Association of maternal dietary patterns derived by multiple approaches with gestational diabetes mellitus: a prospective cohort study

Abstract

We used two a priori diet scores [Mediterranean diet (aMed) and Diet Balance Index (DBI)] and two a posteriori approaches [principal components analysis (PCA) and reduced-rank regression (RRR)] to examine the association of maternal dietary patterns with risk of gestational diabetes mellitus (GDM) and blood glucose among 2202 pregnant women in the Tongji Birth Cohort. Compared to the highest quartile of the aMed and legumes-vegetables-fruits (derived by PCA) scores, the fasting blood glucose (FBG) levels were higher in the lower quartiles (p-trend < 0.05). Lower scores of the meats-eggs-dairy (derived by PCA) and eggs-fish patterns (derived by RRR; characterised by higher intakes of freshwater fish, eggs, and lower intakes of leafy and cruciferous vegetables and fruits) were associated with decreased FBG levels (p-trend < 0.05). Similarities were found across approaches that some dietary patterns were associated with FBG, but not with postprandial glucose and GDM risk.

Keywords:

• Dietary patterns
• gestational diabetes mellitus
• blood glucose
• Mediterranean diet
• principal components analysis
• reduced-rank regression

Acknowledgement

We would like to thank all the participants for their cooperation and the staff of the Central Hospital of Wuhan for their considerable assistance.

Ethical approval

Ethical approval was acquired from the Ethics Committee of Tongji Medical College of Huazhong University of Science and Technology [approval number: S044] and all participants provided written informed consent prior to enrolment.

Author contributions

SW and LH designed the research. GX supervised the study conduct. SW, HL, CL, RZ, LZ, SH, YG, NC, JS, and XY conducted the research. SW analysed the data and wrote the manuscript. LH and GX coedited, revised, and finally reviewed the manuscript critically for important intellectual content. All the authors read and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Additional information

Funding

This work was supported by the [National Nature Science Foundation of China #1] under Grant [number 82173513]; [Scientific Research Project of Hubei Provincial Health Committee #2] under Grant [number WJ2021F003]; and [Wuhan Health Commission #3] under Grant [number WX21D01].