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)