March 02, 2015
TAKE-HOME MESSAGE
- The authors of this study examined gestational weight gain (GWG) in pregnant women and the effect of the protein:carbohydrate (P/C) ratio and added sugar intake. Participants were given a food frequency questionnaire at 25 weeks of gestation to record P/C ratio and added sugar intake reported in quintiles. They reported their weight at 12 and 30 weeks. GWG was then calculated as gain in g/week and relative change in GWG. The highest quintile (Q5) of the P/C ratio showed a weight gain of 16 g/week lower than the lowest quintile (Q1). Women with a higher P/C ratio showed a lower intake of added sugars. There was a significant association between GWG and sugar consumption.
- A high P/C ratio in pregnancy results in less GWG, partly due to a lower intake of added sugars. Dietary advice for pregnant women should include increasing P/C ratio and reducing added sugars to reduce GWG.
Abstract
OBJECTIVE
To examine the relation between the protein:carbohydrate (P/C) ratio and added sugar intake in pregnancy and gestational weight gain (GWG).
DESIGN
A prebirth cohort including 103 119 pregnancies enrolled between 1996 and 2003.
SETTING
All women in Denmark were eligible to participate if they spoke Danish and were planning to carry to term.The pregnant women were recruited and enrolled during their first antenatal visit (6-10 weeks of gestation).
PARTICIPANTS
Participants included women with live-born singletons and complete data on dietary intake and GWG, leaving 46 262 women for the analysis.
EXPOSURE
Macronutrient intake was quantified using a validated food frequency questionnaire administered in the 25th week of gestation. The P/C ratio and added sugar intake were examined in quintiles.
PRIMARY OUTCOME MEASURES
GWG was based on self-reported weight in gestational weeks 12 and 30 and defined as gain in g/week. We used multivariable linear regression, including adjusting for pre-pregnancy body mass index, to calculate relative change in GWG and 95% CI.
RESULTS
Average GWG was 471(224) g/week. The adjusted weight gain was 16 g/week lower (95% CI 9 to 22, p for trend <0.001) in the highest (Q5) versus lowest (Q1) quintile of the P/C ratio (∼3% average reduction across the entire pregnancy). Weight gain for those with >20%E vs <12%E from protein was 36 g/week lower (95% CI 20 to 53, p for trend <0.0001; ∼8% average reduction). A high P/C ratio was inversely related to intake of added sugars. Added sugar consumption was strongly associated with GWG (Q5 vs Q1: 34, 95% CI 28 to 40 g/week, p for trend <0.0001).
CONCLUSIONS
A high P/C ratio was associated with reduced GWG. This association appeared to be partly driven by a decrease in intake of added sugar. These results are consistent with randomised trials in non-pregnant participants. A dietary intervention targeting an increased P/C ratio with emphasis on reducing added sugar can contribute to reducing excessive GWG.