Original Article
European Journal of Clinical Nutrition (2007) 61, 736–742; doi:10.1038/sj.ejcn.1602574; published online 20 December 2006
Increased body fat percentage and physical inactivity are independent predictors of gestational diabetes mellitus in South Asian women
Guarantors: R Iqbal and K Gray-Donald.
Contributors: RI contributed to the conception and design of the study, coordinated data collection, conducted data analysis and wrote the paper. GR, SB and RQ aided in design and data collection as well as provided comments on the paper. RC provided significant consultation in the statistical analysis and interpretation of results. KGD contributed to the conception, design and analysis of the data, and the writing of the paper.
R Iqbal1, G Rafique2,3, S Badruddin2,3, R Qureshi2,3, R Cue4 and K Gray-Donald5
- 1Department of Medicine, Population Health Research Institute, McMaster University, Hamilton, Canada
- 2Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- 3Department of Obstetrics and Gynaecology, Aga Khan University, Karachi, Pakistan
- 4Department of Animal Science, McGill University, Montreal, Canada
- 5School of Dietetics and Human Nutrition, McGill University, Montreal, Canada
Correspondence: Dr K Gray-Donald, School of Dietetics and Human Nutrition, McGill University, 21, 111 Lakeshore Road, Ste-Anne-de-Bellevue, Montreal, Quebec, Canada H9X 3V9. E-mail: katherine.gray-donald@mcgill.ca
Received 1 November 2005; Revised 7 September 2006; Accepted 23 October 2006; Published online 20 December 2006.
Abstract
Objective:
This study aims to identify lifestyle predictors of gestational diabetes mellitus (GDM) in South Asian women. Pre-gravid body mass index, body composition, rate of weight gain during pregnancy, physical activity (PA) and dietary intake were studied.
Design:
Prospective cohort study (n=611) of South Asian women at Aga Khan University Hospital antenatal clinic in Karachi, Pakistan. Weight, height and body fat % were measured and data on PA, diet and socio-economic covariates were collected at baseline. A glucose screen was performed at 29.8
2.6 weeks.
Results:
Using logistic regression analysis for the full cohort, the risk of GDM increased with older maternal age (odds ratio (OR) 1.13, confidence interval (CI) 1.06–1.21), increased body fat % (OR 1.07, CI 1.03–1.13) and the risk was inversely associated with PA (100 kcal) (OR 0.79–0.99, CI 0.89). Using a nested case (n=49) control (n=98) design to study dietary intake, the risk of GDM decreased with increasing protein (% energy) in the diet (OR 0.75, CI 0.60–0.95).
Conclusions:
Body fat %, physical inactivity and, possibly, diet quality are important modifiable risk factors for GDM.
Keywords:
risk factors, lifestyle, body fat percentage, physical inactivity, nutrition transition
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