{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T16:02:20Z","timestamp":1784908940607,"version":"3.55.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gestational diabetes mellitus (GDM) presents significant risks to maternal and offspring health. Modifiable factors like dietary quality are important for prevention. The Dietary Obesity-Prevention Score (DOS) is a validated tool for assessing obesity-related dietary quality. Nevertheless, its association with GDM remain unclear. This study aimed to examine the relationship between DOS and GDM risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This prospective cohort included 1,894 pregnant women across nine medical centers in China. Dietary intake was assessed by 3-day 24-h recalls. The DOS was derived from 6 food groups. Multivariable binary logistic regression, component analysis, subgroup analysis, and restricted cubic splines (RCS) were used to evaluate associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the overall population, DOS showed no significant association with GDM (OR = 0.944, 95% CI: 0.879\u20131.015). The interaction between DOS and energy intake status was not significant (\n                      <jats:italic>p<\/jats:italic>\n                      for interaction = 0.193). Exploratory subgroup analyses showed that among women with inadequate energy intake, higher DOS was associated with reduced GDM risk (OR = 0.867, 95% CI: 0.773\u20130.973). Likelihood ratio tests showed that excluding fruit from the full model worsened the model fit (\u0394-2LL = 16.091, df = 1,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Component analysis suggested a possible inverse association between fruit intake and GDM risk (OR per 50 g\/1,000 kcal = 0.905, 95% CI: 0.817\u20131.001,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.053). Fruit intake was associated with lower GDM risk in the middle DOS tertile (OR = 0.783, 95% CI: 0.620\u20130.990,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.041) and showed a borderline significant association in the high DOS tertile (OR = 0.828, 95% CI: 0.686\u20131.000,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.049). In the inadequate energy intake subgroup, RCS analysis revealed a non-linear association between fruit intake and GDM risk (\n                      <jats:italic>p<\/jats:italic>\n                      for non-linearity = 0.048), with risk decreasing to a nadir at approximately 400 g\/day, after which it stabilized. The 95% CI widened beyond 600 g\/day due to sparse data, and these inflection points should be interpreted as exploratory descriptive features rather than precise thresholds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In pregnant women with inadequate energy intake, higher dietary quality was associated with reduced GDM risk. Fruits may play a role, although these findings are exploratory and require confirmation in independent cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1869787","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T15:11:17Z","timestamp":1784905877000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between the dietary obesity-prevention score and risk of gestational diabetes mellitus: an exploratory subgroup analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Ying","family":"Xie","sequence":"first","affiliation":[{"name":"School of Public Health, Hebei Medical University","place":["Shijiazhuang, China"]},{"name":"Department of Clinical Nutrition, The First Hospital of Hebei Medical University","place":["Shijiazhuang, 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health, Hebei Medical University","place":["Shijiazhuang, China"]},{"name":"Department of Clinical Nutrition, The First Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Public Health, Hebei Medical University","place":["Shijiazhuang, China"]},{"name":"Department of Clinical Nutrition, The First Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianqiang","family":"Lai","sequence":"additional","affiliation":[{"name":"National Center for Rural Water Supply Technical Guidance, Chinese Center for Disease Control and Prevention","place":["Beijing, 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