shriver National Institute of Health and Human Development (NICHD).