Healthful dietary patterns and long-term weight change among women with a history of gestational diabetes mellitus

D K Tobias; C Zhang; J Chavarro; S Olsen; W Bao; A A Bjerregaard; T T Fung; J E Manson; F B Hu

doi:10.1038/ijo.2016.156

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Healthful dietary patterns and long-term weight change among women with a history of gestational diabetes mellitus

Journal article

Peer reviewed

Healthful dietary patterns and long-term weight change among women with a history of gestational diabetes mellitus

D K Tobias, C Zhang, J Chavarro, S Olsen, W Bao, A A Bjerregaard, T T Fung, J E Manson and F B Hu

International journal of obesity (2005), Vol.40(11), pp.1748-1753

11/2016

DOI: 10.1038/ijo.2016.156

PMCID: PMC5101125

PMID: 27569683

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Abstract

Diet represents a key strategy for the prevention of obesity and type 2 diabetes among women with a history of gestational diabetes mellitus (GDM), although effective dietary patterns to prevent weight gain in the long term are largely unknown. We sought to evaluate whether improvement in overall diet quality is associated with less long-term weight gain among high-risk women with prior GDM. Women with a history of GDM (N=3397) were followed from 1991 to 2011, or until diagnosis of type 2 diabetes or other chronic disease. Usual diet was assessed via food frequency questionnaire every 4 years from which we calculated the Alternative Healthy Eating Index (aHEI-2010), Alternate Mediterranean Diet (AMED) and Dietary Approaches to Stop Hypertension (DASH) dietary pattern scores. Weight, lifestyle and health-related outcomes were self-reported every 2 years. We estimated the change in dietary score with change in body weight using linear regression models adjusting for age, baseline body mass index (BMI), baseline and simultaneous change in physical activity and smoking status and other risk factors. Women were followed up to 20 years, gaining an average 1.9 kg (s.d.=7.0) per 4-year period. Women in the highest quintile (Q5) of diet change (most improvement in quality) gained significantly less weight per 4-year period than the lowest quintile (Q1; decrease in quality), independent of other risk factors (4-year weight change, aHEI-2010: Q5=1.30 kg vs Q1=3.27 kg; AMED: Q5=0.94 kg vs Q1=2.56 kg, DASH: Q5=0.64 kg vs Q1=2.75 kg). Significant effect modification by BMI (p-interactions <0.001) indicated a greater magnitude of weight change among women with a higher baseline BMI for all three patterns. Increased diet quality was associated with less weight gain, independent of other lifestyle factors. Post-partum recommendations on diet quality may provide one strategy to prevent long-term weight gain in this high-risk group.

Pregnancy

Body Mass Index

Obesity - diet therapy

United States - epidemiology

Prospective Studies

Diet, Mediterranean

Follow-Up Studies

Obesity - complications

Humans

Diabetes Mellitus, Type 2 - prevention & control

Diabetes Mellitus, Type 2 - diet therapy

Feeding Behavior

Diabetes, Gestational - epidemiology

Incidence

Young Adult

Obesity - prevention & control

Adult

Diabetes Mellitus, Type 2 - etiology

Female

Weight Gain

Longitudinal Studies

Details

Title: Subtitle: Healthful dietary patterns and long-term weight change among women with a history of gestational diabetes mellitus
Creators: D K Tobias - Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
C Zhang - National Institutes of Health
J Chavarro - Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
S Olsen - Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
W Bao - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
A A Bjerregaard - Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
T T Fung - Department of Nutrition, Simmons College, Boston, MA, USA
J E Manson - Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
F B Hu - Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Resource Type: Journal article
Publication Details: International journal of obesity (2005), Vol.40(11), pp.1748-1753
DOI: 10.1038/ijo.2016.156
PMID: 27569683
PMCID: PMC5101125
NLM abbreviation: Int J Obes (Lond)
ISSN: 0307-0565
eISSN: 1476-5497
Publisher: England
Grant note: P30 ES005605 / NIEHS NIH HHS HHSN275201000020C / NICHD NIH HHS UM1 CA176726 / NCI NIH HHS P30 DK046200 / NIDDK NIH HHS R01 DK058845 / NIDDK NIH HHS K01 DK103720 / NIDDK NIH HHS R01 HL060712 / NHLBI NIH HHS
Language: English
Date published: 11/2016
Academic Unit: Epidemiology; Fraternal Order of Eagles Diabetes Research Center
Record Identifier: 9983996062602771

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