Dietary patterns during pregnancy and maternal and birth outcomes in women with type 1 diabetes: the Environmental Determinants of Islet Autoimmunity (ENDIA) study
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(Published version)
Date
2024
Authors
Thomson, R.L.
Brown, J.D.
Oakey, H.
Palmer, K.
Ashwood, P.
Penno, M.A.S.
McGorm, K.J.
Battersby, R.
Colman, P.G.
Craig, M.E.
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Journal article
Citation
Diabetologia, 2024; 67(11):2420-2432
Statement of Responsibility
Rebecca L. Thomson, James D. Brown, Helena Oakey, Kirsten Palmer, Pat Ashwood, Megan A. S. Penno, Kelly J. McGorm, Rachel Battersby, Peter G. Colman, Maria E. Craig, Elizabeth A. Davis, Tony Huynh, Leonard C. Harrison, Aveni Haynes, Richard O. Sinnott, Peter J. Vuillermin, John M. Wentworth, Georgia Soldatos, Jennifer J. Couper, on behalf of on behalf of the ENDIA Study Group
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Abstract
Aims/hypothesis Dietary patterns characterised by high intakes of vegetables may lower the risk of pre-eclampsia and premature birth in the general population. The effect of dietary patterns in women with type 1 diabetes, who have an increased risk of complications in pregnancy, is not known. The aim of this study was to investigate the relationship between dietary patterns and physical activity during pregnancy and maternal complications and birth outcomes in women with type 1 diabetes. We also compared dietary patterns in women with and without type 1 diabetes. Methods Diet was assessed in the third trimester using a validated food frequency questionnaire in participants followed prospectively in the multi-centre Environmental Determinants of Islet Autoimmunity (ENDIA) study. Dietary patterns were characterised by principal component analysis. The Pregnancy Physical Activity Questionnaire was completed in each trimester. Data for maternal and birth outcomes were collected prospectively. Results Questionnaires were completed by 973 participants during 1124 pregnancies. Women with type 1 diabetes (n=615 pregnancies with dietary data) were more likely to have a ‘fresh food’ dietary pattern than women without type 1 diabetes (OR 1.19, 95% CI 1.07, 1.31; p=0.001). In women with type 1 diabetes, an increase equivalent to a change from quartile 1 to 3 in ‘fresh food’ dietary pattern score was associated with a lower risk of pre-eclampsia (OR 0.37, 95% CI 0.17, 0.78; p=0.01) and premature birth (OR 0.35, 95% CI 0.20, 0.62, p<0.001). These associations were mediated in part by BMI and HbA(1c). The ‘processed food’ dietary pattern was associated with an increased birthweight (β coefficient 56.8 g, 95% CI 2.8, 110.8; p=0.04). Physical activity did not relate to outcomes. Conclusions/interpretation A dietary pattern higher in fresh foods during pregnancy was associated with sizeable reductions in risk of pre-eclampsia and premature birth in women with type 1 diabetes.
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Data source: Supplementary information, https://doi.org/10.1007/s00125-024-06259-5
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© The Author(s) 2024. This 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/.