Dietary Risk Factors for Gestational Diabetes Mellitus
Are sugar-sweetened soft drinks culpable or guilty by association?
- Robert G. Moses, MD1 and
- Jennie C. Brand-Miller, PHD2
- 1The Diabetes Service, South Eastern Sydney and Illawarra Area Health Service, Wollongong, New South Wales, Australia;
- 2Boden Institute of Obesity, Nutrition and Exercise, University of Sydney, New South Wales, Australia.
- Corresponding author: Robert G. Moses, robert.moses{at}sesiahs.health.nsw.gov.au.
Gestational diabetes mellitus (GDM) is one of the most common medical problems found in pregnancy. Categorizing a woman as having GDM with a glucose tolerance test (GTT) identifies the top 5–10% of a continuum of risk for certain adverse pregnancy outcomes. Women with GDM are themselves very likely to ultimately develop type 2 diabetes. In addition, the offspring of women with GDM have a greater risk of childhood obesity, glucose intolerance, and diabetes in early adulthood. The advantages of treatment on adverse pregnancy outcomes have been clearly identified (1), but more research is needed to determine whether offspring outcomes can also be altered by interventions during pregnancy.
The risk factors for the development of GDM are well established, but of the major ones, only maternal obesity is potentially preventable or reversible. At the time of diagnosis one of the most commonly asked questions by patients relates to whether poor diet may have caused the problem. Although we can say that a change in diet will have a favorable effect, at this stage we cannot say with any certainty that any dietary factor causes GDM.
Epidemiological studies provide clues that generate hypotheses for further research. In this context, for both young and middle-aged women, a habitual diet that is high in fiber has an inverse association with the development of type 2 diabetes (2–4). Because dietary fiber is found only in plant foods closely associated with starch and naturally occurring sugars, the findings imply that low carbohydrate diets are not likely to be protective. In meta-analyses, dietary glycemic index (GI) and glycemic load (GL) are also predictive of type 2 …
