Diet During Pregnancy: Sugary Drinks and Risk

Chapter summary

Soda in pregnancy can raise the risk of type 2 diabetes, miscarriage and newborn death, and of obesity or diabetes in children.
Diet before and after birth appears to set up obesity for life. If there is one group to get right, it is pregnant women gaining a reasonable amount of weight.
It is also one of the hardest, because of hormone changes and the social and political context.

Gestational diabetes mellitus (GDM) is glucose intolerance first recognised in pregnancy. It is one of the most common pregnancy complications.
Women with GDM face a higher risk of complications, including miscarriage after 24 weeks and death in the first week of life.
The study: Dr Chen and colleagues followed 13,475 women in the Nurses’ Health Study II. Women who drank more than five servings a week of sugar-sweetened cola before pregnancy had a 22% higher risk of GDM than those who drank less than one can a month.

Cola specifically: The study picked out cola and not other sweetened drinks.
The author’s view: Other studies show no major difference between sweetened beverages in weight and metabolic effects, so it is prudent to avoid all of them.
Observational data: The study shows association and not proof of cause.

Studies in humans and animals link fetal and early infant growth patterns to adult metabolic disease.
Maternal health and nutrition set infant growth, but the exact molecular mechanism is unknown. There are critical time windows.
In animals, the “fat child equals diseased adult” pattern can be reversed, either through the mother or directly in the newborn.
One idea is to give leptin in drops or milk to newborns, which might help reverse the obesity and type 2 diabetes epidemic. The author notes the ethics and politics would be tough.

Avoid sweetened drinks before and during pregnancy.
Aim for steady, reasonable weight gain.
Seek advice from your own doctor on individual care. This chapter is a summary of research and not medical advice.

Chen, L. et al. (2009) Prospective study of pre-gravid sugar-sweetened beverage consumption and the risk of gestational diabetes mellitus. Diabetes Care 32(12):2236-2241.