Center for Research in Food Environments and Prevention of Nutrition-Related Chronic Diseases (CIAPEC)(,) Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.
Faculty of Health Sciences, Universidad San Sebastián, Santiago, Chile.
Nutrition. 2024 Dec;128:112560. doi: 10.1016/j.nut.2024.112560. Epub 2024 Sep 7.
To evaluate the association between consumed non-nutritive sweeteners (NNS) and gestational diabetes mellitus (GDM) in a cohort of pregnant women from Santiago, Chile.
This secondary data analysis of a cohort.involved 1,472 pregnant women from the Chilean Maternal-Infant Cohort Study-II (CHiMINCs-II). These women received care at primary health care centers in Puente Alto county, South-Eastern Metropolitan Health Service of Santiago, Chile. NNS consumption was estimated using 24-h dietary recalls and linked to the packaged foods nutrition facts panel. Plasma glucose values were extracted from clinical records. GDM was defined according to national criteria: 1) fasting plasma glucose (FPG) ≥100 and <126 mg/dL at the first antenatal visit; 2) FPG ≥100 mg/dL or 2-hour plasma glucose ≥140 mg/dL in the 75 g oral glucose tolerance test at 24-28 weeks. Cases with a GDM diagnosis in their medical records were also considered regardless of test results. The association between each NNS and GDM was assessed using logistic regression models.
A total of 77.8% of the participants consumed NNS. The most consumed was sucralose (66%), followed by acesulfame-K (43.6%), and steviol glycosides (41.1%). Beverages (82%), dairy (12.4%) and candy products (4.4%) were the primary dietary sources of NNS. The GDM incidence was 18.9%, higher among consumers of any NNS compared to non-consumers (20.3% vs. 14.2%, p < 0.05). The adjusted model showed a significant association between the consumption of any NNS and sucralose and the risk of GDM (OR for any NNS = 1.58; 95% CI: 1.10-2.26; P = 0.014; OR sucralose = 1.44; 95% CI 1.06-1.95; P = 0.020).
The consumption of NNS, particularly sucralose, is associated with an increased risk of GDM in pregnant women. Further studies are essential to validate these results in other contexts and to guide future recommendations for healthier dietary practices among pregnant populations.
评估智利圣地亚哥孕妇队列中非营养性甜味剂（NNS）消费与妊娠糖尿病（GDM）之间的关联。
这是一项智利母婴队列研究 II（CHiMINCs-II）的队列内二次数据分析。该研究纳入了来自智利东南部圣地亚哥大都市卫生服务中心Puente Alto 县初级保健中心的 1472 名孕妇。使用 24 小时膳食回忆法评估 NNS 摄入量，并与包装食品营养成分标签相关联。血糖值从临床记录中提取。GDM 根据国家标准定义：1）第一次产前就诊时空腹血糖（FPG）≥100 且＜126mg/dL；2）24-28 周时 75g 口服葡萄糖耐量试验中 FPG≥100mg/dL 或 2 小时血糖≥140mg/dL。无论检测结果如何，病历中诊断为 GDM 的病例也被视为 GDM。使用逻辑回归模型评估每种 NNS 与 GDM 的关联。
共有 77.8%的参与者摄入 NNS。消耗量最大的是三氯蔗糖（66%），其次是乙酰磺胺酸钾（43.6%）和甜菊糖苷（41.1%）。饮料（82%）、乳制品（12.4%）和糖果产品（4.4%）是 NNS 的主要膳食来源。GDM 的发病率为 18.9%，与非消费者相比，任何 NNS 的消费者中 GDM 的发生率更高（20.3%比 14.2%，p＜0.05）。调整后的模型显示，任何 NNS 的消耗与三氯蔗糖与 GDM 的风险之间存在显著关联（任何 NNS 的消耗比值比=1.58；95%置信区间：1.10-2.26；P=0.014；三氯蔗糖的消耗比值比=1.44；95%置信区间 1.06-1.95；P=0.020）。
NNS 的消耗，特别是三氯蔗糖的消耗，与孕妇 GDM 的风险增加有关。需要进一步的研究来验证这些结果在其他环境中的有效性，并为孕妇群体更健康的饮食实践提供未来的建议。
