Dose-response association between animal protein sources and risk of gestational diabetes mellitus: a systematic review and meta-analysis.

ABSTRACT

CONTEXT There are contradictory findings about the relationship between various animal protein sources and the risk of gestational diabetes mellitus (GDM). OBJECTIVE: The purpose of our study was to understand better the associations between total protein, animal protein, and animal protein sources and the risk of developing GDM. DATA SOURCES A systematic literature search was conducted in PubMed, Scopus, and Web of Science encompassing the literature up until August 2022. A random-effects model was used to combine the data. For estimating the dose-response curves, a one-stage linear mixed-effects meta-analysis was conducted. DATA EXTRACTION Data related to the association between animal protein consumption and the risk of GDM in the general population was extracted from prospective cohort studies. DATA ANALYSIS: It was determined that 17 prospective cohort studies with a total of 49 120 participants met the eligibility criteria. It was concluded with high certainty of evidence that there was a significant association between dietary animal protein intake and GDM risk (1.94, 95% CI 1.42 to 2.65, n = 6). Moreover, a higher intake of total protein, total meat, and red meat was positively and significantly associated with an increased risk of GDM. The pooled relative risks of GDM were 1.50 (95% CI 1.16, 1.94; n = 3) for a 30 g/d increment in processed meat, 1.68 (95% CI 1.25, 2.24; n = 2) and 1.94 (95% CI 1.41, 2.67; n = 4) for a 100 g/d increment in total and red meat, and 1.21 (95% CI 1.10, 1.33; n = 4) and 1.32 (95% CI 1.15, 1.52; n = 3) for a 5% increment in total protein and animal protein, respectively. GDM had a positive linear association with total protein, animal protein, total meat consumption, and red meat consumption, based on non-linear dose-response analysis. CONCLUSION: Overall, consuming more animal protein-rich foods can increase the risk of GDM. The results from the current study need to be validated by other, well-designed prospective studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022352303.