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Early Pregnancy Cravings, Dietary Intake, and Development of Abnormal Glucose Tolerance

      Abstract

      Background

      Little is known about the relationships between pregnancy cravings, maternal diet, and development of abnormal glucose tolerance.

      Objectives

      We examined relationships of pregnancy cravings with dietary intake and risk of developing isolated hyperglycemia (IH), impaired glucose tolerance (IGT), or gestational diabetes (GDM) later in pregnancy.

      Design/setting

      Among 2,022 mothers in Project Viva, a prospective birth cohort recruited from medical practices in eastern Massachusetts between 1999 and 2002, we assessed type of pregnancy craving based on self-report at mean gestation of 10.9 weeks.

      Main outcome measures

      The outcomes were cross-sectional dietary intake from a food frequency questionnaire and incident IH, IGT, or GDM determined by glucose tolerance screening at 26 to 28 weeks.

      Statistical analyses performed

      We used linear regression to analyze the cross-sectional relationships between pregnancy cravings and dietary intake and multinomial logistic regression to analyze the prospective relationships among pregnancy cravings and development of IH, IGT, or GDM.

      Results

      During the first trimester, 443 (22%) women craved sweets, 225 (11%) craved salty foods, 261 (13%) craved savory foods, and 100 (4.9%) craved starchy foods. Sweet cravings were associated with increased intake of sucrose (1.9 g/day; 95% CI 0.1 to 3.7), total fat (1.5 g/day; 95% CI 0.1 to 2.9), and saturated fat (0.8 g/day; 95% CI 0.2 to 1.4); salty cravings were associated with increased fiber (0.7 servings/day; 95% CI –0.1 to 1.6); savory cravings were associated with increased n-3 fatty acids (0.10 g/day; 95% CI 0.02 to 0.17); and starchy cravings were associated with increased carbohydrates (8.0 g/day; 95% CI 0.3 to 15.7) and decreased total fat (–2.6 g/day; 95% CI –5.2 to –0.1). Salty cravings were associated with lower risk of GDM (adjusted odds ratio 0.34, 95% CI 0.12-0.97).

      Conclusions

      New cravings in the first trimester of pregnancy were associated with dietary intake. Craving salty foods may predict reduced risk of developing GDM, whereas craving sweet food does not appear to alter one’s risk.

      Keywords

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      References

        • Pope J.F.
        • Skinner J.D.
        • Carruth B.R.
        Cravings and aversions of pregnant adolescents.
        J Am Diet Assoc. 1992; 92: 1479-1482
        • Wijewardene K.
        • Fonseka P.
        • Goonaratne C.
        Dietary cravings and aversions during pregnancy.
        Indian J Public Health. 1994; 38: 95-98
        • Worthington-Roberts B.
        • Little R.E.
        • Lambert M.D.
        • Wu R.
        Dietary cravings and aversions in the postpartum period.
        J Am Diet Assoc. 1989; 89: 647-651
        • Tepper B.J.
        • Seldner A.C.
        Sweet taste and intake of sweet foods in normal pregnancy and pregnancy complicated by gestational diabetes mellitus.
        Am J Clin Nutr. 1999; 70: 277-284
        • Belzer L.M.
        • Smulian J.C.
        • Lu S.E.
        • Tepper B.J.
        Food cravings and intake of sweet foods in healthy pregnancy and mild gestational diabetes mellitus. A prospective study.
        Appetite. 2010; 55: 609-615
        • Petrou S.
        • Kupek E.
        • Vause S.
        • Maresh M.
        Antenatal visits and adverse perinatal outcomes: Results from a British population-based study.
        Eur J Obstet Gynecol Reproduct Biol. 2003; 106: 40-49
        • Persson B.
        • Hanson U.
        Neonatal morbidities in gestational diabetes mellitus.
        Diabetes Care. 1998; 21: B79-B84
        • Yogev Y.
        • Visser G.H.
        Obesity, gestational diabetes and pregnancy outcome.
        Semin Fetal Neonatal Med. 2009; 14: 77-84
        • Tallarigo L.
        • Giampietro O.
        • Penno G.
        • Miccoli R.
        • Gregori G.
        • Navalesi R.
        Relation of glucose tolerance to complications of pregnancy in nondiabetic women.
        N Engl J Med. 1986; 315: 989-992
        • Jensen D.M.
        • Korsholm L.
        • Ovesen P.
        • Beck-Nielsen H.
        • Molsted-Pedersen L.
        • Damm P.
        Adverse pregnancy outcome in women with mild glucose intolerance: is there a clinically meaningful threshold value for glucose?.
        Acta Obstet Gynecol Scand. 2008; 87: 59-62
        • Yogev Y.
        • Langer O.
        • Xenakis E.M.
        • Rosenn B.
        The association between glucose challenge test, obesity and pregnancy outcome in 6390 non-diabetic women.
        J Maternal-Fetal Neonatal Med. 2005; 17: 29-34
        • Bo S.
        • Menato G.
        • Lezo A.
        • et al.
        Dietary fat and gestational hyperglycaemia.
        Diabetologia. 2001; 44: 972-978
        • Solomon C.G.
        • Willett W.C.
        • Carey V.J.
        • et al.
        A prospective study of pregravid determinants of gestational diabetes mellitus.
        JAMA. 1997; 278: 1078-1083
        • Moses R.G.
        • Shand J.L.
        • Tapsell L.C.
        The recurrence of gestational diabetes: could dietary differences in fat intake be an explanation?.
        Diabetes Care. 1997; 20: 1647-1650
        • Radesky J.S.
        • Oken E.
        • Rifas-Shiman S.L.
        • Kleinman K.P.
        • Rich-Edwards J.W.
        • Gillman M.W.
        Diet during early pregnancy and development of gestational diabetes.
        Paediatr Perinat Epidemiol. 2008; 22: 47-59
        • Zhang C.
        • Liu S.
        • Solomon C.G.
        • Hu F.B.
        Dietary fiber intake, dietary glycemic load, and the risk for gestational diabetes mellitus.
        Diabetes Care. 2006; 29: 2223-2230
        • Gillman M.W.
        • Rich-Edwards J.W.
        • Rifas-Shiman S.L.
        • Lieberman E.S.
        • Kleinman K.P.
        • Lipshultz S.E.
        Maternal age and other predictors of newborn blood pressure.
        J Pediatr. 2004; 144: 240-245
        • Oken E.
        • Kleinman K.P.
        • Olsen S.F.
        • Rich-Edwards J.W.
        • Gillman M.W.
        Associations of seafood and elongated n-3 fatty acid intake with fetal growth and length of gestation: Results from a US pregnancy cohort.
        Am J Epidemiol. 2004; 160: 774-783
        • Oken E.
        • Baccarelli A.A.
        • Gold D.R.
        • et al.
        Cohort profile: Project viva.
        Int J Epidemiol. 2015; 44: 37-48
        • Fawzi W.W.
        • Rifas-Shiman S.L.
        • Rich-Edwards J.W.
        • Willett W.C.
        • Gillman M.W.
        Calibration of a semi-quantitative food frequency questionnaire in early pregnancy.
        Ann Epidemiol. 2004; 14: 754-762
        • Willett W.C.
        Nutritional Epidemiology.
        3rd ed. Oxford University Press, New York, NY2012

      Biography

      L. V. Farland is a doctoral candidate, Department of Epidemiology, Harvard School of Public Health, Boston, MA.

      Biography

      S. L. Rifas-Shiman is a senior research associate, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.

      Biography

      M. W. Gillman is a professor and director of the Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.