Sociodemographic Factors Associated with Adherence to Dietary Guidelines in Women with Gestational Diabetes: A Cohort Study

Overview

Journal Nutrients

Date 2021 Jun 2

PMID 34072685

Citations 8

Authors

Sara Mustafa

Jane Harding

Clare Wall

Caroline Crowther

Affiliations

Soon will be listed here.

Abstract

Dietary advice is the cornerstone of care for women with gestational diabetes mellitus (GDM). However, adherence to this advice is variable. We aimed to identify the proportion of women with GDM who adhere to the New Zealand nutrition guideline recommendations and assess the sociodemographic factors linked to dietary adherence. We assessed dietary intake at 36 weeks' gestation in a cohort of 313 women with GDM and compared this with the dietary recommendations for the management of GDM. Associations between maternal characteristics and dietary adherence were assessed using ANOVA, chi square, logistic regression, and linear regression tests. Women with GDM had an average adherence score of 6.17 out of 10 to dietary recommendations, but no one adhered to all the recommendations. Adherence to recommendations was lowest for saturated fat, and wholegrain breads and cereals. While 85% visited a dietitian, only 28% of women achieved their recommended weight gain. Maternal factors associated with lower dietary adherence were primiparity, no previous history of GDM, being underweight, and smoking. Adherence to the dietary recommendations by women with GDM in New Zealand for the management could be improved. Further research is needed to identify ways for women with GDM to improve their dietary adherence.

Citing Articles

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References

Quansah D, Gross J, Gilbert L, Helbling C, Horsch A, Puder J . Intuitive eating is associated with weight and glucose control during pregnancy and in the early postpartum period in women with gestational diabetes mellitus (GDM): A clinical cohort study. Eat Behav. 2019; 34:101304. DOI: 10.1016/j.eatbeh.2019.101304. View

Clapp J . Effects of Diet and Exercise on Insulin Resistance during Pregnancy. Metab Syndr Relat Disord. 2008; 4(2):84-90. DOI: 10.1089/met.2006.4.84. View

Martis R, Brown J, Crowther C . Views and Experiences of New Zealand Women with Gestational Diabetes in Achieving Glycaemic Control Targets: The Views Study. J Diabetes Res. 2017; 2017:2190812. PMC: 5684580. DOI: 10.1155/2017/2190812. View

Kim C . Gestational diabetes: risks, management, and treatment options. Int J Womens Health. 2010; 2:339-51. PMC: 2990903. DOI: 10.2147/IJWH.S13333. View

. SMFM Statement: Pharmacological treatment of gestational diabetes. Am J Obstet Gynecol. 2018; 218(5):B2-B4. DOI: 10.1016/j.ajog.2018.01.041. View

Metzger B, Coustan D . Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. The Organizing Committee. Diabetes Care. 1998; 21 Suppl 2:B161-7. View

Hansen C, Overvad K, Tetens I, Tjonneland A, Parner E, Jakobsen M . Adherence to the Danish food-based dietary guidelines and risk of myocardial infarction: a cohort study. Public Health Nutr. 2018; 21(7):1286-1296. PMC: 10261609. DOI: 10.1017/S1368980017003822. View

Hansen S, Overvad K, Hansen C, Dahm C . Adherence to national food-based dietary guidelines and incidence of stroke: A cohort study of Danish men and women. PLoS One. 2018; 13(10):e0206242. PMC: 6200254. DOI: 10.1371/journal.pone.0206242. View

Gou B, Guan H, Bi Y, Ding B . Gestational diabetes: weight gain during pregnancy and its relationship to pregnancy outcomes. Chin Med J (Engl). 2019; 132(2):154-160. PMC: 6365271. DOI: 10.1097/CM9.0000000000000036. View

10.

Kant A . Indexes of overall diet quality: a review. J Am Diet Assoc. 1996; 96(8):785-91. DOI: 10.1016/S0002-8223(96)00217-9. View

11.

Vestgaard M, Christensen A, Viggers L, Lauszus F . Birth weight and its relation with medical nutrition therapy in gestational diabetes. Arch Gynecol Obstet. 2017; 296(1):35-41. DOI: 10.1007/s00404-017-4396-7. View

12.

Lawrence R, Wall C, Bloomfield F, Crowther C . Dietetic management of gestational diabetes in New Zealand: A cross-sectional survey. Nutr Diet. 2017; 74(1):95-104. DOI: 10.1111/1747-0080.12311. View

13.

Martis R, Brown J, McAra-Couper J, Crowther C . Enablers and barriers for women with gestational diabetes mellitus to achieve optimal glycaemic control - a qualitative study using the theoretical domains framework. BMC Pregnancy Childbirth. 2018; 18(1):91. PMC: 5896082. DOI: 10.1186/s12884-018-1710-8. View

14.

Bookari K, Yeatman H, Williamson M . Falling short of dietary guidelines - What do Australian pregnant women really know? A cross sectional study. Women Birth. 2016; 30(1):9-17. DOI: 10.1016/j.wombi.2016.05.010. View

15.

Naiqiso S, Christensen P, Okesene-Gafa K, McCowan L . Gestational weight gain in a multi-ethnic sample of pregnant women from Counties Manukau Health, Auckland, New Zealand. N Z Med J. 2019; 132(1497):37-45. View

16.

Carter K, Lanumata T, Kruse K, Gorton D . What are the determinants of food insecurity in New Zealand and does this differ for males and females?. Aust N Z J Public Health. 2010; 34(6):602-8. DOI: 10.1111/j.1753-6405.2010.00615.x. View

17.

Gante I, Amaral N, Dores J, Almeida M . Impact of gestational weight gain on obstetric and neonatal outcomes in obese diabetic women. BMC Pregnancy Childbirth. 2015; 15:249. PMC: 4599662. DOI: 10.1186/s12884-015-0692-z. View

18.

Headen I, Davis E, Mujahid M, Abrams B . Racial-ethnic differences in pregnancy-related weight. Adv Nutr. 2012; 3(1):83-94. PMC: 3262620. DOI: 10.3945/an.111.000984. View

19.

Martin L, Williams S, Haskard K, DiMatteo M . The challenge of patient adherence. Ther Clin Risk Manag. 2008; 1(3):189-99. PMC: 1661624. View

20.

Morton S, Grant C, Wall C, Atatoan Carr P, Bandara D, Schmidt J . Adherence to nutritional guidelines in pregnancy: evidence from the Growing Up in New Zealand birth cohort study. Public Health Nutr. 2014; 17(9):1919-29. PMC: 11108684. DOI: 10.1017/S1368980014000482. View