Pre-gestational consumption of ultra-processed foods and risk of gestational diabetes in a mediterranean cohort. The SUN project

We aimed to investigate the relationship between the pre-gestational consumption of ultra-processed foods (UPF) and the risk of gestational diabetes (GDM). We carried out a prospective study among 3730 Spanish women of the SUN cohort who reported at least one pregnancy after baseline recruitment. Cases of GDM were identified among women with a confirmed diagnosis of GDM. UPF consumption was assessed through a validated, semi-quantitative food frequency questionnaire and the frequency of UPF consumption was categorized in tertiles. We identified 186 cases of GDM. In the pooled sample, we did not observe a significant association of UPF with the risk of GDM. When we stratified by age, the multivariate OR for the third tertile of UPF consumption compared with the lowest one was 2.05 (95% CI 1.03, 4.07) in women aged ≥30 years at baseline (Ptrend = 0.041). The association remained significant in a sensitivity analysis after changing many of our assumptions and adjusting for additional confounders. No association between a higher UPF consumption and GDM risk was observed in women aged 18–29 years. The pre-gestational UPF consumption may be a risk factor for GDM, especially in women aged 30 years or more. Confirmatory studies are needed to validate these findings.