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The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies.

Abstract

OBJECTIVE

Diet may influence the risk of gestational diabetes mellitus (GDM), but inconsistent findings have been reported. The purpose of this study was to synthesize evidence from observational studies on the associations between dietary factors and GDM.

RESEARCH DESIGN AND METHODS

Medline and Embase were searched for articles published until January 2015. We included observational studies of reproductive-aged women that reported on associations of maternal dietary intake before or during pregnancy, including energy, nutrients, foods, and dietary patterns, with GDM. All relevant results were extracted from each article. The number of comparable studies that adjusted for confounders was insufficient to perform a meta-analysis.

RESULTS

The systematic review included 34 articles comprising 21 individual studies (10 prospective cohort, 6 cross-sectional, and 5 case-control). A limited number of prospective cohort studies adjusting for confounders indicated associations with a higher risk of GDM for replacing 1-5% of energy from carbohydrates with fat and for high consumption of cholesterol (≥300 mg/day), heme iron (≥1.1 mg/day), red and processed meat (increment of 1 serving/day), and eggs (≥7 per week). A dietary pattern rich in fruit, vegetables, whole grains, and fish and low in red and processed meat, refined grains, and high-fat dairy was found to be beneficial. The current evidence is based on a limited number of studies that are heterogeneous in design, exposure, and outcome measures.

CONCLUSIONS

The findings support current dietary guidelines to limit consumption of foods containing saturated fat and cholesterol, such as processed meat and eggs, as part of an overall balanced diet. Further large prospective studies are warranted.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    School of Public Health, University of Queensland, Brisbane, Australia d.schoenaker@uq.edu.au.

    ,

    School of Public Health, University of Queensland, Brisbane, Australia.

    ,

    School of Medicine, University of Queensland, Brisbane, Australia Departments of Obstetric and Internal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.

    Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands.

    Source

    Diabetes care 39:1 2016 Jan pg 16-23

    MeSH

    Cholesterol, Dietary
    Cross-Sectional Studies
    Diabetes, Gestational
    Diet
    Dietary Fats
    Energy Intake
    Feeding Behavior
    Female
    Fruit
    Humans
    Meat
    Pregnancy
    Prospective Studies
    Risk Factors
    Vegetables

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    26696657

    Citation

    Schoenaker, Danielle A J M., et al. "The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: a Systematic Review of Observational Studies." Diabetes Care, vol. 39, no. 1, 2016, pp. 16-23.
    Schoenaker DA, Mishra GD, Callaway LK, et al. The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies. Diabetes Care. 2016;39(1):16-23.
    Schoenaker, D. A., Mishra, G. D., Callaway, L. K., & Soedamah-Muthu, S. S. (2016). The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies. Diabetes Care, 39(1), pp. 16-23. doi:10.2337/dc15-0540.
    Schoenaker DA, et al. The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: a Systematic Review of Observational Studies. Diabetes Care. 2016;39(1):16-23. PubMed PMID: 26696657.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies. AU - Schoenaker,Danielle A J M, AU - Mishra,Gita D, AU - Callaway,Leonie K, AU - Soedamah-Muthu,Sabita S, PY - 2015/12/24/entrez PY - 2015/12/24/pubmed PY - 2016/6/2/medline SP - 16 EP - 23 JF - Diabetes care JO - Diabetes Care VL - 39 IS - 1 N2 - OBJECTIVE: Diet may influence the risk of gestational diabetes mellitus (GDM), but inconsistent findings have been reported. The purpose of this study was to synthesize evidence from observational studies on the associations between dietary factors and GDM. RESEARCH DESIGN AND METHODS: Medline and Embase were searched for articles published until January 2015. We included observational studies of reproductive-aged women that reported on associations of maternal dietary intake before or during pregnancy, including energy, nutrients, foods, and dietary patterns, with GDM. All relevant results were extracted from each article. The number of comparable studies that adjusted for confounders was insufficient to perform a meta-analysis. RESULTS: The systematic review included 34 articles comprising 21 individual studies (10 prospective cohort, 6 cross-sectional, and 5 case-control). A limited number of prospective cohort studies adjusting for confounders indicated associations with a higher risk of GDM for replacing 1-5% of energy from carbohydrates with fat and for high consumption of cholesterol (≥300 mg/day), heme iron (≥1.1 mg/day), red and processed meat (increment of 1 serving/day), and eggs (≥7 per week). A dietary pattern rich in fruit, vegetables, whole grains, and fish and low in red and processed meat, refined grains, and high-fat dairy was found to be beneficial. The current evidence is based on a limited number of studies that are heterogeneous in design, exposure, and outcome measures. CONCLUSIONS: The findings support current dietary guidelines to limit consumption of foods containing saturated fat and cholesterol, such as processed meat and eggs, as part of an overall balanced diet. Further large prospective studies are warranted. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/26696657/full_citation L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=26696657 DB - PRIME DP - Unbound Medicine ER -