A study on the quality of overall beverage intake and its association with glucose metabolism in pregnant women

Objective To assess the overall beverage intake quality of pregnant women using the healthy beverage index (HBI) and to explore its association with glucose metabolism and gestational diabetes mellitus (GDM).Methods This study is a cross-sectional study based on the baseline data from the Yuexiu Birth Cohort in Guangzhou. From 2017 to 2018, a total of 1029 pregnant women at 20-28 weeks of gestation were enrolled at the Yuexiu District Maternal and Child Health Hospital. General demographic and lifestyle data of the pregnant women were collected through face-to-face questionnaire surveys. The food frequency questionnaire, validated for reliability and validity, was used to collect data on beverage intake frequency and quantity. The scores for the subcategories and the total score of the HBI were calculated. Glucose metabolism indicators were obtained through the Oral Glucose Tolerance Test (OGTT) and blood sample analysis to diagnose GDM. Multiple linear regression and logistic regression models were employed to explore the associations between HBI total score and its subcategories with glucose metabolism levels and GDM.Results The total score of HBI for pregnant women was 79.81±9.84, and 18.85% of them had GDM. Regression results revealed that, within the subcategories, sugar-sweetened beverages intake in line with the recommended levels (constituting ≤8% of total fluid intake) was associated with a decrease in fasting blood glucose levels (β= -0.387, P=0.002). Additionally, the proportion of total fluid intake energy to total energy intake in the range of [10%, 15%) was associated with a decrease in fasting blood glucose levels (β= -0.089, P=0.022) and reduced GDM risk (OR=0.521, P=0.026). No significant associations of HBI total score and other HBI subcategories with glucose metabolism indicators or GDM were found.Conclusions For the first time, HBI was used to assess the quality of overall beverage intake in pregnant women, revealing generally good quality. Moreover, selecting a healthy beverage consumption pattern, particularly adhering to recommended guidelines for sugar-sweetened beverages intake and daily total fluid intake energy, was associated with a decrease in fasting blood glucose levels and a reduced risk of GDM. (Trial registration number: NCT03023293)

目的 本研究旨在通过健康饮料指数（Healthy Beverage Index, HBI）评估孕妇整体饮料摄入质量，并探讨其与糖代谢及妊娠糖尿病（Gestational Diabetes Mellitus, GDM）的关联。方法 本研究为基于广州越秀出生队列基线数据的横断面研究。2017至2018年，研究团队于广州市越秀区妇幼保健院纳入1029名妊娠20~28周的孕妇。通过面对面问卷调查收集孕妇的一般人口学资料与生活方式数据；采用经过信效度验证的食物频率问卷收集饮料摄入频率与摄入量数据，并计算健康饮料指数各亚项得分及总得分。通过口服葡萄糖耐量试验（Oral Glucose Tolerance Test, OGTT）及血液样本分析获取糖代谢指标，以此诊断妊娠糖尿病。采用多重线性回归与logistic回归模型，探究健康饮料指数总得分及其亚项与糖代谢水平、妊娠糖尿病的关联。结果 孕妇的健康饮料指数总得分为79.81±9.84，其中18.85%的孕妇罹患妊娠糖尿病。回归分析结果显示，在各亚项中，符合推荐摄入量（占总液体摄入≤8%）的含糖饮料摄入与空腹血糖水平降低相关（β=-0.387，P=0.002）。此外，总液体摄入能量占总能量摄入的比例处于[10%,15%)区间时，与空腹血糖水平降低（β=-0.089，P=0.022）及妊娠糖尿病风险降低（OR=0.521，P=0.026）相关。未发现健康饮料指数总得分及其他亚项与糖代谢指标或妊娠糖尿病存在显著关联。结论 本研究首次采用健康饮料指数评估孕妇整体饮料摄入质量，结果显示其整体摄入质量良好。此外，选择健康的饮料摄入模式，尤其是遵循含糖饮料摄入及每日总液体摄入能量的推荐指南，与空腹血糖水平降低及妊娠糖尿病风险降低相关。（试验注册编号：NCT03023293）