Determinants of Healthy Diet Among Children Exposed and Unexposed to Gestational Diabetes

Abstract

Objectives: To evaluate the association between individual and environmental determinants of diet quality with diet quality of children exposed to gestational diabetes mellitus (GDM+) and unexposed (GDM-); to study the association between mother and child vegetables and fruit (VF) intakes.

Design: Cross-sectional study.

Participants: One hundred forty-two children (104 GDM+; 38 GDM-) aged 6.2 ± 2.5 years.

Variables: Canadian Healthy Eating Index 2007 (HEI-C) and VF were obtained with 2 24-hour dietary recall questionnaires in children. Maternal VF was obtained by a validated food frequency questionnaire, and weight and height were measured. Sociodemographic determinants were obtained by questionnaires.

Analysis: Linear regression models were used to evaluate the association between individual and environmental determinants and the HEI-C score with interaction for GDM status.

Results: Family meals were associated with HEI-C among GDM- but not GDM+ children (β = 9.97, P = 0.01 and β = -0.41, P = 0.84, respectively; P for interaction = 0.02). Children's age (β = -1.45; 95% confidence interval, -2.19 to -0.72; P < 0.001) was a determinant of HEI-C among all children. Maternal VF intakes were positively associated with children's VF intake (r = 0.30, P < 0.001, r² = 0.09), with association of larger variance among GDM- children (r = 0.38, r² = 0.14, P = 0.02) than GDM+ children (r = 0.23, r² = 0.05, P = 0.02).

Conclusions: The food environment at home was associated differently with the diet quality of GDM+ and GDM- children. Whether targeting family meals and maternal diet quality is a good strategy to improve children's diet quality among GDM+ children needs to be further investigated.

Keywords: Gestational diabetes mellitus; food environment; healthy diet.