{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:30:03Z","timestamp":1788366603490,"version":"build-2803163510"},"reference-count":24,"publisher":"Bioscientifica","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["ec.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11,14]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gestational diabetes mellitus (GDM) affects 7\u201314% of pregnancies, increasing maternal and neonatal complications. Phytochemical-rich diets, abundant in plant-based foods, may improve glucose metabolism and reduce inflammation. The phytochemical dietary index (PDI) measures intake of such foods, but prospective data on GDM risk are scarce. This study aimed to examine early-pregnancy PDI in relation to subsequent GDM risk in a large birth cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 2,770 pregnant women (mean age 29.61 \u00b1 4.55 years; mean pre-pregnancy BMI 23.96 \u00b1 1.19 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) from the Women's Health Center of Shanxi were included. Dietary intake was assessed using a validated food frequency questionnaire. The plant-based diet index (PDI) was calculated as the proportion of daily energy intake from whole grains, fruits, vegetables, legumes, nuts, seeds, and olive oil. Participants were divided into PDI quartiles. GDM was diagnosed at 24\u201328 weeks\u2019 gestation using a 75 g oral glucose tolerance test based on IADPSG criteria. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for confounders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      GDM occurred in 377 women (13.6%). Higher PDI was inversely associated with GDM risk (\n                      <jats:italic>P<\/jats:italic>\n                      -trend &lt;0.001). Each 10% increase in PDI was associated with a 14% lower odds of GDM (OR 0.86; 95% CI: 0.82\u20130.91). Higher PDI was associated with lower risk of neonatal hypoglycemia (OR 0.93; 95% CI: 0.92\u20130.95) and better maternal biochemical profiles, including lower fasting glucose, HbA1c, post-load glucose, triglycerides, total cholesterol, and higher HDL cholesterol.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher early-pregnancy PDI was associated with substantially lower risk of GDM, reduced neonatal hypoglycemia, and improved maternal metabolic profiles. Our findings support the integration of phytochemical-rich dietary guidance into early prenatal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-25-0615","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T13:07:33Z","timestamp":1763125653000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":2,"title":["Pregnancy phytochemical dietary index is associated with the risk of gestational diabetes and perinatal outcomes"],"prefix":"10.1530","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8297-759X","authenticated-orcid":true,"given":"Hongli","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Children's Hospital of Shanxi, Women's Health Center of Shanxi, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"J Clin Med","first-page":"5736","article-title":"Gestational diabetes mellitus \u2013 recent literature review","volume":"11","author":"Modzelewski R","year":"2022","unstructured":"Modzelewski R\n, \nSmith J\n, \nJohnson P\n, et al.\n Gestational diabetes mellitus \u2013 recent literature review. J Clin Med 2022 11 5736. (https:\/\/doi.org\/10.3390\/jcm11195736)"},{"key":"bib2","series-title":"INOSR Sci Res","first-page":"63","article-title":"Beyond pregnancy: understanding the long-term implications of gestational diabetes mellitus","volume":"11","author":"Alum EU","year":"2024","unstructured":"Alum EU\n, \nUgwu OP\n, \nObeagu EI\n, et al.\n Beyond pregnancy: understanding the long-term implications of gestational diabetes mellitus. INOSR Sci Res 2024 11 63\u201371. (https:\/\/doi.org\/10.59298\/inosrsr\/2024\/1.1.16371)"},{"key":"bib3","series-title":"Nat Rev Dis Primers","first-page":"47","article-title":"Gestational diabetes mellitus","volume":"5","author":"McIntyre HD","year":"2019","unstructured":"McIntyre HD\n, \nCatalano P\n, \nZhang C\n, et al.\n Gestational diabetes mellitus. Nat Rev Dis Primers 2019 5 47. (https:\/\/doi.org\/10.1038\/s41572-019-0098-8)"},{"key":"bib4","series-title":"Trends Endocrinol Metab","first-page":"743","article-title":"Gestational diabetes mellitus: mechanisms, treatment, and complications","volume":"29","author":"Johns EC","year":"2018","unstructured":"Johns EC\n, \nDenison FC\n, \nNorman JE\n, et al.\n Gestational diabetes mellitus: mechanisms, treatment, and complications. Trends Endocrinol Metab 2018 29 743\u2013754. (https:\/\/doi.org\/10.1016\/j.tem.2018.09.004)"},{"key":"bib5","series-title":"BMC Med","first-page":"418","article-title":"Maternal factors during pregnancy influencing maternal, fetal, and childhood outcomes","volume":"20","author":"Muglia LJ","year":"2022","unstructured":"Muglia LJ\n, \nLynch CD\n, \nThoma ME\n, et al.\n Maternal factors during pregnancy influencing maternal, fetal, and childhood outcomes. BMC Med 2022 20 418. (https:\/\/doi.org\/10.1186\/s12916-022-02632-6)"},{"key":"bib6","series-title":"Curr Diabetes Rev","first-page":"12","article-title":"Nutraceuticals and diet-based phytochemicals in type 2 diabetes mellitus","volume":"16","author":"Onaolapo AY","year":"2020","unstructured":"Onaolapo AY\n, \nOnaolapo OJ\n, \nAdewale T\n, et al\n. Nutraceuticals and diet-based phytochemicals in type 2 diabetes mellitus. Curr Diabetes Rev 2020 16 12\u201325. (https:\/\/doi.org\/10.2174\/1573399814666181031103930)"},{"key":"bib7","series-title":"Nutrients","first-page":"3709","article-title":"Plant-based diets and phytochemicals in diabetes management","volume":"16","author":"Ansari P","year":"2024","unstructured":"Ansari P\n, \nSharma R\n, \nGupta S\n, et al\n. Plant-based diets and phytochemicals in diabetes management. Nutrients 2024 16 3709. (https:\/\/doi.org\/10.3390\/nu16213709)"},{"key":"bib8","series-title":"BMC Public Health","first-page":"1587","article-title":"Dietary phytochemical index and metabolic syndrome","volume":"21","author":"Vasmehjani AA","year":"2021","unstructured":"Vasmehjani AA\n, \nMehrabani S\n, \nKhosravi M\n, et al\n. Dietary phytochemical index and metabolic syndrome. BMC Public Health 2021 21 1587. (https:\/\/doi.org\/10.1186\/s12889-021-11590-2)"},{"key":"bib9","series-title":"Med Hypotheses","first-page":"813","article-title":"Proposal for a dietary phytochemical index","volume":"63","author":"McCarty MF","year":"2004","unstructured":"McCarty MF\n, \nBarroso-Aranda J\n, \nContreras F\n, et al.\n Proposal for a dietary phytochemical index. Med Hypotheses 2004 63 813\u2013817. (https:\/\/doi.org\/10.1016\/j.mehy.2002.11.004)"},{"key":"bib10","series-title":"BMC Cardiovasc Disord","first-page":"293","article-title":"Dietary phytochemical index and cardiovascular risk in type 1 diabetes","volume":"21","author":"Delshad-Aghdam S","year":"2021","unstructured":"Delshad-Aghdam S\n, \nHashemi R\n, \nMirmiran P\n, et al\n. Dietary phytochemical index and cardiovascular risk in type 1 diabetes. BMC Cardiovasc Disord 2021 21 293. (https:\/\/doi.org\/10.1186\/s12872-021-02106-2)"},{"key":"bib11","series-title":"BMC Nutr","first-page":"105","article-title":"Dietary phytochemical index and gestational diabetes risk","volume":"11","author":"Bahramfard T","year":"2025","unstructured":"Bahramfard T\n, \nHosseini B\n, \nMahmoodi M\n, et al\n. Dietary phytochemical index and gestational diabetes risk. BMC Nutr 2025 11 105. (https:\/\/doi.org\/10.1186\/s40795-025-01070-w)"},{"key":"bib12","series-title":"World J Diabetes","article-title":"Food insecurity, diet diversity, and GDM","volume":"16","author":"Hou HL","year":"2025","unstructured":"Hou HL\n, \nSun GX\n, \nZhao L\n, et al.\n Food insecurity, diet diversity, and GDM. World J Diabetes 2025 16 95463. (https:\/\/doi.org\/10.4239\/wjd.v16.i2.95463)"},{"key":"bib13","series-title":"Front Public Health","article-title":"The effect of diet quality on the risk of developing gestational diabetes mellitus: a systematic review and meta-analysis.","volume":"10","author":"Gao X","year":"2023","unstructured":"Gao X\n, \nZheng Q\n, \nJiang X\n, et al\n. The effect of diet quality on the risk of developing gestational diabetes mellitus: a systematic review and meta-analysis. Front Public Health 2023 10 1062304. (https:\/\/doi.org\/10.3389\/fpubh.2022.1062304)"},{"key":"bib14","series-title":"BMC Pregnancy Childbirth","first-page":"447","article-title":"Pre-pregnancy phytochemical index and GDM","volume":"24","author":"Heidarzadeh-Esfahani N","year":"2024","unstructured":"Heidarzadeh-Esfahani N\n, \nDjalalinia S\n, \nKelishadi R\n, et al\n. Pre-pregnancy phytochemical index and GDM. BMC Pregnancy Childbirth 2024 24 447. (https:\/\/doi.org\/10.1186\/s12884-024-06643-4)"},{"key":"bib15","series-title":"Adv Nutr","first-page":"1353","article-title":"Western diet and risk of GDM: meta-analysis","volume":"12","author":"Quan W","year":"2021","unstructured":"Quan W\n, \nZhang H\n, \nChen L\n, et al\n. Western diet and risk of GDM: meta-analysis. Adv Nutr 2021 12 1353\u20131364. (https:\/\/doi.org\/10.1093\/advances\/nmaa184)"},{"key":"bib16","series-title":"Nutr J","first-page":"27","article-title":"Fruits\/vegetables and GDM risk: meta-analysis","volume":"22","author":"Liao YP","year":"2023","unstructured":"Liao YP\n, \nWang H\n, \nChen X\n, et al\n. Fruits\/vegetables and GDM risk: meta-analysis. Nutr J 2023 22 27. (https:\/\/doi.org\/10.1186\/s12937-023-00855-8)"},{"key":"bib17","series-title":"Biomed Environ Sci","first-page":"1","article-title":"Reproducibility and validity of Chinese FFQ","volume":"23","author":"Wen-Hua Z","year":"2010","unstructured":"Wen-Hua Z\n, \nMin L\n, \nFangfang W\n, et al\n. Reproducibility and validity of Chinese FFQ. Biomed Environ Sci 2010 23 1\u201338. (https:\/\/doi.org\/10.1016\/S0895-3988(11)60014-7)"},{"key":"bib18","series-title":"J Perinatol","first-page":"100","article-title":"IADPSG criteria and pregnancy outcomes","volume":"34","author":"Shang M","year":"2014","unstructured":"Shang M\n, \nLin L\n, \nZhang Y\n, et al\n. IADPSG criteria and pregnancy outcomes. J Perinatol 2014 34 100\u2013104. (https:\/\/doi.org\/10.1038\/jp.2013.143)"},{"key":"bib19","series-title":"BMC Pregnancy Childbirth","first-page":"647","article-title":"Mediterranean diet and GDM risk","volume":"23","author":"Mohtashaminia F","year":"2023","unstructured":"Mohtashaminia F\n, \nRahmani J\n, \nYekaninejad MS\n, et al\n. Mediterranean diet and GDM risk. BMC Pregnancy Childbirth 2023 23 647. (https:\/\/doi.org\/10.1186\/s12884-023-05960-4)"},{"key":"bib20","series-title":"Crit Rev Food Sci Nutr","first-page":"830","article-title":"Regulation of glucose metabolism by bioactive phytochemicals for the management of type 2 diabetes mellitus","volume":"59","author":"Zhao C","year":"2019","unstructured":"Zhao C\n, \nYang J\n, \nWei Y\n, et al\n. Regulation of glucose metabolism by bioactive phytochemicals for the management of type 2 diabetes mellitus. Crit Rev Food Sci Nutr 2019 59 830\u2013847. (https:\/\/doi.org\/10.1080\/10408398.2018.1501658)"},{"key":"bib21","series-title":"Nutrients","first-page":"4131","article-title":"Diet-gut microbiota interactions in GDM prevention","volume":"16","author":"Beldie LA","year":"2024","unstructured":"Beldie LA\n, \nPopa AR\n, \nBerceanu C\n, et al\n. Diet-gut microbiota interactions in GDM prevention. Nutrients 2024 16 4131. (https:\/\/doi.org\/10.3390\/nu16234131)"},{"key":"bib22","series-title":"Curr Opin Food Sci","first-page":"33","article-title":"Dietary polyphenols, oxidative stress and inflammation","volume":"8","author":"Zhang H","year":"2016","unstructured":"Zhang H\n, \nTsao R\n, \nWang X\n, et al\n. Dietary polyphenols, oxidative stress and inflammation. Curr Opin Food Sci 2016 8 33\u201342. (https:\/\/doi.org\/10.1016\/j.cofs.2016.02.002)"},{"key":"bib23","series-title":"Foods","first-page":"3934","article-title":"Soluble fibers and glycemic response","volume":"11","author":"Giuntini EB","year":"2022","unstructured":"Giuntini EB\n, \nSard\u00e1 FAH\n, \nde Menezes EW\n, et al\n. Soluble fibers and glycemic response. Foods 2022 11 3934. (https:\/\/doi.org\/10.3390\/foods11233934)"},{"key":"bib24","series-title":"Nutr Metab Cardiovasc Dis","first-page":"126","article-title":"Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome. Nutrition, metabolism and cardiovascular diseases.","volume":"21","author":"Casas-Agustench P","year":"2011","unstructured":"Casas-Agustench P\n, \nL\u00f3pez-Uriarte P\n, \nBull\u00f3 M\n, et al\n. Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome. Nutrition, metabolism and cardiovascular diseases. Nutr Metab Cardiovasc Dis 2011 21 126\u2013135. (https:\/\/doi.org\/10.1016\/j.numecd.2009.08.005)"}],"container-title":["Endocrine Connections"],"original-title":[],"link":[{"URL":"https:\/\/ec.bioscientifica.com\/view\/journals\/ec\/14\/11\/EC-25-0615.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/14\/11\/EC-25-0615.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/14\/11\/EC-25-0615.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T14:43:14Z","timestamp":1764340994000},"score":1,"resource":{"primary":{"URL":"https:\/\/ec.bioscientifica.com\/view\/journals\/ec\/14\/11\/EC-25-0615.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":24,"journal-issue":{"issue":"11"},"URL":"https:\/\/doi.org\/10.1530\/ec-25-0615","relation":{},"ISSN":["2049-3614"],"issn-type":[{"value":"2049-3614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,1]]}}}