{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T10:15:29Z","timestamp":1782814529967,"version":"3.54.5"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005047","name":"Natural Science Foundation of Liaoning Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Nutritional management is the cornerstone of gestational diabetes mellitus (GDM) prevention. High quality instead of low quantity of carbohydrate intake has been paying attention in controlling glycemia. Air pollution exposure can be interacted with dietary sourced nutrients, which may modify the associations with GDM. This study aims to explore the associations between overall quality of carbohydrate intake and GDM as well as the modifying effect of prenatal air pollution exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Carbohydrate quality index (CQI) was calculated was calculated by summing scores of the four components; Land use regression prediction models were used to assess the air pollution exposure levels. GDM definition was based on 75 g glucose tolerance test results. Associations between pre-pregnancy CQI, pre-natal air pollution as well as the modifying effect on GDM were explored based on a birth cohort in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3,183 participants were included, of which 784 (24.63%) were diagnosed with GDM. Higher pre-pregnancy CQI was associated with a lower incidence of GDM [odds ratio (OR) = 0.75, 95% confidence interval (CI): 0.56\u20130.99, <jats:italic>P<\/jats:italic><jats:sub>for trend<\/jats:sub> = 0.04], especially for higher fasting blood glucose related GDM (OR = 0.66, 95% CI: 0.47, 0.91). Higher air pollution exposure before and during pregnancy was associated with a greater risk of GDM. Higher exposure to particulate matter with an aerodynamic diameter of &amp;lt; 2.5 \u03bcm (<jats:italic>P<\/jats:italic><jats:sub>for interaction<\/jats:sub> &amp;lt; 0.01), particulate matter with an aerodynamic diameter of &amp;lt; 10 \u03bcm (<jats:italic>P<\/jats:italic><jats:sub>for interaction<\/jats:sub> &amp;lt; 0.01), and sulfur dioxide (<jats:italic>P<\/jats:italic><jats:sub>for interaction<\/jats:sub> = 0.02) during pregnancy decreased the beneficial effect of high pre-pregnancy CQI on GDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CQI related dietary interventions pre-pregnancy to prevent GDM incidence should be considered. Women who are planning to be pregnant should avoid high exposure to air pollution during pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2022.992472","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T15:41:43Z","timestamp":1672933303000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Carbohydrate intake quality and gestational diabetes mellitus, and the modifying effect of air pollution"],"prefix":"10.3389","volume":"9","author":[{"given":"Hehua","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangsu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhong","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19113342","article-title":"The pathophysiology of gestational diabetes mellitus.","volume":"19","author":"Plows","year":"2018","journal-title":"Int J Mol Sci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1515\/med-2021-0408","article-title":"Effect of gestational diabetes mellitus on lipid profile: a systematic review and meta-analysis.","volume":"17","author":"Rahnemaei","year":"2022","journal-title":"Open Med."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0098-8","article-title":"Gestational diabetes mellitus.","volume":"5","author":"McIntyre","year":"2019","journal-title":"Nat Rev Dis Primers."},{"key":"B4","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1038\/nrendo.2012.96","article-title":"Gestational diabetes mellitus: risks and management during and after pregnancy.","volume":"8","author":"Buchanan","year":"2012","journal-title":"Nat Rev Endocrinol."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2021.1989658","article-title":"Association of maternal pre-pregnancy dietary intake with adverse maternal and neonatal outcomes: a systematic review and meta-analysis of prospective studies.","author":"Cui","year":"2021","journal-title":"Crit Rev Food Sci Nutr."},{"key":"B6","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1080\/07315724.1990.10720387","article-title":"Dietary manipulation as a primary treatment strategy for pregnancies complicated by diabetes.","volume":"9","author":"Jovanovic-Peterson","year":"1990","journal-title":"J Am Coll Nutr."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1621","DOI":"10.1016\/S0002-8223(02)90346-9","article-title":"Food and Nutrition Board of the Institute of Medicine, The National Academies. 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