Dietary patterns during pregnancy derived by reduced-rank regression and their association with gestational diabetes mellitus

Objective: Evidence for the combined association of the quality of dietary carbohydrates and fats during pregnancy with gestational diabetes mellitus (GDM) is scarce. The aim of this study was to identify dietary patterns during pregnancy, derived by the reduced-rank regression (RRR) model, associated with fiber density (g/1000 kcal) and the Thrombogenicity Index (TI) and to investigate their relationship with GDM. Methods: This was a cross-sectional study conducted with 785 pregnant women at gestational weeks 24 to 39. The diagnosis of GDM was based on the World Health Organization criteria. One 24-h dietary recall was obtained from all women and a second measurement from 73% of the sample, with the multiple source method used to estimate the usual diet. The patterns were determined by RRR, and the relationship with GDM was investigated using adjusted logistic regression models. Results: The mean (standard deviation) age of the women was 28 y and 17.7% had GDM. Dietary pattern 1 (high rice, beans, and vegetables, with low full-fat dairy products, biscuits, and sweets) correlated positively with fiber density and negatively with TI and was inversely associated with GDM after multiple adjustments (odds ratio [OR], 0.58; 95% confidence interval [CI], 0.36-0.95; P = 0.03). Dietary pattern 2 (high red meats, full-fat dairy products, chocolate powder and fruits, with low chicken and margarine) correlated positively with both TI and fiber density, with no association with GDM found (OR, 1.48; 95% CI, 0.91-2.40; P = 0.11). Conclusion: These data highlight the joint importance of the quality of dietary carbohydrates and fats in the dietary patterns of pregnant women in relation to the risk for developing GDM. (C) 2018 Elsevier Inc. All rights reserved.