Association between dietary inflammatory potential and risk of developing gestational diabetes: a prospective cohort study

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Abstract

Background

Limited and inconsistent data are available regarding the relationship between the dietary inflammatory potential (DIP) and risk of gestational diabetes mellitus (GDM).

Objective

The present prospective study aimed to evaluate the association between DIP score during the first trimester of pregnancy and risk of developing GDM among Iranian women.

Methods

In this prospective cohort study, 812 pregnant women aged 20–40 years, who were in their first trimester, were recruited and followed up until week 24–28 of gestation. Dietary intakes of study subjects were examined using an interviewer-administered validated 117-item semi-quantitative food frequency questionnaire (FFQ). DIP score was calculated from 29 available food parameters based on earlier literature. The results of a fasting plasma glucose concentration and a 50-g, 1-h oral glucose tolerance test, between the 24th and 28th week of gestation, were used to diagnose GDM. The risk of developing GDM across quartiles of DIP score was estimated using Cox regression in several models.

Results

At study baseline, mean (SD) age and BMI of study participants were 29.4 (±4.84) y and 25.14 (±4.08) kg/m ², respectively. No significant association was found between DIP score and risk of GDM in the crude model (RR: 1.01; 95% CIs: 0.71–1.45). When we adjusted for age the association did not alter (RR: 1.04; 95% CIs: 0.72–1.48). Even after further adjustment for maternal weight gain we failed to find a significant association between DIP score and risk of GDM (RR: 0.97; 95% CIs: 0.66–1.41).

Conclusion

We found no significant association between DIP and risk of developing GDM. Further longitudinal studies among other populations are needed to elucidate the association between DIP score and GDM.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-021-00705-5.

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Most cited references 50

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Adjustment for total energy intake in epidemiologic studies

W Willett, G R Howe, L H Kushi (1997)

In epidemiologic studies, total energy intake is often related to disease risk because of associations between physical activity or body size and the probability of disease. In theory, differences in disease incidence may also be related to metabolic efficiency and therefore to total energy intake. Because intakes of most specific nutrients, particularly macronutrients, are correlated with total energy intake, they may be noncausally associated with disease as a result of confounding by total energy intake. In addition, extraneous variation in nutrient intake resulting from variation in total energy intake that is unrelated to disease risk may weaken associations. Furthermore, individuals or populations must alter their intake of specific nutrients primarily by altering the composition of their diets rather than by changing their total energy intake, unless physical activity or body weight are changed substantially. Thus, adjustment for total energy intake is usually appropriate in epidemiologic studies to control for confounding, reduce extraneous variation, and predict the effect of dietary interventions. Failure to account for total energy intake can obscure associations between nutrient intakes and disease risk or even reverse the direction of association. Several disease-risk models and formulations of these models are available to account for energy intake in epidemiologic analyses, including adjustment of nutrient intakes for total energy intake by regression analysis and addition of total energy to a model with the nutrient density (nutrient divided by energy).

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Designing and developing a literature-derived, population-based dietary inflammatory index.

Nitin Shivappa, Susan E Steck, Thomas Hurley … (2014)

To design and develop a literature-derived, population-based dietary inflammatory index (DII) to compare diverse populations on the inflammatory potential of their diets.

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Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis.

Leanne Bellamy, Juan-Pablo Casas, Aroon D Hingorani … (2009)

Women with gestational diabetes are at increased risk of developing type 2 diabetes, but the risk and time of onset have not been fully quantified. We therefore did a comprehensive systematic review and meta-analysis to assess the strength of association between these conditions and the effect of factors that might modify the risk. We identified cohort studies in which women who had developed type 2 diabetes after gestational diabetes were followed up between Jan 1, 1960, and Jan 31, 2009, from Embase and Medline. 205 relevant reports were hand searched. We selected 20 studies that included 675 455 women and 10 859 type 2 diabetic events. We calculated and pooled unadjusted relative risks (RRs) with 95% CIs for each study using a random-effects model. Subgroups analysed were the number of cases of type 2 diabetes, ethnic origin, duration of follow-up, maternal age, body-mass index, and diagnostic criteria. Women with gestational diabetes had an increased risk of developing type 2 diabetes compared with those who had a normoglycaemic pregnancy (RR 7.43, 95% CI 4.79-11.51). Although the largest study (659 164 women; 9502 cases of type 2 diabetes) had the largest RR (12.6, 95% CI 12.15-13.19), RRs were generally consistent among the subgroups assessed. Increased awareness of the magnitude and timing of the risk of type 2 diabetes after gestational diabetes among patients and clinicians could provide an opportunity to test and use dietary, lifestyle, and pharmacological interventions that might prevent or delay the onset of type 2 diabetes in affected women. None.

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Author and article information

Contributors

Ahmad Esmaillzadeh: a-esmaillzadeh@tums.ac.ir

Journal

Journal ID (nlm-ta): Nutr J

Journal ID (iso-abbrev): Nutr J

Title: Nutrition Journal

Publisher: BioMed Central (London )

ISSN (Electronic): 1475-2891

Publication date (Electronic): 2 June 2021

Publication date PMC-release: 2 June 2021

Publication date Collection: 2021

Volume: 20

Electronic Location Identifier: 48

Affiliations

[1 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, , Tehran University of Medical Sciences, ; P.O. Box 14155-6117, Tehran, Iran

[2 ]GRID grid.444768.d, ISNI 0000 0004 0612 1049, Research Center for Biochemistry and Nutrition in Metabolic Diseases, , Kashan University of Medical Sciences, ; Kashan, Iran

[3 ]GRID grid.411036.1, ISNI 0000 0001 1498 685X, Food Security Research Center, , Isfahan University of Medical Sciences, ; Isfahan, Iran

[4 ]GRID grid.486769.2, ISNI 0000 0004 0384 8779, Food Safety Research Center (salt), , Semnan University of Medical Sciences, ; Semnan, Iran

[5 ]GRID grid.411036.1, ISNI 0000 0001 1498 685X, Department of Community Nutrition, , Isfahan University of Medical Sciences, ; Isfahan, Iran

[6 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, , Tehran University of Medical Sciences, ; Tehran, Iran

[7 ]GRID grid.411036.1, ISNI 0000 0001 1498 685X, Department of Gynecology, School of Medicine Science, , Isfahan University of Medical Sciences, ; Isfahan, Iran

[8 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, , Tehran University of Medical Sciences, ; Tehran, Iran

Article

Publisher ID: 705

DOI: 10.1186/s12937-021-00705-5

PMC ID: 8173880

PubMed ID: 34078385

SO-VID: a8953c7b-c577-4798-9975-c17d381e9537

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 12 October 2020

Date accepted : 13 May 2021

Custom metadata

ScienceOpen disciplines: Nutrition & Dietetics

Keywords: cohort,dietary inflammatory potential,gestational diabetes mellitus,pregnancy

Data availability:

ScienceOpen disciplines: Nutrition & Dietetics

Keywords: cohort, dietary inflammatory potential, gestational diabetes mellitus, pregnancy

Association between dietary inflammatory potential and risk of developing gestational diabetes: a prospective cohort study

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Abstract

Background

Objective

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Results

Conclusion

Supplementary Information

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Karger: Nutrition and Dietetics

Most cited references 50

Adjustment for total energy intake in epidemiologic studies

Designing and developing a literature-derived, population-based dietary inflammatory index.

Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis.

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