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Effect of macronutrient intake during the second trimester on glucose metabolism later in pregnancy.
MedLine Citation:
PMID:  21955650     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Dietary intake is known to influence glucose metabolism, but there is little consensus on the optimal distribution of macronutrient intakes during pregnancy to prevent gestational diabetes (GDM). OBJECTIVE: We aimed to investigate whether macronutrient intake distribution during the second trimester of pregnancy was associated with glucose metabolism later in pregnancy. DESIGN: Women with singleton pregnancies and without preexisting type 1 or type 2 diabetes were included. Participants underwent a 3-h oral-glucose-tolerance test at 30 wk (95% CI: 25, 33 wk) gestation and were asked to recall their second-trimester dietary intake by using a validated food-frequency questionnaire. RESULTS: Of the 205 participants, 47 (22.9%) had a diagnosis of GDM. A higher intake of saturated fat (β ± SEE: 0.059 ± 0.021; P = 0.005) and trans fat (0.381 ± 0.145; P = 0.009) as a percentage of energy and of added sugar (0.017 ± 0.007; P = 0.02) and a lower intake of vegetable and fruit fiber (-0.026 ± 0.012; P = 0.03) were individually associated with increased fasting glucose after multiple adjustment. In participants with a family history of type 2 diabetes, a higher vegetable and fruit fiber intake was associated with reduced insulin resistance (-0.100 ± 0.029; P = 0.0008) and increased insulin sensitivity (0.029 ± 0.012; P = 0.01), after similar adjustment. An increased risk (OR per 1-SD change) of GDM was associated with lower carbohydrate (0.60; 95% CI: 0.40, 0.90) and higher total fat (1.61; 95% CI: 1.06, 2.44) intakes as a percentage of energy, after similar adjustment. CONCLUSIONS: Macronutrient intake during the second trimester of pregnancy was associated with a risk of abnormal glucose metabolism later in pregnancy. This finding supports the need for continued work to determine optimal prenatal nutritional strategies to prevent GDM. This trial is registered at clinicaltrials.gov as NCT01405547.
Authors:
Sylvia H Ley; Anthony J Hanley; Ravi Retnakaran; Mathew Sermer; Bernard Zinman; Deborah L O'Connor
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-28
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  -     ISSN:  1938-3207     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Nutritional Sciences and Division of Endocrinology, Mount Sinai Hospital, Toronto, Canada.
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