Adherence to the Norwegian dietary recommendations in a multi-ethnic pregnant population prior to being diagnosed with gestational diabetes mellitus.

Maternal diet is a modifiable risk factor for the development of gestational diabetes mellitus (GDM). Even though pregnant women are considered to be motivated to eat healthy, previous research found unhealthy eating patterns among some ethnic and lower socio-economic status groups. This cross-sectional study assessed adherence to national dietary recommendations prior to GDM diagnosis in a multi-ethnic population comprising 237 pregnant women. Participants were diagnosed with GDM after performing a two-hour oral glucose tolerance test ≥ 9 mmol/L. Participants answered a 41-item Food Frequency Questionnaire about dietary habits prior to being diagnosed with GDM from October 2015 to March 2018. Their scores were based on adherence to the recommended intake in each food group and summed into a Healthy Diet Score (HDS). Results showed low adherence to national dietary recommendations. A significantly higher proportion of non-native Norwegian-speaking women had a high HDS compared with native Norwegian-speaking women. Participants with a normal prepregnancy weight were more likely to have a high HDS compared with overweight or obese participants. Participants showed low adherence to the recommendations for whole grains, vegetables, and fruits and berries, and a relatively low proportion adhered to the recommendations for intakes of fish, red/processed meat, and ready-made meals. However, the food group intakes varied by country of birth. Given the increase in women with GDM and the emerging evidence that maternal diet is a modifiable risk factor for GDM, effective nutrition communication strategies in antenatal care are urgently needed.