A Healthy Pre-Pregnancy Diet and Gestational Diabetes

Gestational Diabetes (GDM) can have long-term and short-term complications for both mother and baby. While early detection and treatment can help prevent some of those complications, prevention is always preferable. Unfortunately, the rate of gestational diabetes in the United States is approximately 7% and is increasing as obesity among childbearing women rises.

Previous research has looked at individual nutrients and the possibility that they may be able to reduce the risk of GDM. However, those nutrients can interact and there may be components within foods that we do not yet understand. We don't eat "nutrients" - we eat food. Some foods we only eat occasionally, others we eat consistently. Considering the complications of those nutrient interactions, can a woman's pre-pregnancy eating patterns influence her risk of gestational diabetes?

A recent research study analyzed the pre-pregnancy diet of a large group of women, comparing it to 3 different healthy eating dietary patterns, and looked for correlation between dietary patterns and the risk of gestational diabetes. (Am J Clin Nutr 2012;96:289-95)

Data for this study was drawn from the Nurses' Health Study, a longitudinal study that follows a number of health practices and health outcomes. Researchers looked at women who had not previously had GDM, cancer, or cardiovascular disease event before their pregnancy. They compared women who developed GDM with women who did not develop GDM

The women's pre-pregnancy eating patterns were analyzed to see how well the woman's eating patterns matched one of three healthy eating plans:

• The Mediterranean Diet,
• the DASH diet (Dietary Approach to Stop Hypertension) and
• the Healthy Eating Index (this is a measure of how well a person's diet conforms to US federal dietary guidelines)

Conformity to the Healthy Eating Index was associated with the lowest risk of developing gestational diabetes in this study (a 46% reduction in risk). The DASH diet reduced risk by 34% and the Mediterranean Diet reduced risk by 24%. Note: This study used the aMed diet (an alternate Mediterranean diet adapted for the American population). A previous study conducted in Europe showed a 35% reduction in risk for those closely following a Mediterranean diet. (BMJ. 2008 Jun 14;336(7657):1348-51.)

While it is useful to look at the risk reduction for the various eating plans, perhaps most important take away from this study is that if a woman's diet matched any of the above eating plans her risk of developing gestational diabetes during pregnancy was significantly less that a woman who ate an unhealthy diet.

While it appeared that it was the diet as a whole that reduced risk, researchers did note several dietary components that were associated with a reduced risk. These include fruit, nuts, soy, whole grains and cereal fiber, moderate use of alcohol, and decreased consumption of red meat, processed meat, trans fat and sugary beverages. These plans all include fruits and vegetables, whole grains, and a decreased use of red meats and highly processed foods.

To further decrease your risk of gestational diabetes, work to attain a healthy weight, exercise consistently, and live smoke free. If at all possible, start these habits before you plan to conceive.

Nourish yourself and your child!