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 language | English |
|---|---|
| Journal | The American Journal of Clinical Nutrition |
| Volume | 99 |
| Issue number | 6 |
| Pages (from-to) | 1378-1384 |
| Number of pages | 7 |
| ISSN | 0002-9165 |
| DOIs | |
| Publication status | Published - 1 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
