TY - JOUR
T1 - Peri-conceptional diet patterns and the risk of gestational diabetes mellitus in South Indian women
AU - Mahendra, Anvesha
AU - Kehoe, Sarah H.
AU - Crozier, Sarah R.
AU - Kumaran, Kalyanaraman
AU - Krishnaveni, G. V.
AU - Arun, Nalini
AU - Padmaja,
AU - Kini, Prakash
AU - Taskeen, Unaiza
AU - Kombanda, Krupa T.
AU - Johnson, Matthew
AU - Osmond, Clive
AU - Fall, Caroline H.D.
N1 - Publisher Copyright:
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society.
PY - 2022/5/27
Y1 - 2022/5/27
N2 - Objective: To identify peri-conceptional diet patterns among women in Bangalore and examine their associations with risk of gestational diabetes mellitus (GDM). Design: BAngalore Nutrition Gestational diabetes LifEstyle Study, started in June 2016, was a prospective observational study, in which women were recruited at 5-16 weeks' gestation. Peri-conceptional diet was recalled at recruitment, using a validated 224-item FFQ. GDM was assessed by a 75-g oral glucose tolerance test at 24-28 weeks' gestation, applying WHO 2013 criteria. Diet patterns were identified using principal component analysis, and diet pattern-GDM associations were examined using multivariate logistic regression, adjusting for 'a priori' confounders. Setting: Antenatal clinics of two hospitals, Bangalore, South India. Participants: Seven hundred and eighty-five pregnant women of varied socio-economic status. Results: GDM prevalence was 22 %. Three diet patterns were identified: (a) high-diversity, urban (HDU) characterised by diverse, home-cooked and processed foods was associated with older, more affluent, better-educated and urban women; (b) rice-fried snacks-chicken-sweets (RFCS), characterised by low diet diversity, was associated with younger, less-educated, and lower-income, rural and joint families; and (c) healthy, traditional vegetarian (HTV), characterised by home-cooked vegetarian and non-processed foods, was associated with less-educated, more affluent, and rural and joint families. The HDU pattern was associated with a lower GDM risk (adjusted odds ratio (aOR): 0·80/sd, 95 % CI (0·64, 0·99), P = 0·04) after adjusting for confounders. BMI was strongly related to GDM risk and possibly mediated diet-GDM associations. Conclusions: The findings support global recommendations to encourage women to attain a healthy pre-pregnancy BMI and increase diet diversity. Both healthy and unhealthy foods in the patterns indicate low awareness about healthy foods and a need for public education.
AB - Objective: To identify peri-conceptional diet patterns among women in Bangalore and examine their associations with risk of gestational diabetes mellitus (GDM). Design: BAngalore Nutrition Gestational diabetes LifEstyle Study, started in June 2016, was a prospective observational study, in which women were recruited at 5-16 weeks' gestation. Peri-conceptional diet was recalled at recruitment, using a validated 224-item FFQ. GDM was assessed by a 75-g oral glucose tolerance test at 24-28 weeks' gestation, applying WHO 2013 criteria. Diet patterns were identified using principal component analysis, and diet pattern-GDM associations were examined using multivariate logistic regression, adjusting for 'a priori' confounders. Setting: Antenatal clinics of two hospitals, Bangalore, South India. Participants: Seven hundred and eighty-five pregnant women of varied socio-economic status. Results: GDM prevalence was 22 %. Three diet patterns were identified: (a) high-diversity, urban (HDU) characterised by diverse, home-cooked and processed foods was associated with older, more affluent, better-educated and urban women; (b) rice-fried snacks-chicken-sweets (RFCS), characterised by low diet diversity, was associated with younger, less-educated, and lower-income, rural and joint families; and (c) healthy, traditional vegetarian (HTV), characterised by home-cooked vegetarian and non-processed foods, was associated with less-educated, more affluent, and rural and joint families. The HDU pattern was associated with a lower GDM risk (adjusted odds ratio (aOR): 0·80/sd, 95 % CI (0·64, 0·99), P = 0·04) after adjusting for confounders. BMI was strongly related to GDM risk and possibly mediated diet-GDM associations. Conclusions: The findings support global recommendations to encourage women to attain a healthy pre-pregnancy BMI and increase diet diversity. Both healthy and unhealthy foods in the patterns indicate low awareness about healthy foods and a need for public education.
KW - Diet patterns
KW - Gestational diabetes mellitus and India
KW - Peri-conceptional
KW - Prospective study
UR - http://www.scopus.com/inward/record.url?scp=85131646526&partnerID=8YFLogxK
U2 - 10.1017/S1368980022001288
DO - 10.1017/S1368980022001288
M3 - Article
AN - SCOPUS:85131646526
SN - 1368-9800
VL - 26
SP - 779
EP - 791
JO - Public Health Nutrition
JF - Public Health Nutrition
IS - 4
ER -