Donazar-Ezcurra Mikel, Lopez-Del Burgo Cristina, Martinez-Gonzalez Miguel A, Basterra-Gortari Francisco J, de Irala Jokin, Bes-Rastrollo Maira
1Department of Preventive Medicine and Public Health,University of Navarra,31008 Pamplona,Spain.
Br J Nutr. 2017 Nov;118(9):715-721. doi: 10.1017/S0007114517002537. Epub 2017 Oct 4.
The aim of this study was to investigate the association between the adherence to empirically derived dietary patterns and gestational diabetes mellitus (GDM) risk and of healthy lifestyles with the prevention of GDM defining an overall healthy score. The Seguimiento Universidad de Navarra project is a Mediterranean cohort of university graduates started in 1999. We included 3455 pregnant women. During a mean follow-up of 10·3 (sd 3·3) years, we identified 173 incident GDM cases. Two major dietary patterns were identified using principal component analysis: the Western dietary pattern (WDP) (characterised by a high consumption of meat-based products and processed foods) and the Mediterranean dietary pattern (MDP) (characterised by a high consumption of vegetables, fruits, fish and non-processed foods). A low-risk score for GDM was defined taking into account important risk factors (age, BMI and unhealthy dietary pattern) for GDM. Positive association was found in the multivariable model between the highest quartile of adherence to WDP and GDM incidence compared with the lowest quartile (OR 1·56; 95 % CI 1·00, 2·43). No association was found between adherence to the MDP and GDM incidence (OR 1·08; 95 % CI 0·68, 1·70 for the highest quartile compared with the lowest). Women who adhered to all three low-risk factors had a 76 % lower risk of GDM (OR 0·24; 95 % CI 0·10, 0·55) compared with women who did not adhere to any factor before pregnancy. In conclusion, our results reinforce the importance of dietary recommendations and other two factors (low BMI and young age at pregnancy) in pre-gravid women.
本研究的目的是调查遵循经验性得出的饮食模式与妊娠期糖尿病(GDM)风险之间的关联,以及健康生活方式与预防GDM之间的关联,定义一个总体健康评分。纳瓦拉大学跟踪项目是始于1999年的一个针对大学毕业生的地中海队列研究。我们纳入了3455名孕妇。在平均10.3(标准差3.3)年的随访期间,我们确定了173例新发GDM病例。使用主成分分析确定了两种主要饮食模式:西方饮食模式(WDP)(其特点是肉类产品和加工食品的高消费量)和地中海饮食模式(MDP)(其特点是蔬菜、水果、鱼类和未加工食品的高消费量)。考虑到GDM的重要风险因素(年龄、BMI和不健康饮食模式),定义了一个GDM低风险评分。在多变量模型中,与最低四分位数相比,WDP依从性最高四分位数与GDM发病率之间存在正相关(OR 1.56;95%CI 1.00,2.43)。未发现MDP依从性与GDM发病率之间存在关联(最高四分位数与最低四分位数相比,OR 1.08;95%CI 0.68,1.70)。与孕前未遵循任何因素的女性相比,遵循所有三个低风险因素的女性患GDM的风险降低了76%(OR 0.24;95%CI 0.10,0.55)。总之,我们的结果强化了孕前女性饮食建议以及其他两个因素(低BMI和年轻孕龄)的重要性。