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Dietary energy density but not glycemic load is associated with gestational weight gain^1,2,3

¹ From the Departments of Nutrition (ALD and AMS-R), Epidemiology (AMS-R), and Biostatistics (AH), University of North Carolina School of Public Health and the Carolina Population Center (AMS-R and AH), Chapel Hill, NC

Background: Most pregnant women gain more weight than the ranges recommended. Excessive weight gain is linked to pregnancy complications and to long-term maternal and child health outcomes.

Objective: The objective was to examine the impact of dietary glycemic load and energy density on total gestational weight gain and the weight gain ratio (observed weight gain/expected weight gain).

Design: Data are from 1231 women with singleton pregnancies who participated in the Pregnancy, Infection, and Nutrition Cohort Study. Dietary information was collected at 26–29 wk of gestation with the use of a semiquantified food-frequency questionnaire. Linear regression models were used to estimate the associations between quartiles of glycemic load and energy density with total gestational weight gain and weight gain ratio.

Results: Dietary patterns of pregnant women significantly differed across many sociodemographic and behavioral characteristics, with the greatest contrasts seen for glycemic load. After adjustment for covariates, compared with women in the first quartile consuming a mean dietary energy density of 0.71 kcal/g (reference), women in the third quartile consuming a mean energy density of 0.98 kcal/g gained an excess of 1.13 kg (95% CI: 0.24, 2.01), and women in the fourth quartile consuming a mean energy density of 1.21 kcal/g gained an excess of 1.08 kg (95% CI: 0.20, 1.97) and had an increase of 0.13 (95% CI: 0.006, 0.24) units in the weight gain ratio. All other comparisons of energy intakes were not statistically significant. Glycemic load was not associated with total gestational weight gain or weight gain ratio.

Conclusion: Dietary energy density is a modifiable factor that may assist pregnant women in managing gestational weight gains.