Association between postpartum low-carbohydrate-diet scores and glucose levels in Chinese women

Abstract Objectives Views on the relationship between low-carbohydrate-diet (LCD) with glucose levels are controversial and no study has examined this association in postpartum women. We aimed to explore the association between postpartum LCD scores and glucose levels. Methods We included 500 postpartum women from a prospective cohort study in Guangzhou, China during 2017-2018. Dietary information during the first month after delivery was assessed via a validated food-frequency questionnaire. The overall, animal, and plant LCD scores were determined based on percentages of energy from carbohydrate, protein, and fat. Higher score reflected higher intakes of fat and protein, and lower intakes of carbohydrate. At 6-8 weeks postpartum, women with previous gestational diabetes mellitus (GDM) underwent oral glucose tolerance tests (n=104), and the others had fasting plasma glucose (FPG) tests (n=396). Multivariable linear, quantile, and logistic regressions were conducted. Results Of the 500 postpartum women, 71 (14.20%) developed impaired fasting glucose (IFG). The animal LCD score was positively associated with FPG levels (β: 0.007, P=0.017). While quantile regression showed that LCD scores were only related to FPG in women with lower FPG levels, but had no significant association in those with higher FPG levels. No significant interaction was found between LCD scores and history of gestational diabetes mellitus (GDM) on FPG (Pinteraction>0.40). Furthermore, the relationships between the three LCD scores and risk of developing IFG were not statistically significant. Conclusions The findings indicated that animal LCD score during puerperium may be positively associated with FPG levels at early postpartum period in Chinese women, but had no interactions with GDM history. Stronger associations were observed in women with lower FPG levels.