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妊娠期糖尿病女性的饮食摄入量及对推荐饮食的依从性

Diet intake and adherence to recommendations in women with gestational diabetes mellitus.

作者信息

Saros Lotta, Vahlberg Tero, Pellonperä Outi, Tertti Kristiina, Laitinen Kirsi

机构信息

Integrative Physiology and Pharmacology Unit, Institute of Biomedicine, University of Turku, 20520, Turku, Finland.

Department of Biostatistics, University of Turku and Turku University Hospital, 20520, Turku, Finland.

出版信息

Eur J Clin Nutr. 2025 Mar 19. doi: 10.1038/s41430-025-01596-z.

Abstract

BACKGROUND/OBJECTIVES: Gestational diabetes mellitus (GDM) is best managed via lifestyle changes. We aimed at investigating to which extent women with GDM adhered to dietary recommendations and to which extent an impact was observed on the glycaemic control compared to women without GDM.

SUBJECTS/METHODS: Women with overweight/obesity (n = 349) were recruited in early pregnancy. GDM was diagnosed with a 2-h oral glucose tolerance test in mid-or-early pregnancy (median 25.9 and 14.7 gestational weeks). Dietary assessments included an index of dietary quality (good ≥ 10 and poor < 10/15 scores) and 3-day food-diaries with nutrient intake calculated and dietary patterns identified. Glucose and insulin concentrations were analysed from blood samples collected in late pregnancy (after GDM diagnosis).

RESULTS

Women with GDM (n = 98) followed more often a healthier dietary pattern (62.2%) than women without GDM (49.0%, p < 0.05), but no difference in good dietary quality was seen (53% vs. 59.8%, p = 0.071). While the majority of women with GDM adhered to some recommendations, 51% to carbohydrate, 54.1% to total fat and 69.4% to sucrose, only 16.3% adhered to the protein and 4.1% to the fibre intake recommendations. Women with GDM had lower adherence to protein, total fat and fibre recommendations but higher adherence to that of sucrose than women without GDM (p < 0.05). A good dietary quality was associated with lower insulin and HOMA2-IR values (p < 0.05).

CONCLUSIONS

Adherence to dietary recommendations, particularly fibre and protein intake, is unsatisfactory in women with GDM. Overall dietary quality is related to better control of glucose metabolism proposing a target for dietary counselling.

摘要

背景/目的:妊娠糖尿病(GDM)最佳的管理方式是通过生活方式的改变。我们旨在调查患有GDM的女性在多大程度上遵循了饮食建议,以及与未患GDM的女性相比,在血糖控制方面观察到了多大程度的影响。

对象/方法:在妊娠早期招募超重/肥胖的女性(n = 349)。在妊娠中期或早期(妊娠周数中位数分别为25.9周和14.7周)通过2小时口服葡萄糖耐量试验诊断GDM。饮食评估包括饮食质量指数(良好≥10分,较差<10/15分)以及3天的食物日记,计算营养素摄入量并确定饮食模式。从妊娠晚期(GDM诊断后)采集的血样中分析葡萄糖和胰岛素浓度。

结果

患有GDM的女性(n = 98)比未患GDM的女性(49.0%,p<0.05)更常遵循更健康的饮食模式(62.2%),但在良好饮食质量方面未观察到差异(53%对59.8%,p = 0.071)。虽然大多数患有GDM的女性遵循了一些建议,51%遵循碳水化合物摄入建议,54.1%遵循总脂肪摄入建议,69.4%遵循蔗糖摄入建议,但只有16.3%遵循蛋白质摄入建议,4.1%遵循纤维摄入建议。与未患GDM的女性相比,患有GDM的女性对蛋白质、总脂肪和纤维摄入建议的遵循率较低,但对蔗糖摄入建议的遵循率较高(p<0.05)。良好的饮食质量与较低的胰岛素和HOMA2-IR值相关(p<0.05)。

结论

患有GDM的女性对饮食建议的遵循情况,尤其是纤维和蛋白质摄入方面,并不理想。总体饮食质量与更好地控制葡萄糖代谢相关,这为饮食咨询提出了一个目标。

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