Department of Social Medicine, School of Public Health, China Medical University, Shenyang 110122, China.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA.
Nutrients. 2019 Feb 15;11(2):405. doi: 10.3390/nu11020405.
Dietary patterns during pregnancy have been shown to influence the development of gestational diabetes mellitus (GDM). However, evidence from Asian populations is limited and inconsistent. We conducted a prospective cohort study in China to assess the relationship between dietary patterns and GDM. We administered three-day food diaries (TFD) and food frequency questionnaires (FFQ) at the second trimester. GDM was diagnosed with a 75 g 2-h oral glucose tolerance test at 24⁻28 weeks of gestation. We identified dietary patterns using principal components analysis and used multivariable logistic regression to investigate associations of dietary patterns with GDM. Of the 1014 participants, 23.5% were diagnosed with GDM. Both the TFD and FFQ identified a "traditional pattern", consisting of high vegetable, fruit, and rice intake, which was associated with a lower GDM risk (odds ratio (OR) for quartile 4 versus quartile 1: 0.40, 95% CI: 0.23⁻0.71 for traditional pattern (TFD); OR: 0.44, CI: 0.27⁻0.70 for traditional pattern (FFQ)). The protective associations were more pronounced among women ≥35 years old. A whole grain⁻seafood TFD pattern was associated with higher risk of GDM (OR: 1.73, 95% CI: 1.10⁻2.74). These findings may provide evidence for making dietary guidelines among pregnant women in Chinese populations to prevent GDM.
孕期饮食模式已被证明会影响妊娠期糖尿病（GDM）的发生。然而，亚洲人群的证据有限且不一致。我们在中国进行了一项前瞻性队列研究，以评估饮食模式与 GDM 之间的关系。我们在妊娠中期进行了为期三天的食物日记（TFD）和食物频率问卷（FFQ）调查。GDM 的诊断标准为 24⁻28 周时进行 75g 2 小时口服葡萄糖耐量试验。我们采用主成分分析来识别饮食模式，并采用多变量逻辑回归来研究饮食模式与 GDM 的关联。在 1014 名参与者中，23.5%被诊断为 GDM。TFD 和 FFQ 均识别出一种“传统模式”，包括高蔬菜、水果和大米摄入量，与较低的 GDM 风险相关（传统模式四分位 4 与四分位 1 的比值比（OR）：0.40，95%可信区间：0.23⁻0.71；传统模式 TFD：OR：0.44，CI：0.27⁻0.70；传统模式 FFQ））。这种保护关联在年龄≥35 岁的女性中更为明显。全谷物-海鲜 TFD 模式与 GDM 风险增加相关（OR：1.73，95%可信区间：1.10⁻2.74）。这些发现可能为制定中国人群孕妇饮食指南以预防 GDM 提供证据。
