Dietary Changes and Their Predictors in the First Year After Childbirth in Women with Gestational Diabetes Mellitus: A Post Hoc Longitudinal Analysis from the Face-it Trial.

BACKGROUND

Healthy diet is essential to reduce the increased risk of developing type 2 diabetes mellitus (T2DM) among women with previous gestational diabetes mellitus (GDM).

OBJECTIVES

This study investigates dietary changes and predictors of dietary improvement during first year after childbirth among women with GDM.

METHODS

This post hoc longitudinal analysis used data from the Face-it randomized controlled trial, which evaluated a health promotion intervention for women with recent GDM. As the intervention had no effect on diet, data from both intervention and usual care groups were pooled, collected at baseline and follow-up (3 and 12 mo after childbirth). Dietary quality score (DQS) was used to assess self-reported dietary habits. Predictor variables included body mass index (BMI), risk perception of T2DM, self-perceived dietary habits, social support, breastfeeding status, and mental well-being. Paired t-test and ordinal logistic regression adjusted for randomization group were conducted.

RESULTS

This study included 232 women. The overall mean DQS did not change from baseline to follow-up; however, 66% women modified their dietary quality, with an equal split between improvement and decline. Higher odds of dietary improvement were seen in women with baseline BMI ≥30 kg/m2 [odds ratio (OR): 3.29; 95% confidence interval (CI): 1.60, 6.80] and BMI 25-29.9 kg/m2 (OR: 2.41; 95% CI: 1.28, 4.54) compared with those with a BMI <25 kg/m2. Women who perceived their diet as unhealthy had increased odds of improvement compared with those who perceived it as healthy (OR: 3.84; 95% CI: 1.40, 10.56). Fully breastfeeding women at baseline had lower odds of dietary improvement than nonbreastfeeding women (OR: 0.39; 95% CI: 0.18, 0.84). No associations were found for risk perception of T2DM, social support, and mental well-being.

CONCLUSIONS

Dietary patterns after a GDM-affected pregnancy are heterogeneous, underscoring the importance of tailored dietary interventions addressing individual needs to improve dietary quality and reduce the risk of T2DM.