Influence of Diet and Lifestyle on the Development of Gestational Diabetes Mellitus and on Perinatal Results
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Diagnosis of Gestational Diabetes
2.3. Patient Recruitment
2.4. Questionnaire
2.5. Biochemical Analysis and Clinical Parameters Assessed
2.6. Statistical Analysis
3. Results
3.1. Demographics
3.2. Medical and Obstetric History
3.3. Anthropometrics and Body Perception
3.4. Dietary Habits and Lifestyle
3.5. Consumption of Tobacco, Alcohol, Caffeine and Processed Foods
3.6. Biochemical Results
3.7. Perinatal Results
3.8. Comparison of Biochemical and Perinatal Results between the Group of Pregnant Women Who Developed GDM and the Normoglycemic Women
3.8.1. Biochemical Results
3.8.2. Obstetric and Perinatal Results
3.9. Relationship between Lifestyle, Dietary Habits and Nutritional Knowledge with the Development of GDM
3.10. Relationship between Lifestyle and Eating Habits and Glucose Intolerance
3.11. Results of the Nutritional Survey Significant in the Development of GDM
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
WEEKLY FREQUENCY/ DAILY CONSUMPTION RATION | N | MINIMUM | MAXIMUM | MEAN | SD |
---|---|---|---|---|---|
White Bread | |||||
Frequency | 100 | 0 | 7 | 5.3 | 2.3 |
Ration | 100 | 0 | 5 | 1.5 | 0.8 |
Wholemeal Bread | |||||
Frequency | 4 | 4 | 7 | 6.2 | 1.5 |
Ration | 4 | 2 | 2 | 2.0 | 0.0 |
Cereals | |||||
Frequency | 102 | 0 | 7 | 3.5 | 2.0 |
Ration | 101 | 0 | 5 | 1.2 | 0.6 |
Legume | |||||
Frequency | 100 | 0 | 7 | 2.1 | 1.7 |
Ration | 101 | 0 | 3 | 0.9 | 0.5 |
Vegetable | |||||
Frequency | 101 | 0 | 7 | 4.1 | 2.4 |
Ration | 101 | 0 | 7 | 1.1 | 0.8 |
Fruit | |||||
Frequency | 101 | 0 | 8 | 5.7 | 2.4 |
Ration | 100 | 0 | 6 | 1.9 | 1.3 |
Whole Milk | |||||
Frequency | 79 | 0 | 7 | 5.1 | 2.9 |
Ration | 78 | 0 | 3 | 1.0 | 0.7 |
0% gm Milk | |||||
Frequency | 30 | 0 | 7 | 4.9 | 3.0 |
Ration | 29 | 0 | 2 | 1.0 | 0.7 |
VEGETABLE MILK | 1 | 7 | 7 | 7.0 | . |
Yogurt | |||||
Frequency | 101 | 0 | 7 | 3.8 | 2.8 |
Ration | 101 | 0 | 7 | 0.9 | 1.0 |
Whole Cheese | |||||
Frequency | 83 | 0 | 7 | 2.4 | 2.2 |
Ration | 83 | 0 | 4 | 0.90 | 0.9 |
0% gm Cheese | |||||
Frequency | 32 | 0 | 7 | 1.8 | 2.4 |
Ration | 32 | 0 | 2 | 0.6 | 0.7 |
Red Meat | |||||
Frequency | 99 | 0 | 7 | 2.1 | 1.8 |
Ration | 101 | 0 | 4 | 1.0 | 0.7 |
White Meat | |||||
Frequency | 102 | 0 | 7 | 2.9 | 1.6 |
Ration | 102 | 0 | 3 | 1.1 | 0.6 |
Fish/Seafood | |||||
Frequency | 101 | 0 | 7 | 1.9 | 1.4 |
Ration | 102 | 0 | 3 | 1.0 | 0.6 |
Egg | |||||
Frequency | 101 | 0 | 7 | 2.8 | 1.7 |
Ration | 102 | 0 | 4 | 1.3 | 0.7 |
Evoo | |||||
Frequency | 94 | 0 | 7 | 5.8 | 2.2 |
Ration | 88 | 0 | 3 | 1.3 | 0.8 |
Sunflower Oil | |||||
Frequency | 32 | 0 | 7 | 3.6 | 3.1 |
Ration | 29 | 0 | 4 | 1.0 | 1.0 |
Other oils (ration) | 9 | 0 | 7 | 1.6 | 3.0 |
Butter | |||||
Frequency | 97 | 0 | 7 | 2.1 | 2.7 |
Ration | 94 | 0 | 7 | 0.7 | 1.1 |
Cream | |||||
Frequency | 78 | 0 | 7 | 1.3 | 2.1 |
Ration | 77 | 0 | 2 | 0.4 | 0.5 |
Nuts | |||||
Frequency | 101 | 0 | 7 | 2.1 | 2.2 |
Ration | 101 | 0 | 3 | 0.8 | 0.6 |
Candy | |||||
Frequency | 100 | 0 | 7 | 3.7 | 2.7 |
Ration | 99 | 0 | 5 | 1.3 | 1.0 |
Water | |||||
Frequency | 102 | 0 | 7 | 6.7 | 1.2 |
Ration | 101 | 0 | 4.0 | 1.5 | 0.7 |
VARIABLE | GDM | p-Value | |||||||
---|---|---|---|---|---|---|---|---|---|
NO | YES | ||||||||
MEAN | SD | MEDIAN | RANK | MEAN | SD | MEDIAN | RANK | ||
Age | 33 | 5.6 | 33.65 | 7 | 32.22 | 4.53 | 33 | 3 | 0.67 |
Residence time in Spain | 14.36 | 9.51 | 12 | 30.5 | 14 | 1 | 14 | 2 | 0.42 |
Gestational age | 12.09 | 3.03 | 12 | 17 | 10.63 | 2.97 | 11 | 9 | 0.19 |
Number of pregnancies | 1.53 | 0.75 | 1 | 3 | 1.33 | 0.70 | 1 | 2 | 0.34 |
Size | 162.82 | 7.34 | 162 | 40 | 161 | 7.5 | 160.5 | 23 | 0.56 |
Weight in the first week of gestation | 63.78 | 8.86 | 63.3 | 45.7 | 62.87 | 12.50 | 63.5 | 39 | 0.86 |
BMI | 24.13 | 3.38 | 23.93 | 20.24 | 24.40 | 5.42 | 22.85 | 16.24 | 0.85 |
Weight prior to gestation | 62.78 | 8.66 | 62.5 | 41 | 62.88 | 12.78 | 68 | 38 | 0.93 |
BMI prior to gestation | 23.77 | 3.40 | 23.01 | 20.94 | 23.65 | 5.20 | 22.61 | 15.82 | 0.78 |
Previous child weight | 3.18 | 0.57 | 3.17 | 2.3 | 3.03 | . | 3.03 | 0 | 0.89 |
VARIABLE | p-Value |
---|---|
Country of origin | 0.55 |
Marital status | 0.36 |
Work | 0.67 |
Chronic disease | 0.47 |
Allergies | 0.05 |
Relatives with Diabetes | 0.021 |
Previous Diabetes | 0.468 |
Previous GDM | 0.43 |
Insulin treatment in previous GDM | 0.28 |
Previous childbirth | 1 |
PARAMETERS | MEAN |
---|---|
Fasting glycemia | 76.70 ± 7.5 (62–104) mg/dL |
O’Sullivan 1 h | 124.57 ± 29.8 (65–211) mg/dL |
OGTT 100 g | 79.29 ± 9.124 (57–98) mg/dL |
OGTT 100 g 1 h | 165.21 ± 28.89 (120–219) mg/dL |
OGTT 100 g 2 h | 150 ± 40 (84–249) mg/dL |
OGTT 100 g 3 h | 131.43 ± 32 (89–235) mg/dL |
Fasting insulin | 10.22 ± 5 (1–18) (U/mL) |
HbA1c | 5.33 ± 0.388 (4.3–5.7)% |
Ferritin | 16.86 ± 16.14 (5–89) mg/L |
Total plasma protein | 6.1 ±0.348 (5.4–6.8) g/dL |
Hemoglobin | 11.81 ± 1.01 (8.9–14.2) g/dL |
Total cholesterol | 234 ± 36.40 (174–316) mg/dL |
Vitamin D | 21 ± 5.55 (12–32) ng/mL |
PARAMETERS | MEAN ± SD |
---|---|
GAD | 38 ± 4.28 (9–41) weeks |
NB weight | 3187.82 ± 560.624 (1160–4980) kg |
Head circumference | 34.119 ± 1.539 (28–37) cm |
Apgar 1 min | 8.65 ± 0.886 (4–10) |
Apgar 5 min | 9.61 ± 0.820 (5–10) |
Weight percentile | 57.081 ± 26.71 (3–99) |
Variable | DIABETES | p-Value | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NO | YES | TOTAL | |||||||||||
Mean | SD | Median | Rank | Mean | SD | Median | Rank | Mean | SD | Median | Rank | ||
Time of activity during pregnancy | 331.9 | 227.8 | 315 | 780 | 258.7 | 188.6 | 277.5 | 360 | 314.71 | 215.9 | 315 | 780 | 0.684 |
ACTIVITY DURING GESTATION | RHO SPEARMAN | p-Value |
---|---|---|
OGTT 100 g 2 h | −0.426 | 0.024 |
WHITE BREAD | RHO SPEARMAN | p-Value |
---|---|---|
OGTT 2 h | 0.450 | 0.018 |
ADDED SUGAR | RHO SPEARMAN | p-Value |
---|---|---|
Baseline OGTT | 0.396 | 0.037 |
OGTT 1 h | 0.486 | 0.009 |
OGTT 2 h | 0.465 | 0.013 |
OGTT 3 h | 0.434 | 0.021 |
LEGUME (FC) | RHO SPEARMAN | p-Value |
Fasting glycemia | −0.273 | 0.025 |
LEGUME (RATION) | RHO SPEARMAN | p-Value |
Fasting glycemia | −0.337 | 0.005 |
FISH (RATION) | RHO SPEARMAN | p-Value |
---|---|---|
Fasting glycemia | −0.294 | 0.014 |
BUTTER (FC) | RHO SPEARMAN | p-Value |
---|---|---|
Fasting glycemia | 0.313 | 0.010 |
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Variable | DIABETES | p-Value | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NO | YES | Total | |||||||||||
Mean | SD | Median | Rank | Mean | SD | Median | Rank | Mean | SD | Median | Rank | ||
Fasting glycemia (mg/dl) | 75.5 | 6.9 | 74 | 42 | 86.5 | 7.7 | 82 | 18 | 76.7 | 7.7 | 75 | 42 | 0.001 |
O’Sullivan 1 h (mg/dl) | 118.7 | 23.2 | 118 | 95 | 172 | 41.3 | 179 | 120 | 124.7 | 30.5 | 120 | 146 | 0.002 |
OGTT basal (mg/dl) | 77.8 | 7.4 | 76 | 27 | 84 | 8.1 | 83 | 80.0 | 8,1 | 77 | 29 | 0.069 | |
OGTT 1 h (mg/dl) | 154.1 | 26.4 | 150 | 70 | 190.4 | 19.6 | 192 | 73 | 167.2 | 29.6 | 180 | 99 | 0.002 |
OGTT 2 h (mg/dl) | 127.3 | 20.5 | 127 | 72 | 198.4 | 27.4 | 186 | 81 | 152.9 | 41.5 | 149 | 165 | 0 |
OGTT 3 h (mg/dl) | 114.1 | 15.1 | 115.5 | 62 | 167.5 | 29.3 | 152 | 91 | 133.3 | 33.4 | 121 | 146 | 0 |
Fasting insulin (U/mL) | 10.2 | 5.0 | 9 | 17 | 10.2 | 5.0 | 9 | 17 | - | ||||
HbA1C (%) | 5.3 | 0.3 | 5.4 | 1.4 | 5.3 | 0.39 | 5.4 | 1.4 | - | ||||
Ferritin (ng/mL) | 17.9 | 17.5 | 11 | 84 | 11,3 | 6.9 | 8.5 | 16 | 17.2 | 16.8 | 10 | 84 | 0.466 |
Total proteins (g/dL) | 6.1 | 0.3 | 6.2 | 1.4 | 6.0 | 0.2 | 6 | 0.8 | 6.1 | 0.3 | 6.2 | 1.4 | 0.610 |
Hemoglobin (g/dL) | 11.7 | 1.0 | 11.8 | 5 | 12,0 | 1.1 | 11.9 | 4.1 | 11.8 | 1.0 | 11.8 | 5.3 | 0.452 |
Total cholesterol (mg/dL) | 238.8 | 35.0 | 241.5 | 142 | 217.9 | 29.5 | 218.5 | 78 | 233.3 | 34.6 | 232 | 142 | 0.119 |
Vitamin D (ng/mL) | 21.1 | 5.8 | 21.5 | 20 | 21 | 21 | 0 | 21.0 | 5.5 | 21 | 20 | 1 |
Variable | DIABETES | p-Value | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NO | YES | Total | |||||||||||
Mean | SD | Median | Rank | Mean | SD | Median | Rank | Mean | SD | Median | Rank | ||
Final weight (kg) | 73.9 | 9.6 | 72.3 | 50.7 | 73.1 | 13.8 | 76.2 | 40.9 | 73.8 | 10.2 | 73.0 | 58.2 | 0.847 |
GA at delivery (weeks) | 38.6 | 2.5 | 39 | 14 | 37.7 | 1.0 | 38 | 3 | 38.5 | 2.4 | 39 | 14 | 0.021 |
Newborn weight (g) | 3163.1 | 520,9 | 3120 | 3490 | 3133.8 | 567.3 | 3340 | 1655 | 3159.1 | 523.0 | 3122.5 | 3490 | 0.918 |
Newborn height (cm) | 48.8 | 1.9 | 49 | 10 | 48 | 2.1 | 48.5 | 7 | 48.7 | 1.9 | 49 | 10 | 0.259 |
Head circumference (cm) | 34.1 | 1.5 | 3. 4 | 9 | 34,0 | 1.4 | 34.5 | 4.5 | 34.0 | 1.5 | 34.2 | 9 | 0.951 |
Apgar 1 | 8.6 | 0.9 | 9 | 6 | 8.8 | 0.3 | 9 | 1 | 8.6 | 0.8 | 9 | 6 | 0.411 |
Apgar 5 | 9.59 | 0.8 | 10 | 5 | 9.6 | 0.5 | 10 | 1 | 9.6 | 0.8 | 10 | 5 | 0.858 |
Weight percentile | 57.7 | 25.6 | 60 | 96 | 55.6 | 37.9 | 61 | 90 | 57.4 | 27.0 | 60 | 96 | 0.909 |
Weight gain (Kg) | 9.8 | 4.9 | 10.5 | 18.6 | 10,3 | 5.1 | 12.4 | 13.6 | 9.8 | 4.9 | 10.6 | 18.6 | 0.777 |
Rho Spearman | p-Value | |
---|---|---|
Gestational age and fasting glycemia | −0.343 | 0.006 |
Gestational age and OGTT 1 h | −0.613 | 0.001 |
Gestational age and OGTT 2 h | −0.502 | 0.012 |
Gestational age and OGTT 3 h | −0.550 | 0.005 |
Variable | Gestational Diabetes | p-Value | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NO | YES | TOTAL | |||||||||||
Mean | SD | Median | Rank | Mean | SD | Median | Rank | Mean | SD | Median | Rank | ||
White bread (fc) | 5.5 | 2.2 | 7 | 7 | 6.7 | 1 | 7 | 3 | 5.6 | 2.2 | 7 | 7 | 0.012 |
Cereal (fc) | 3.5 | 1.8 | 3 | 6 | 2.8 | 2.4 | 2 | 7 | 3.4 | 1.9 | 3 | 7 | 0.159 |
Legume (fc) | 2.0 | 1.5 | 2 | 7 | 1.4 | 2 | 4 | 2.1 | 1.5 | 2 | 7 | 0.599 | |
Vegetable (fc) | 4.1 | 2.3 | 4 | 7 | 4.9 | 2.6 | 6.5 | 6 | 4.2 | 2.4 | 5 | 7 | 0.261 |
Fruit (fc) | 5.6 | 2.2 | 7 | 8 | 5.3 | 2.8 | 7 | 7 | 5.6 | 2.3 | 7 | 8 | 0.897 |
Whole milk (fc) | 5.5 | 2.7 | 7 | 7 | 3.7 | 3.7 | 4 | 7 | 5.4 | 2.8 | 7 | 7 | 0.288 |
Milk 0% | 5 | 3.1 | 7 | 7 | 5.1 | 2.9 | 7 | 7 | 5.0 | 3 | 7 | 7 | 0.815 |
Yogurt (fc) | 3.7 | 2.7 | 4 | 7 | 2.9 | 3.2 | 1.5 | 7 | 3.6 | 2.8 | 4 | 7 | 0.393 |
Red meat (fc) | 2.0 | 1.7 | 2 | 7 | 2.1 | 2.3 | 1 | 7 | 2.1 | 1.8 | 2 | 7 | 0.699 |
White meat (fc) | 2.8 | 1.5 | 3 | 7 | 2.8 | 1.1 | 3 | 4 | 2.8 | 1.5 | 3 | 7 | 0.931 |
Fish/seafood (fc) | 1.9 | 1.3 | 2 | 6 | 1.8 | 1.2 | 2 | 4 | 1.9 | 1.3 | 2 | 6 | 0.944 |
Egg (fc) | 2.7 | 1.5 | 3 | 7 | 3.4 | 2.7 | 4 | 7 | 2. | 1.7 | 3 | 7 | 0.392 |
Evoo (fc) | 5.7 | 2.5 | 7 | 7 | 6.1 | 2.2 | 7 | 7 | 5.7 | 2.4 | 7 | 7 | 0.691 |
Sunflower oil | 1.1 | 0.9 | 1 | 3 | 1 | 0 | 1 | 0 | 1.1 | 0.9 | 1 | 3 | 0.403 |
Butter (fc) | 2.2 | 2.7 | 1 | 7 | 2.6 | 2.9 | 2 | 7 | 2.2 | 2.7 | 1 | 7 | 0.617 |
Cream (fc) | 1.1 | 1.8 | 0 | 7 | 2.3 | 2.8 | 1.5 | 7 | 1.2 | 1.9 | 0 | 7 | 0.295 |
Dry fruits (fc) | 2.0 | 2.2 | 2 | 7 | 2.7 | 1.5 | 7 | 2.1 | 2.3 | 2 | 7 | 0.937 | |
Added sugar (fc) | 2.9 | 3.4 | 0 | 7 | 4.2 | 3.6 | 7 | 7 | 3.1 | 3.4 | 0 | 7 | 0.277 |
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Yuste Gómez, A.; Ramos Álvarez, M.d.P.; Bartha, J.L. Influence of Diet and Lifestyle on the Development of Gestational Diabetes Mellitus and on Perinatal Results. Nutrients 2022, 14, 2954. https://doi.org/10.3390/nu14142954
Yuste Gómez A, Ramos Álvarez MdP, Bartha JL. Influence of Diet and Lifestyle on the Development of Gestational Diabetes Mellitus and on Perinatal Results. Nutrients. 2022; 14(14):2954. https://doi.org/10.3390/nu14142954
Chicago/Turabian StyleYuste Gómez, Alba, Maria del Pilar Ramos Álvarez, and José Luis Bartha. 2022. "Influence of Diet and Lifestyle on the Development of Gestational Diabetes Mellitus and on Perinatal Results" Nutrients 14, no. 14: 2954. https://doi.org/10.3390/nu14142954