Aim: It is unclear if women with gestational diabetes mellitus (GDM) are adhering to nutrition recommendations after education. This pilot study aimed to evaluate carbohydrate intake and spread, diet quality and factors influencing intake of women with GDM after receiving initial nutrition education.
Methods: All women with GDM who attended group education at the Women’s and Children’s Hospital(WCH) between July- November 2018 (N=111) were eligible. Dietary intake was assessed two weeks after education using the automated, self-administered 24-hour dietary recall(ASA24). Nutrition knowledge, attitudes and beliefs were collected using a predictor questionnaire. Daily carbohydrate intake and spread across the day was compared to the standard recommendations (15-30g at snacks, 30-45g at meals) and food group intake to the Australian Guide to Healthy Eating for Pregnancy. Spread of carbohydrate adherence was rated on a scale of 0-5 (5=adherent at three meals and two snacks).
Results: 38 women participated (n=32 with data for dietary analysis). Median total daily carbohydrate intake was 136.3g, below minimum recommendations of 150g. Median carbohydrate intake was below recommendations for dinner (27.4g) and within recommendations for breakfast (33.8g), morning tea (19.8g), lunch (34.9g), afternoon tea (16.5g) and supper (20.0g). Number of women adherent to the standard recommendations was 13/32 (breakfast), 6/32 (morning tea), 9/32 (lunch), 8/32 (afternoon tea) and 7/32 (dinner). All food group serves were below recommendations for pregnancy and the number of women adherent was low. Country of birth (Asian countries) (r2=-0.610, p<0.001) and greater gestational age at diagnosis (r2=-0.534, p=0.003) were associated with poor adherence to recommended spread of carbohydrate.
Conclusion: Women with GDM had poor adherence to nutrition recommendations two weeks after initial nutrition education. Greater gestational age at initial education and country of birth were associated with poor adherence to the recommended spread of carbohydrate across the day. There is an opportunity to optimise nutrition two weeks after initial education. It is important that education is soon after diagnosis, individualised and considers cultural practices.