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Nutrients 2018, 10(6), 698; https://doi.org/10.3390/nu10060698

Associations of Diet and Physical Activity with Risk for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

1
Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
2
The School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia
3
Faculty of Health Sciences, The University of Sydney, Lidcombe 2141, Australia
4
Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney 2006, Australia
5
School of Biological Sciences, Faculty of Science, The University of Hong Kong, Pokfulam, Hong Kong, China
6
Westmead Hospital, Western Sydney Local Health District, Westmead 2145, Australia
7
Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead 2145, Australia
8
Department of Diabetes and Endocrinology, Westmead Hospital, Westmead 2145, Australia
9
Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown 2050, Australia
10
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
11
School of Mathematics and Statistics, The University of Sydney, Sydney 2006, Australia
*
Author to whom correspondence should be addressed.
Received: 3 May 2018 / Revised: 25 May 2018 / Accepted: 28 May 2018 / Published: 30 May 2018
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Abstract

Rising rates of gestational diabetes mellitus (GDM) and related complications have prompted calls to identify potentially modifiable risk factors that are associated with gestational diabetes mellitus (GDM). We systematically reviewed the scientific literature for observational studies examining specific dietary and/or physical activity (PA) factors and risk of GDM. Our search included PubMed, Medline, CINAHL/EBSCO, Science Direct and EMBASE, and identified 1167 articles, of which 40 met our inclusion criteria (e.g., singleton pregnancy, reported diet or PA data during pre-pregnancy/early pregnancy and GDM as an outcome measure). Studies were assessed for quality using a modified Quality Criteria Checklist from American Dietetic Association. Of the final 40 studies, 72% obtained a positive quality rating and 28% were rated neutral. The final analysis incorporated data on 30,871 pregnant women. Dietary studies were categorised into either caffeine, carbohydrate, fat, protein, calcium, fast food and recognized dietary patterns. Diets such as Mediterranean Diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH) diet and Alternate Healthy Eating Index diet (AHEI) were associated with 15–38% reduced relative risk of GDM. In contrast, frequent consumption of potato, meat/processed meats, and protein (% energy) derived from animal sources was associated with an increased risk of GDM. Compared to no PA, any pre-pregnancy or early pregnancy PA was associated with 30% and 21% reduced odds of GDM, respectively. Engaging in >90 min/week of leisure time PA before pregnancy was associated with 46% decreased odds of GDM. We conclude that diets resembling MedDiet/DASH diet as well as higher PA levels before or in early pregnancy were associated with lower risks or odds of GDM respectively. The systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42016027795. View Full-Text
Keywords: pregnancy; pre-pregnancy; gestational diabetes; diet; physical activity; exercise pregnancy; pre-pregnancy; gestational diabetes; diet; physical activity; exercise
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Mijatovic-Vukas, J.; Capling, L.; Cheng, S.; Stamatakis, E.; Louie, J.; Cheung, N.W.; Markovic, T.; Ross, G.; Senior, A.; Brand-Miller, J.C.; Flood, V.M. Associations of Diet and Physical Activity with Risk for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients 2018, 10, 698.

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