Better diet before pregnancy lowers GDM risk

By Helen Albert

Adhering to a healthy diet before pregnancy can significantly reduce a woman's likelihood for developing gestational diabetes mellitus (GDM), show study findings published in the American Journal of Clinical Nutrition.

Of three possible diets known for their health benefits, the researchers found that following the alternate Healthy Eating Index (aHEI) diet reduced the risk for GDM the most, followed by the Dietary Approaches to Stop Hypertension (DASH) and the alternate Mediterranean Diet (aMED).

GDM is an increasingly common pregnancy complication affecting around 7% of all pregnancies in the USA.

To assess whether prepregnancy diet can affect a woman's risk for this condition, Deirdre Tobias (Harvard School of Public Health, Boston, Massachusetts, USA) and colleagues analyzed data collected on 21,376 singleton live births (1991-2001) from 15,254 women participating in the Nurses' Health Study II.

Prepregnancy dietary patterns were assessed by scoring women's diets based on their intake of the components of the aHEI, DASH, and aMED diets. No prepregnancy chronic disease or GDM was experienced by the women in the study and, in total, 872 women reported first-time GDM.

All the diets assessed have common components such as increased intake of fruit, vegetables, and nuts, legumes, or soy.

For the aHEI diet, which is characterized by a high white to red meat ratio, a high cereal fiber component, and a high polyunsaturated to saturated fatty acid ratio, women in the highest quartile had a 46% lower risk for GDM than those in the lowest adherence quartile.

Similarly, women in the highest versus the lowest quartile of adherence for the DASH diet, which encourages higher low-fat dairy consumption, increased whole grain consumption, reduced intake of sweetened drinks, and reduced salt intake, had a 34% reduced risk for GDM.

Finally, the aMED diet, which is characterized by high fish and seafood intake, increased whole grain intake, moderate alcohol intake, and an increased monounsaturated to saturated fatty acid ratio, reduced the risk for GDM by 24% in women with the highest versus the lowest levels of adherence.

"These results suggest that clinical and public health efforts to encourage diets similar to the aMED, DASH, and aHEI patterns for women of a reproductive age might yield benefits in the reduction of GDM risk in a future pregnancy," write Tobias and team.

However, "further research is required to know whether improving one's dietary pattern adherence during pregnancy is associated with a lower risk of GDM," they conclude.

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