Fresh fruit intake in pregnancy and association with gestational diabetes mellitus: A prospective cohort study

Fresh fruit intake has been found to be associated with risk of gestational diabetes mellitus (GDM); however, the evidence is limited and the findings are inconsistent. We aimed to assess the association of fresh fruit intake by fruit subgroups based on their glycemic index (GI) and glycemic load (GL) values and GDM incidence in Chinese pregnant women.

We included 3300 eligible women from the Tongji Maternal and Child Health Cohort. Dietary intakes were assessed by using a validated semiquantitative food frequency questionnaire. GDM was diagnosed based on the results of a 75-g, 2-h oral glucose tolerance test. In the adjusted logistic regression model, odds ratios and 95% confidence intervals for GDM were computed for the highest compared with lowest quintiles of fruit intake.

GDM occurred in 378 (11.5%) of 3300 pregnant women. The average fresh fruit consumption was 381.7 g/d. The adjusted odds ratios (95% confidence intervals) for GDM from the lowest to highest quintile of whole fruit consumption were 1.00 (referent), 0.80 (0.56, 1.12), 0.74 (0.52, 1.05), 0.63 (0.44, 0.92), and 0.41 (0.27, 0.62), respectively; P_trend < 0.001. Higher overall midpregnancy fresh fruit consumption was associated with lower plasma 1-h OGTT glucose and 2-h OGTT glucose levels (all P < 0.05). In addition, the stratified analysis results indicated that greater consumption of low and high GI fruits and low GL fruits were both associated with a lower risk of GDM but not high GL fruits.

Our findings suggested an inverse association of fresh fruit intake with the risk of GDM in Chinese pregnant women. In women with GDM risk, low GI and GL fresh fruit consumption should be privileged versus those with high GI and GL.