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Increased body fat percentage and physical inactivity are independent predictors of gestational diabetes mellitus in South Asian women



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.


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.


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).


Body fat %, physical inactivity and, possibly, diet quality are important modifiable risk factors for GDM.

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Research grant for this study was received from the Aga Khan University's Research Council, Pakistan. RI is the recipient of the Canadian Commonwealth Scholarship during her doctoral studies at McGill, Canada. The contributors thank Dr Arriaza at the Centers for Disease Control and Prevention (CDC) for providing the MOSPA algorithm for analysis of our physical activity data. We also thank Dr Fareeha Warsi for data collection and Louise Johnson-Down for help in dietary analysis.

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Correspondence to K Gray-Donald.

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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.

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Iqbal, R., Rafique, G., Badruddin, S. et al. Increased body fat percentage and physical inactivity are independent predictors of gestational diabetes mellitus in South Asian women. Eur J Clin Nutr 61, 736–742 (2007).

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