Mom’s Healthy Post-Baby Diet May Lower HTN Risk – MedPage Today

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Women with a history of gestational diabetes (GDM) may benefit from adhering to a healthy diet, according to results of a prospective cohort study.

Analysis of data from the Nurses’ Health Study II (NHSII) revealed that adherence to a dietary pattern characterized by rich intake in fruits, vegetables, and whole grains, and low in red and processed meats, as well as refined grains, was related to a significantly reduced risk of developing hypertension among women who had pregnancy-related diabetes, wrote Cuilin Zhang, MD, PhD, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Rockville, Md., and colleagues.

Cox proportional hazard models were used to evaluate the associations between dietary scores and hypertension while adjusting for major risk factors for hypertension such as body mass index (BMI). Alternative Healthy Eating Index (AHEI) scores were significantly inversely associated with the risk of hypertension (hazard ratio 0.76, 95% CI 0.61-0.94, P=0.03 for linear trend), they reported in Hypertension.

The same association was seen for the Dietary Approaches to Stop Hypertension (DASH, HR 0.70, 95% CI 0.56-0.88, P=0.002 for trend) score and the alternative Mediterranean diet score (aMed, HR 0.72, 95% CI 0.58-0.90, P=0.01 for trend), they stated.

“In this large long-term prospective cohort of U.S. women with a history of gestational diabetes, we observed an inverse association between adherence to healthful dietary patterns, AHEI, DASH or Mediterranean diet, and risk of hypertension later in life,” the authors wrote. “Comparing extreme categories, women consuming a higher quality diet after GDM had on average a 20% lower risk of subsequent hypertension. Increase in BMI explained around 20%-30% of the association between healthful dietary patterns and hypertension.”

They started with a sample of 94,166 women from NHSII who had a history of GDM and reported at least one pregnancy. They excluded all participants with a history of cardiovascular diseases or cancer at baseline, multiple gestations or pregnancies lasting fewer than 6 months, a history of hypertension prior to GDM diagnosis, or with missing data regarding post-pregnancy diet.

That left 3,818 women with a history of GDM enrolled in NHSII as a part of the ongoing Diabetes & Women’s Health Study. After a median of 18.5 years of follow-up, 1,069 women were identified as having developed high blood pressure.

The 3,818 remaining participants, mean age of 32, were followed from 1989 to 2011, and completed a self-administered questionnaire regarding their lifestyle information and medical history every 2 years. They completed a validated semi-quantitative food frequency questionnaire (FFQ) every 4 years.

The authors used results from the dietary questionnaire to prospectively examine participants’ risk of hypertension in respect to their long-term adherence to three healthy diets, AHEI, aMed, and DASH.

They reported that women with greater adherence to the AHEI, DASH, or aMED diet patterns were more likely to be moderate alcohol drinkers, eat more cereal fiber, be more physically active, and less likely to consume trans fat or be current smokers.

“GDM has both long-term and short-term health impacts on both women themselves and their children. Children born from pregnancies complicated by GDM may be at higher risk for obesity, impaired glucose tolerance, etc.,” Zhang told MedPage Today. “Encouraging healthy diet and lifestyle may help prevent GDM, which may lower the subsequent adverse impact on both women and their children.”

Robert H. Eckel, MD, of the University of Colorado in Anschutz, agreed that healthcare providers should encourage mothers with GDM to eat healthy, both before and after delivery.

“A heart healthy diet has merit for not only reduction of [cardiovascular] risk, but diabetes and cancer as well. It’s not good foods or bad, it’s the overall diet! Enjoy eating but eat healthy,” said Eckel, who was not involved in the study.

He pointed out that the large sample size and the quality of the data were notable strengths of the study. But the NHSII cohort is predominantly white and well educated, so “generalizability is limited,” he told MedPage Today.

Zhang acknowledged this as a study limitation and stressed that “future studies are needed to examine this association in other race/ethnic groups, as previous studies have suggested that Hispanic and African-American women have an increased risk of hypertension compared with Caucasian women.”

The study was supported by the intramural research program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development and grants from the NIH.

Zhang and co-authors disclosed no relevant relationships with industry.

  • Reviewed by
    Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

last updated 04.19.2016

Mom’s Healthy Post-Baby Diet May Lower HTN Risk – MedPage Today