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, Cuilin Zhang

Research output: Contribution to journalArticlepeer-review

105 Citations (Scopus)

Abstract

BACKGROUND: 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.OBJECTIVE: We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.DESIGN: 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.RESULTS: 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.CONCLUSIONS: 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.
Original languageEnglish
Pages (from-to)1378-1384
Number of pages7
JournalAmerican journal of clinical nutrition
Volume99
Issue number6
DOIs
Publication statusPublished - Jun 2014

Keywords

  • Adult
  • Cohort Studies
  • Diabetes, Gestational
  • Diet, Carbohydrate-Restricted
  • Diet, High-Fat
  • Diet, Reducing
  • Dietary Proteins
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Maternal Nutritional Physiological Phenomena
  • Meat
  • Nurses
  • Pregnancy
  • Prospective Studies
  • Risk Factors
  • Self Report
  • United States
  • Vegetable Proteins

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