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We examined the associations of combined aMED and POP exposure with GDM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>In 61 of 1,572 (3.88%) women with GDM, 25 of 53 included POPs had a detection rate &amp;gt;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 \u22120.74 (95% CI \u22121.41, \u22120.07). 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc24-1452","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T17:13:31Z","timestamp":1728494011000},"page":"2239-2247","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":9,"title":["The Interplay of Persistent Organic Pollutants and Mediterranean Diet in Association With the Risk of Gestational Diabetes Mellitus"],"prefix":"10.2337","volume":"47","author":[{"given":"Guoqi","family":"Yu","sequence":"first","affiliation":[{"name":"1Global Centre for Asian Women\u2019s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"2Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"3Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei Wei","family":"Pang","sequence":"additional","affiliation":[{"name":"1Global Centre for Asian Women\u2019s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"2Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"3Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxi","family":"Yang","sequence":"additional","affiliation":[{"name":"1Global Centre for Asian Women\u2019s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"2Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"3Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Guivarch","sequence":"additional","affiliation":[{"name":"1Global Centre for Asian Women\u2019s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"2Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"3Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagteshwar","family":"Grewal","sequence":"additional","affiliation":[{"name":"4Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Chen","sequence":"additional","affiliation":[{"name":"4Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8014-2708","authenticated-orcid":false,"given":"Cuilin","family":"Zhang","sequence":"additional","affiliation":[{"name":"1Global Centre for Asian Women\u2019s Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"2Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"3Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"5Department of Nutrition, Harvard T.H. 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