Poster Presentation Australasian Diabetes in Pregnancy Society Annual Scientific Meeting 2024

Obesity and younger age at diagnosis are associated with poorer diet quality and lower intake of dietary fibres in Gestational Diabetes.  (#28)

Cathy Latino 1 2 , Amanda Devine 2 3 , Johnny Lo 4 , Claus Christophersen 2 3 5 , Emily Gianatti 6
  1. Dietetics Department, Fiona Stanley Fremantle Hospitals Group, Murdoch, WA, Australia
  2. Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
  3. School of Medical & Health Sciences, Edith Cowan University, Joondalup, WA, Australia
  4. School of Science, Edith Cowan University, Joondalup, WA, Australia
  5. WA Human Microbiome Collaboration Centre, Curtin University, Bentley, WA, Australia
  6. Department of Endocrinology, Fiona Stanley Fremantle Hospitals Group, Murdoch, WA, Australia

Background:  

Medical Nutrition Therapy improves maternal-fetal outcomes in Gestational Diabetes Mellitus (GDM). However, implementation of current dietary education by Australian women with GDM may limit fibre-rich foods reducing diet quality and intake of fibres like resistant starch (RS). A fibre-rich diet is crucial for a healthy gut microbiome in both obesity and GDM. A higher intake of fibre-rich food groups and less ultra-processed foods during a GDM pregnancy has the potential to positively impact maternal-fetal outcomes via a healthy gut microbiome. 

 

Method:  

Diets of 54 GDM women, aged 32.1 ± 4.6 years, were characterised in the first week after initial GDM diet education using 3-day weighed dietary records and Diet Quality Index (DQI). Regression analysis was used to assess the association of pre-pregnancy BMI and age with dietary intakes and DQI scores. ANOVA was used to assess differences in nutritional intake and DQI by Body Mass Index (BMI) category. 

 

Results: 

Mean dietary fibre and RS intakes were 24.3 ± 6.3 g/day and 4.9 ± 1.9 g/day; below respective requirements (28 g and 15-20 g/day). Fibre intake was positively associated with intakes of grains (p <0.001), vegetables (p <0.001) and fruit (p = 0.009), whilst increased RS intake was associated with greater intakes of grains (p = 0.032) and vegetables (p = 0.039). 

 

Higher pre-pregnancy BMI was associated with lower DQI score (p = 0.021), lower intakes of wholegrains (p = 0.010), seafood (p = 0.001) and RS (p = 0.006), and greater intakes of processed meats (p = 0.015).  

 

Compared with healthy pre-pregnancy BMI women, obese women consumed less RS (p = 0.028), had lower DQI scores (p = 0.046), were less likely to consume seafood (p = 0.022) and were more likely to consume processed meats (p = 0.033).  

 

Maternal age was positively associated with DQI (p < 0.001) and RS intake (p = 0.049). 

 

Conclusion: 

Obese and younger women with GDM have a poorer diet quality and lower intakes of RS.  As most women with GDM do not meet the fibre and RS intakes recommended for optimal health, more emphasis should be placed on dietary patterns rich in wholegrains, vegetables and fruit and lower in ultra-processed foods. This will also result in improvement in gut health and microbiome.