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Open Access 02-09-2024 | Type 1 Diabetes | Article

Dietary patterns during pregnancy and maternal and birth outcomes in women with type 1 diabetes: the Environmental Determinants of Islet Autoimmunity (ENDIA) study

Authors: Rebecca L. Thomson, James D. Brown, Helena Oakey, Kirsten Palmer, Pat Ashwood, Megan A. S. Penno, Kelly J. McGorm, Rachel Battersby, Peter G. Colman, Maria E. Craig, Elizabeth A. Davis, Tony Huynh, Leonard C. Harrison, Aveni Haynes, Richard O. Sinnott, Peter J. Vuillermin, John M. Wentworth, Georgia Soldatos, Jennifer J. Couper, on behalf of the ENDIA Study Group

Published in: Diabetologia

Abstract

Aims/hypothesis

Dietary patterns characterised by high intakes of vegetables may lower the risk of pre-eclampsia and premature birth in the general population. The effect of dietary patterns in women with type 1 diabetes, who have an increased risk of complications in pregnancy, is not known. The aim of this study was to investigate the relationship between dietary patterns and physical activity during pregnancy and maternal complications and birth outcomes in women with type 1 diabetes. We also compared dietary patterns in women with and without type 1 diabetes.

Methods

Diet was assessed in the third trimester using a validated food frequency questionnaire in participants followed prospectively in the multi-centre Environmental Determinants of Islet Autoimmunity (ENDIA) study. Dietary patterns were characterised by principal component analysis. The Pregnancy Physical Activity Questionnaire was completed in each trimester. Data for maternal and birth outcomes were collected prospectively.

Results

Questionnaires were completed by 973 participants during 1124 pregnancies. Women with type 1 diabetes (n=615 pregnancies with dietary data) were more likely to have a ‘fresh food’ dietary pattern than women without type 1 diabetes (OR 1.19, 95% CI 1.07, 1.31; p=0.001). In women with type 1 diabetes, an increase equivalent to a change from quartile 1 to 3 in ‘fresh food’ dietary pattern score was associated with a lower risk of pre-eclampsia (OR 0.37, 95% CI 0.17, 0.78; p=0.01) and premature birth (OR 0.35, 95% CI 0.20, 0.62, p<0.001). These associations were mediated in part by BMI and HbA_1c. The ‘processed food’ dietary pattern was associated with an increased birthweight (β coefficient 56.8 g, 95% CI 2.8, 110.8; p=0.04). Physical activity did not relate to outcomes.

Conclusions/interpretation

A dietary pattern higher in fresh foods during pregnancy was associated with sizeable reductions in risk of pre-eclampsia and premature birth in women with type 1 diabetes.

Graphical Abstract

Available only for authorised users

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Title: Dietary patterns during pregnancy and maternal and birth outcomes in women with type 1 diabetes: the Environmental Determinants of Islet Autoimmunity (ENDIA) study
Authors: Rebecca L. Thomson
James D. Brown
Helena Oakey
Kirsten Palmer
Pat Ashwood
Megan A. S. Penno
Kelly J. McGorm
Rachel Battersby
Peter G. Colman
Maria E. Craig
Elizabeth A. Davis
Tony Huynh
Leonard C. Harrison
Aveni Haynes
Richard O. Sinnott
Peter J. Vuillermin
John M. Wentworth
Georgia Soldatos
Jennifer J. Couper
on behalf of the ENDIA Study Group
Publication date: 02-09-2024
Publisher: Springer Berlin Heidelberg
Keywords: Type 1 Diabetes
Pre-Eclampsia
Premature Birth
Published in: Diabetologia
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-024-06259-5

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Dietary patterns during pregnancy and maternal and birth outcomes in women with type 1 diabetes: the Environmental Determinants of Islet Autoimmunity (ENDIA) study

Abstract

Aims/hypothesis

Methods

Results

Conclusions/interpretation

Graphical Abstract

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Abstract

Aims/hypothesis

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Conclusions/interpretation

Graphical Abstract

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2024 ESC Congress

Noise pollution dangerous for heart health

Post-TAVI follow up: deploying virtual assistants

Antihypertensives: more effective at morning or night?

Low Lp(a) levels unlikely to increase the risk of diabetes

» View more highlights on the 2024 ESC Congress hub page

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