Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition
Location: Hall D
Poster Board Number: 362
Objectives: Gestational diabetes mellitus (GDM) has an estimated prevalence of 9.2% in the U.S. However, the importance of preconception and prenatal dietary patterns (DP), an important modifiable risk factor for GDM, has not been thoroughly explored. As part of the USDA-HHS Pregnancy and Birth to 24 Months Project, a systematic review was initiated to assess the relationship between maternal DP before and during pregnancy and risk of GDM.
Methods: Nine databases, including PubMed, Embase, Cochrane, and CINAHL were searched from January 1980 to January 2017 for peer-reviewed articles related to dietary patterns and pregnancy/birth outcomes. Using a priori inclusion/exclusion criteria, articles were dual screened, relevant information was extracted, and risk of bias was assessed. The data were quantitatively synthesized, a conclusion statement was drafted and the evidence was graded. Finally, research recommendations were identified.
Results: Of the 9,103 studies identified, 11 studies including a pilot randomized control trial and 10 prospective cohort studies, with sample sizes ranging from 12 to 15,254 subjects, met the criteria. The methods used across studies were heterogeneous and low-income and minority women were underrepresented. Four of the 6 studies that used an index/score method found an inverse association between adherence to a DP (e.g. Healthy Eating Index, modified/alternate Healthy Eating Index, Mediterranean-type diet) and risk of GDM. Four of the 5 studies using data-driven methods found an inverse association between greater adherence to a DP (e.g. Mediterranean-style, prudent) and risk of GDM. All studies that examined DP before pregnancy and 3 of the 5 studies that assessed DP during pregnancy found an association with risk of GDM.
Conclusions: Limited but consistent evidence suggests that DP before pregnancy are associated with a reduced risk of GDM. These protective DP are higher in vegetables, fruits, whole grains, nuts, legumes, and fish and lower in red and processed meats. Most of the research was conducted in healthy, Caucasian women with access to health care. Evidence is insufficient to estimate the association between DP during pregnancy and risk of GDM. Additional research on diverse U.S. populations is recommended.
Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA and the Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, US Department of Health and Human Services, Rockville, MD.