Association of whole grains, dairy and dietary fibre with neonatal outcomes in women with gestational diabetes mellitus: The WINGS project (WINGS – 12)
Ranjit Mohan Anjana1, Parthasarathy Vijayalakshmi2, Balaji Bhavadharini3, Rajagopal Gayathri2, Nagarajan Lakshmipriya2, Subashchandrabose Uthra1, Ranjit Unnikrishnan1, Ram Uma4, Viswanathan Mohan1, Vasudevan Sudha2
1 Department of Diabetology, Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
2 Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
3 Department of Obstetrics and Gynaecology, Seethapathy Clinic and Hospital, Chennai, Tamil Nadu, India
4 Department of Global Health, Population Health Research Institute, Hamilton, Canada
Mrs. Vasudevan Sudha
Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, 4, Conran Smith Road, Gopalapuram, Chennai - 600 086, Tamil Nadu.
Source of Support: None, Conflict of Interest: None
Background: Dietary modifications have been shown to lower the risk for gestational diabetes mellitus (GDM). However, there is little evidence whether dietary modifications during pregnancy can improve neonatal outcomes in women with GDM, particularly in low-resource settings. Aim: The aim of the study is to assess the effect of a dietary modification delivered through a low-cost model of care (MOC), on neonatal outcomes in women with GDM in India. Methodology: Dietary intake was assessed in 133 women with GDM enrolled under the women in India with GDM strategy-MOC (WINGS-MOC), from six maternity centres in Chennai, in South India. The WINGS-MOC dietary intervention included one-on-one monthly antenatal diet counselling, providing a dietary guideline booklet and healthy recipe demonstrations. Dietary intake was assessed using 24-h dietary recall and an open-ended diet questionnaire. A ‘healthy diet score’ was derived from the reported intake of whole grains, dairy products and dietary fibre. The effect of healthy diet score on neonatal outcomes (macrosomia, hyperbilirubinaemia, congenital anomalies and neonatal intensive care unit admissions) was evaluated. Results: A six-fold increase in the intake of whole grains (30 vs. 5.1g) and 20% increase in consumption of dairy products (265.4 vs. 225g) and dietary fibre (22.3 vs. 18.2g) were observed after the MOC intervention. Higher consumption of whole grain, dairy products and dietary fibre was inversely associated with adverse neonatal outcomes. Those with the highest healthy diet score had lower risk for adverse neonatal outcomes (odds ratio: 0.2, [95% confidence interval: 0.04–0.9]; P = 0.04) even after adjusting for potential confounders. Conclusions: A low-cost dietary intervention helps to improve neonatal outcomes in women with GDM.