The association of dietary fat intake before and during pregnancy with the risk of gestational diabetes mellitus and impaired glucose intolerance: a systematic review and dose-response meta-analysis on observational investigations.
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Abstract
Background: Previous studies investigating the relationship of dietary fat intake with gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) have yielded inconsistent findings. Therefore, the relationship between fat intake before and during pregnancy and risk of GDM and IGT was assessed.
Methods: A comprehensive search was conducted using electronic databases up to June 2024. Our selection criteria focused on observational studies that reported odds ratios (ORs)/ relative risks (RRs)/ hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between total, animal or plant fat intake and risks of GDM and IGT.
Results: A total of 14 studies comprising 39,399 participants were included. Comparing the highest versus lowest intakes of total, animal, and plant fat revealed the summary RRs of 1.49 (95% CI: 1.20, 1.83), 1.56 (95% CI: 1.32, 1.85), and 1.26 (95% CI: 1.08, 1.47), respectively, indicating significant positive associations of total, animal and plant fat with GDM. Subgroup analysis indicated that total fat intake during pregnancy had a stronger association with GDM than pre-pregnancy intake. For animal and plant fat, significant associations were only observed for intake during pregnancy. Based on the linear dose-response analysis, each 5% energy increment in total dietary fat during pregnancy was associated with a 6% increased risk of GDM (RR = 1.06; 95% CI: 1.03, 1.10). The non-linear dose-response analysis indicated an increasing trend between total fat intake during pregnancy (23%-50% E) and the risk of GDM. However, there was no significant relationship between fat intake and IGT.
Conclusion: Higher total fat intake before and during pregnancy is directly and dose-dependently associated with increased GDM risk. The highest versus lowest values of animal and plant fat intakes during pregnancy were related to higher risk of GDM. No significant association was observed for IGT; however, the limited number of included studies especially on "pre-pregnancy" and the cross-sectional nature of several studies on "during pregnancy" prevent us from establishing causal relationships.
期刊介绍：
Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered.
Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies.
In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.
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