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Prepregnancy low-carbohydrate dietary pattern and risk of gestational diabetes mellitus: a prospective cohort study
Journal article   Open access   Peer reviewed

Prepregnancy low-carbohydrate dietary pattern and risk of gestational diabetes mellitus: a prospective cohort study

Wei Bao, Katherine Bowers, Deirdre K Tobias, Sjurdur F Olsen, Jorge Chavarro, Allan Vaag, Michele Kiely and Cuilin Zhang
The American journal of clinical nutrition, Vol.99(6), pp.1378-1384
06/2014
DOI: 10.3945/ajcn.113.082966
PMCID: PMC4021782
PMID: 24717341
url
https://doi.org/10.3945/ajcn.113.082966View
Published (Version of record) Open Access

Abstract

Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown. We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM. We included 21,411 singleton pregnancies in the Nurses' Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal fat; and a vegetable LCD score on the basis of intakes of carbohydrate, vegetable protein, and vegetable fat. A higher score reflected a higher intake of fat and protein and a lower intake of carbohydrate, and it indicated closer adherence to a low-carbohydrate dietary pattern. RRs and 95% CIs were estimated by using generalized estimating equations with log-binomial models. We documented 867 incident GDM pregnancies during 10 y follow-up. Multivariable-adjusted RRs (95% CIs) of GDM for comparisons of highest with lowest quartiles were 1.27 (1.06, 1.51) for the overall LCD score (P-trend = 0.03), 1.36 (1.13, 1.64) for the animal LCD score (P-trend = 0.003), and 0.84 (0.69, 1.03) for the vegetable LCD score (P-trend = 0.08). Associations between LCD scores and GDM risk were not significantly modified by age, parity, family history of diabetes, physical activity, or overweight status. A prepregnancy low-carbohydrate dietary pattern with high protein and fat from animal-food sources is positively associated with GDM risk, whereas a prepregnancy low-carbohydrate dietary pattern with high protein and fat from vegetable food sources is not associated with the risk. Women of reproductive age who follow a low-carbohydrate dietary pattern may consider consuming vegetable rather than animal sources of protein and fat to minimize their risk of GDM.
 Pregnancy Dietary Proteins - administration & dosage United States - epidemiology Maternal Nutritional Physiological Phenomena Prospective Studies Follow-Up Studies Humans Risk Factors Self Report Diet, Reducing - adverse effects Diet, High-Fat - adverse effects Diabetes, Gestational - prevention & control Diabetes, Gestational - epidemiology Incidence Vegetable Proteins - therapeutic use Meat - adverse effects Nurses Diet, Carbohydrate-Restricted - adverse effects Adult Female Dietary Proteins - adverse effects Diabetes, Gestational - etiology Vegetable Proteins - administration & dosage Cohort Studies

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