Dietary Protein Patterns during Pregnancy Are Associated with Risk of Gestational Diabetes Mellitus in Chinese Pregnant Women

Controversies around the association between dietary protein intake and gestational diabetes mellitus (GDM) persist. To the best of our knowledge, this association has not previously been reported from the perspective of dietary protein patterns. We aimed to investigate the relationship between dietary protein patterns and GDM risk in pregnant women, and 1014 pregnant women (20-28 weeks of gestation) were recruited in Guangzhou, China, during 2017-2018. Maternal dietary information was collected by a validated food frequency questionnaire, which covered the most common foods consumed in Guangzhou, China. GDM was identified by a 75g oral glucose tolerance test. A K-means cluster analysis was conducted to aggregate individuals into three groups, which were determined by the major sources of protein. Logistic regression was employed to explore the relationship between dietary protein patterns and the risk of GDM. Among the 1014 participants, 191 (18.84%) were diagnosed with GDM. In the total population, when comparing the highest quartile with the lowest, we found that total protein and animal protein intake increased the risk of GDM with the adjusted odds ratios (95%CI) being 6.27, 5.43 (1.71-23.03, 1.71-17.22), respectively. Pregnant women were further divided into three dietary protein patterns, namely, white meat, plant-dairy-eggs, and red meat protein patterns. Compared to women with the plant-dairy-eggs protein pattern, those with the red meat protein pattern (OR: 1.80; 95%CI: 1.06-3.07) or white meat protein pattern (OR: 1.83; 95%CI: 1.04-3.24) had an increased risk of GDM. Higher dietary intakes of total or animal protein during mid-pregnancy were related to an increased risk of GDM. Furthermore, we first found that, compared to women with the plant-dairy-eggs protein pattern, women with the red meat or white meat protein patterns had a higher risk of GDM.