OBJECTIVE Certain foods characterizing the alternate Mediterranean diet (aMED) are high in persistent organic pollutants (POPs), which are related to greater gestational diabetes mellitus (GDM) risk. We examined the associations of combined aMED and POP exposure with GDM. RESEARCH DESIGN AND METHODS aMED score of 1,572 pregnant women was derived from food frequency questionnaires at early pregnancy within the U.S. Fetal Growth Study and plasma concentrations of 76 POPs, including organochlorine pesticides, polybrominated diphenyl ethers, polychlorinated biphenyls (PCBs), and per- and polyfluoroalkyl substances, were measured. Associations of combined aMED score and exposure to POPs with GDM risk were examined by multivariable logistic regression models. RESULTS In 61 of 1,572 (3.88%) women with GDM, 25 of 53 included POPs had a detection rate >50%. Higher POP levels appeared to diminish potential beneficial associations of aMED score with GDM risk, with the lowest GDM risk observed among women with both high aMED score and low POP concentrations. Specifically, adjusted log-odds ratios of GDM risk comparing women with low PCB and high aMED score with those with low aMED score and high PCB concentrations was −0.74 (95% CI −1.41, −0.07). Inverse associations were also observed among women with low aMED score and high TransNo_chlor, PCB182_187, PCB196_203, PCB199, and PCB206. These associations were more pronounced among women with overweight or obesity. CONCLUSIONS Pregnant women who consumed a healthy Mediterranean diet but had a low exposure to POP concentrations had the lowest GDM risk. Future endeavors to promote a healthy diet to prevent GDM may consider concurrent POP exposure.

中文翻译：

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持久性有机污染物和地中海饮食与妊娠糖尿病风险的相互作用


目的 替代地中海饮食 （aMED） 的某些食物富含持久性有机污染物 （POP），这与更高的妊娠糖尿病 （GDM） 风险有关。我们检查了 aMED 和 POP 联合暴露与 GDM 的关联。研究设计和方法 1,572 名孕妇的 aMED 评分来自美国胎儿生长研究中怀孕早期的食物频率问卷，并测量了 76 种 POPs 的血浆浓度，包括有机氯农药、多溴联苯醚、多氯联苯 （PCB） 以及全氟和多氟烷基物质。通过多变量 logistic 回归模型检查联合 aMED 评分和 POPs 暴露与 GDM 风险的相关性。结果 在 1,572 名 GDM 女性患者中，有 61 名 （3.88%） 患有 POP，其中 53 名中有 25 名的检出率为 >50%。较高的 POP 水平似乎减少了 aMED 评分与 GDM 风险的潜在有益关联，在 aMED 评分高和 POP 浓度低的女性中观察到的 GDM 风险最低。具体而言，将低 PCB 和高 aMED 评分的女性与低 aMED 评分和高 PCB 浓度的女性进行比较，调整后的 GDM 风险对数比值比为 -0.74 （95% CI -1.41，-0.07）。在 aMED 评分低而 TransNo_chlor 高的女性中也观察到PCB182_187、PCB196_203、PCB199 和 PCB206 的负相关。这些关联在超重或肥胖的女性中更为明显。结论 食用健康地中海饮食但 POP 浓度暴露量低的孕妇 GDM 风险最低。未来促进健康饮食以预防 GDM 的努力可以考虑同时暴露 POP。