Abstract
Objective—To examine the association of gestational weight gain and dietary factors with abnormal
glucose tolerance (AGT).
Methods—We conducted a prospective cohort study among 813 Hispanic prenatal care patients in
Massachusetts. Gestational weight gain and oral glucose tolerance test results were abstracted from
medical records. Dietary intake was assessed using a semi-quantitative food frequency questionnaire.
Target weight gain was based on BMI-specific weekly weight gain rates established by the Institute
of Medicine (IOM).
Results—We observed a statistically significant interaction between prepregnancy BMI and weight
gain in relation to AGT (P < 0.01). Class II/III (BMI ≥ 35 kg/m2) obese women who had a high rate
of weight gain (>0.30 kg/week) or who exceeded target weight were 3–4 times as likely to develop
AGT compared to women who gained within IOM ranges (OR = 4.2, 95% CI 1.1–16.0, OR = 3.2
95% CI 1.0–10.5, respectively). Increasing levels of saturated fat and fiber and decreasing levels of
energy-dense snack foods and polyunsaturated fat:saturated fat ratio were significantly associated
with increased risk of AGT, independent of gestational weight gain.
Conclusions—Weight gain among class II/III obese women and certain dietary components may
represent modifiable risk factors for AGT.
Keywords
Abnormal glucose tolerance; Gestational diabetes; Diet; Hispanic; Pregnancy; Weight gain