- © 2017 American Society for Nutrition
Higher Maternal Dietary Protein Intake Is Associated with a Higher Risk of Gestational Diabetes Mellitus in a Multiethnic Asian Cohort1,2,3,4
- Wei Wei Pang5,
- Marjorelee Colega11,
- Shirong Cai5,
- Yiong Huak Chan6,
- Natarajan Padmapriya5,
- Ling-Wei Chen7,
- Shu-E Soh11,
- Wee Meng Han12,
- Kok Hian Tan13,
- Yung Seng Lee7,9,11,
- Seang-Mei Saw10,
- Peter D Gluckman11,14,
- Keith M Godfrey15,16,
- Yap-Seng Chong5,11,
- Rob M van Dam8,10,17,*, and
- Mary FF Chong10,11,17,*
- 5Departments of Obstetrics and Gynaecology,
- 6Biostatistics,
- 7Paediatrics, and
- 8Medicine, Yong Loo Lin School of Medicine,
- 9Khoo Teck Puat-National University Children's Medical Institute,
- 10Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore;
- 11Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore;
- 12Departments of Nutrition and Dietetics and
- 13Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore;
- 14Liggins Institute, University of Auckland, Auckland, New Zealand;
- 15Medical Research Council Lifecourse Epidemiology Unit, Southampton, United Kingdom; and
- 16National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
- ↵*To whom correspondence should be addressed. E-mail: rob.van.dam{at}nus.edu.sg (RM van Dam), ephmcff{at}nus.edu.sg (MFF Chong).
Abstract
Background: Dietary protein may affect glucose metabolism through several mechanisms, but results from studies on dietary protein intake and risk of gestational diabetes mellitus (GDM) have been inconsistent.
Objective: We examined the cross-sectional associations of dietary protein intake from different food sources during pregnancy with the risk of GDM in a multiethnic Asian population.
Methods: We included 980 participants with singleton pregnancies from the Growing Up in Singapore Toward healthy Outcomes (GUSTO) cohort. Protein intake was ascertained from 24-h dietary recall and 3-d food diaries at 26–28 wk gestation. GDM was defined as fasting glucose ≥7.0 mmol/L and/or 2-h postload glucose ≥7.8 mmol/L at 26–28 wk gestation. We evaluated the association of dietary protein intake with GDM risk by substituting carbohydrate with protein in an isocaloric model with the use of multivariable logistic regression analysis.
Results: The prevalence of GDM was 17.9% among our participants. After adjustment for potential confounders, a higher total dietary protein intake was associated with a higher risk of GDM; the OR comparing the highest with the lowest quartile of intake was 2.15 (95% CI: 1.27, 3.62; P-trend = 0.016). Higher intake levels of both animal protein (OR: 2.87; 95% CI: 1.58, 5.20; P-trend = 0.001) and vegetable protein (OR: 1.78; 95% CI: 0.99, 3.20; P-trend = 0.009) were associated with a higher risk of GDM. Among the animal protein sources, higher intake levels of seafood protein (OR: 2.17; 95% CI: 1.26, 3.72; P-trend = 0.023) and dairy protein (OR: 1.87; 95% CI: 1.11, 3.15; P-trend = 0.017) were significantly associated with a higher GDM risk.
Conclusion: Higher intake levels of both animal and vegetable protein were associated with a higher risk of GDM in Asian women. This trial was registered at clinicaltrials.gov as NCT01174875.
Footnotes
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↵1 Growing Up in Singapore Toward healthy Outcomes is supported by the Singapore National Research Foundation under its Translational and Clinical Research Flagship Programme and is administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC/TCR/004-NUS/2008 and NMRC/TCR/012-NUHS/2014). Additional funding was provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, and Nestec. Study sponsors were not involved in the design of the study, statistical analysis, or results interpretation.
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↵2 Author disclosures: YS Lee, KM Godfrey, and Y-S Chong have received reimbursement for speaking at conferences sponsored by companies selling nutritional products. These authors are part of an academic consortium that has received research funding from Abbott Nutrition, Nestec, and Danone. WW Pang, M Colega, S Cai, YH Chan, N Padmapriya, L-W Chen, S-E Soh, WM Han, KH Tan, S-M Saw, PD Gluckman, RM van Dam, and MFF Chong, no conflicts of interest.
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↵3 The study sponsors were not involved in the design of the study, statistical analysis, or results interpretation.
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↵4 Supplemental Figure 1 and Supplemental Tables 1–8 are available from the “Online Supporting Material” link in the online posting of the article and from the same link in the online table of contents at http://jn.nutrition.org.
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↵17 These authors are co-last authors.
- Manuscript received: November 4, 2016.
- Initial review completed: December 1, 2016.
- Revision accepted: February 6, 2017.
