RESEARCH ARTICLE

Nutritional Status, Eating Habits and Foods

Intake by Gestational Diabetes Patients in
National Hospital of Endocrinology
NGUYEN TRONG HUNG 1, LE THI TUYET NHUNG 2, TRAN THI TRA PHUONG 1, HA THI VAN 1,
CHU THI TRANG 3, PHAM THI THU HUONG1, NGUYEN THI LAM 1, NGHIEM NGUYET THU 1,
PHAN HUONG DUONG 4, TRAN NGOC LUONG 4, LE DANH TUYEN1
¹ National Institute of Nutrition, 48B Tang Bat Ho Street, Hanoi, Vietnam, Email: nguyentronghung9602@yahoo.com.
² Andrology and Fertility Hospital of Hanoi, 431 Tam Trinh Street, Hanoi, Vietnam
3
Vietnam-Germany Friendship Hospital
4
National Hospital of Endocrinology, 215 Ngoc Hoi Street, Hanoi, Vietnam

ABSTRACT
KEYWORDS:
A cross-sectional study of 60 gestational diabetes mellitus patients who were
Nutritional status, gestational
examined and treated at National Hospital of Endocrinology in 2017 aimed to diabetes mellitus (GDM),
determine the nutritional status, eating habits and foods intake by these subjects. National Institute of Nutrition,
The results were most gestational diabetes mellitus patients had a body mass index National Hospital of Endocrinology

of 18.5 ≤BMI <25 (76.7%); the rate of overweight and obesity was 6.7%, malnutrition
was 16.6%. Total dietary energy was 1841.7±92.2kcal and energy level of ARTICLE HISTORY:
29.5±1.5kcal/kg body weight. Dietary protein was 18.7%, dietary lipid was 29%, Received April 10, 2021
Accepted April 22, 2021
dietary carbohydrate was 52.3% for total energy. the iron in the diet of gestational Published May 20, 2021
diabetes was 14.5±0.9mg/day. The folate intake approximately 400mcg/day, the
calcium intake 700mg/day, the vitamin D in the diet was 20IU/day, vitamin B12
DOI:
about 2.3mcg/day and zinc about 13.5mg/day. The percentage of gestational 10.5455/jcmr.2021.12.02.17
diabetes mellitus patients who ate ≥ 3 meals per day saw the highest rate of 76.7%;
gestational diabetes mellitus patients ate 1 meal with the lowest rate of 3.3%. In
VOLUME: 12
terms of the frequency of food consumption, meat was the highest group of food ISSUE: 2
consumption with 100% and seafood fish types were 10%. Rice - the highest ISSN: 2146-8397
consumed food accounted for 100%, then to the bread, dumplings taking up 10%.
Oil, peanut group consumed accounted for 86.7% whereas the lowest group was
animal’s fat with 3.3%. All kinds of vegetable consumed recorded 96.7%. In
conclusion, the nutritional diet of women with gestational diabetes with the ratio of
3 thermogenic substances Protein: Lipid: Carbohydrate were 18.7:29:52.3, which
was not consistent with the guidelines of the American Diabetes Association 2017
but also quite consistent with the nutritional facts and habits in Vietnam.

INTRODUCTION in pregnancy, ranging from 1-28% [2] and is on the rise,

especially in the Asia-Pacific region, including Vietnam [3],
Diabetes mellitus is a chronic disease characterized by
[4], [5]. The World Health Organization (WHO) definition,
chronic hyperglycaemia along with disturbances of
GDM is a disorder of glucose tolerance at any level, onset or
metabolism of carbohydrates, proteins, and lipids due to
first detected during pregnancy [6]. Compared with whites,
decreased insulin secretion, decreased ability to function
the risk of gestational diabetes increased by 7.6 times in
insulin or both [1]. Gestational diabetes mellitus (GDM) is a Southeast Asians [7]. In Vietnam, the estimated incidence of
special type of diabetes. This is a common metabolic disorder the disease is from 5.9 to 39% depending on the method of
 144 Nutritional Status, Eating Habits and Foods Intake by Gestational Diabetes Patients in National Hospital…

screening, screening pregnancy week, diagnostic criteria and weight gain and regimen. Nutrition of pregnant women during
population characteristics [3], [8]. pregnancy [20], [21], [22], [23], [24].

The first of gestational diabetes mellitus diagnostic criteria Recently studies have demonstrated the effectiveness of
recommended by John Oimullivan and Claire Mahan in 1964. dietary modifications for the treatment of gestational
They set up diagnostic criteria based on the incidence of diabetes: good blood sugar control and reduction of obstetric
related diseases. Those who meet this diagnostic criterion are complications [3], [25], [26], [27]. The National Hospital of
at increased risk of complications for the newborn and are Endocrinology is a terminal hospital for the treatment of
particularly at increased risk of diabetes mellitus in the endocrine diseases and metabolic disorders and is in charge
future with a 28-year follow-up period [9]. In 2010-2011, The of the National Diabetes Prevention Program. Therefore, we
International Association of the Diabetes and Pregnancy Study conducted the project: "Nutritional status, eating habits and
Group (IADPSG) and American Diabetes Association (ADA) food intake of gestational diabetes patients in National
agreed to standard of diagnosis of gestational diabetes [10], Hospital of Endocrinology". The aims of this study have
[11]. If gestational diabetes is not diagnosed and treated, evaluated diet of pregnant women with gestational diabetes
there is a high risk of obstetrical and pediatric complications as well as describe some characteristics: family history,
such as pre-eclampsia, abortion, stillbirth, neonatal history of disease, nutritional status before pregnancy,
pregnancy, perinatal death, and fetal enlargement, increase weight gain during pregnancy to the situation Diabetes
the risk of difficult delivery and cesarean delivery [12], [13], pregnancy. And at the same time, it also helps to provide
[14] ... Infants of mothers with gestational diabetes are at more information in nutrition counseling for pregnant women
risk of hypoglycemia, hypocalcemia, jaundice, when older with gestational diabetes.
children will be at risk of obesity, diabetes typ 2 [15], [16].
About 30-50% of women with gestational diabetes will get
MATERIALS AND METHODS
gestational diabetes at the next pregnancy [17]. Study Subjects
Approximately 20-50% of mothers with gestational diabetes
A cross-sectional study was designed to collecting 60
will became diabetes mellitus in 5-10 years after birth [18],
pregnant women who came for examination and treatment at
the risk of type 2 diabetes increases 7.4 times [17]. As
the Department of Reproductive Endocrinology at National
recommended by the American Diabetes Association, women
Hospital of Endocrinology in 2018.
at high risk of gestational diabetes should be screened for
screening for gestational diabetes at the first pregnancy This study used the cut-off points for the diagnosis of
check-up. [19]. gestational diabetes mellitus based on the American Diabetes
Association criteria 2011 [28].
Many studies on gestational diabetes have been conducted, so
the knowledge about the disease and its control is Women have testing undertaken at 24–28 weeks of gestation
increasingly effective. The research results in Vietnam and who found not to have diabetes mellitus before. The test
the world show that the incidence of disease is on the rise should be done in the morning after an overnight fast of
day by day. A study conducted in the Department of between 8 and 14 h and after at least 3 days of unrestricted
Endocrinology at Bach Mai Hospital (2012) showed that the diet (≥ 150 g carbohydrate per day) and unlimited physical
rate of pregnant women with gestational diabetes accounted activity. The subject should remain seated and should not
for 39% [3]. Moreover, the research results also pointed out smoke throughout the test. At least one of the venous plasma
some risk factors for gestational diabetes: family history, concentrations must be met or exceeded for a positive
history of disease, nutritional status before pregnancy, diagnosis (Table 1).

Table 1: Diagnosis of GDM with a 75-g oral glucose load

mg/dl mmol/l

Fasting 92 5.1
1h 180 10.0
2h 153 8.5

Exclusion: Patients with diabetes before pregnancy, patients

with diseases affecting carbohydrate metabolism (Basedow,
hypothyroidism, cushing, adrenal myeloma, liver failure,
kidney failure ...), patients are using drugs affecting
carbohydrate metabolism (corticosteroids, salbutamol,
sympathomimetics blockers, thiazide diuretics ...) or are In which: n: number of patients, t: normalized percentile (t =
suffering from acute diseases. 2, probability 0.954). ϭ: standard deviation = 187.5 (standard
deviation taken from a previous study [29]). e: permissible
Sampling size and sampling method
error = 50Kcal (error in the question to write the serving size
Used a sample size formula describing the characteristics of a is 35-50Kcal). N: 1000 (is the number of patients hospitalized
patient with gestational diabetes with gestational diabetes in 1 year). Number of patients: n =
Nguyen Trong Hung et al. 145

54 patients, with 10% prophylaxis, the sample size needed to The height of students was measured in centimeters (cm) by
collect was 60 patients. the Microtoise stature meter with the precision of 0.1 cm,
while weight was measured in kilograms (kg) using a Tanita
The study sample was selected based on the convenient
digital scale. Body mass index (BMI) was then calculated, and
sampling method. All patients who stayed in hospital during
overweight and obesity were classified based on the gender-
the time of conducting the study and met the selection
and age-specific BMI and World Health Organization (WHO
criteria above were selected for the study until there were
2000): BMI= Weight (kg)/Height² (m) (Table 2). [30].
enough sample sizes.

Variable research

Table 2: BMI classification [6]

BMI (kg/m²) Classification

< 18,5 Chronic Energy Disease

18,5 – 24,9 Healthy Weight
25 – 29,9 Overweight (Pre-obesity)
≥ 30 Obesity

- Diet of pregnant women (Protein, Lipid, Carbohydrate) times/week, ≥ 2 times/day, 1 time/day.

- Eating habits of pregnant women (Eat on time, number of
meals a day) Collect measurements of weight and height of subjects by
- Frequency of food consumption (group of meat, fish, rice, asking pregnant women directly on interview date.
cooking oil, fat, green vegetables)
Statistical Analyses
Methods of information collection
The database was established using EpiData software (EpiData
Interviewed subjects from the date of admission using Association, Odense, Denmark, http://www.epidata.dk/).
questionnaires combined with oral record. Subjects to record Reseach was carried out using Stata 12.0.
the 24 hours dietary recall were asked. Diets are calculated Ethical consideration
nutritional values according to a table developed by the
This study was approved by The Ethics Review Board. All
National Institute of Nutrition based on data on nutritional
procedures and experiments performed in studies involving
ingredients of foods in Vietnam [9]. The frequency of human participants were in accordance with approved
consuming certain foods in the past month of study subjects guidelines and regulations, and written informed consent was
is recorded. The frequency is classified according to the obtained from each participant.
landmarks: Never, 1-3 times/month, 1-2 times/week, > 2-4

RESULT

Table 1. General characteristics of the study object

General characteristics Statistical value (n=60, %)

Age, years

< 25 6.7%
25- 35 63.3%
≥ 35 30%
Education

Uneducated and Primary school 3.3%

Junior school 0%

High school 20%

College and above 76.7%

Gestational age at admission, weeks 31.1 ± 0.7
Parity

1 33.3%
2 23.3%
≥3 43.4%
Personal history
 146 Nutritional Status, Eating Habits and Foods Intake by Gestational Diabetes Patients in National Hospital…

Diabetes 0%

Glucose tolerance disorder 6.7%

Gestational diabetes in the previous 3.3%

pregnancy
Family history of diabetes 33.3%
Yes, %
Pre-pregnancy BMI

< 23, % 83.3%

≥ 23, % 16.7%
Plasma glucose (mmol/l)

Fasting 5.1±0.13
≥ 5.1 56.7%
1 hour (mmol/l) 10.9±0.33
≥ 10.0 73.3%
2 hour (mmol/l) 9.0±0.26
≥ 8.5 76.7%
HbA1C 5.4±0.08

Table 1 shows hat, approximately 63.3% of study participants of glucose tolerance disorder was 6.7%. In this study, 33.3%
are between 25-35 years old with the majority of education family history of having siblings having diabetes. The
being college and above levels, accounting for 76.7%. The nutritional status of patients with gestational diabetes pre-
average gestational age was about 31 weeks (31.1 ± 0.7) since pregnancy with BMI> 23 was 16.7%. After glucose tolerance
it was in the second and early trimester of pregnancy. test, the ratio of fasting, after 1 hour of testing and after 2
Number of pregnancies ≥ 3 times was 43.4%. History of hours were 56.7%, 73.3% and 76.7% respectively. The HbA1C
gestational diabetes in previous pregnancy was 3.3%, history result in these patients was 5.4 approximately.

Table 2: Nutritional status and gain weight according to the nutritional status pre-pregnancy of study participants
Nutritional status Statistical value Weight gain at Recommendations to gain
pre-pregnancy (n=60,%) pregnancy weight according to IOM
BMI, kg/m² (kg/week) 2009 (kg/week) [31]
Malnutrition 16.6% 0.46±0.8 0.45-0.59
BMI < 18.5

Normal 76.7% 0.66± 0.05 0.36-0.45

18.5 ≤ BMI ≤ 24.9
Overweight 6.7% 0.93±0.29 0.23-0.32
25.0 ≤ BMI ≤ 29.9

Obesity 0% 0 0
BMI > 3.0

Nutritional status of study subjects was shown in table 2. The normal status gained weight of 0.66±0.05kg/week and
history of pre-pregnancy weight of gestational diabetes 0.93±0.29kg/week in overweight pre-pregnancy, higher than
indicated the result. In particular, the majority (76.7%) of patients with gestational diabetes who were pre-pregnancy
patients with gestational diabetes had normal nutritional malnutrition (0.46±0.8kg/week) and recommendations to
status, 16.6% study subjects had impaired malnutrition and gain weight according to IOM 2009.
6.7% with overweight. The patients who gestational diabetes
Nguyen Trong Hung et al. 147

Table 3: Eating habits of study participants

Percentage (%)
Frequency of meal consumption

Three times a day 100

Frequency of snack consumption

≥3 76.7
2 20.0
1 3.3
End of time of last meal

< 19h 0
19h -21h 56.7
>21h 46.3
Hobby of eating sugary foods 63.3

Table 3 showed the regularity of the meal and snack snacks a day. The last meal usually ended late between 19:00
consumption of the subjects. Investigation on nutritional and 21:00 (56.7%) and after 21 hours (46.3%). The majority of
habits indicated that 100% of study participants consumed 3 patients with gestational diabetes (63.3%) like to eat sugary
meals a day, more than 95% of all subjects consumed 2 or 3 foods (cakes, candies, soft drinks ...).

Table 4: Nutrient intakes status of the subjects

Nutrients Value
Energy, kcal 1841.7±92.2
Energy level, kcal/kg body weight 29.5± 1.5
Carbohydrate, g 243.4± 16.5
% total energy
52.3 ± 2.0
Protein, g 84.3± 3.9
% total energy
18.7±0.67
Lipid, g 59.1± 4.2
% total energy
29.0±1.6
Saturated fattty acide –SFA, g 15.7± 1.2
% total energy
7.7±0.4
Monounsaturated fatty acide –MUFA, g 17.7±1.6
% total energy
8.5±0.6
Cholesterol, mg 299.2± 41.6
% total energy
0.15±0.02
Iron, mg 14.5 ± 0.9
Folic acid, µg 403.5 ± 54.4
Calcium, mg 707.2 ± 44.4
Vitamin D, IU 21.3 ± 5.8
Vitamin B12, µg 2.3 ±0 .19
Zinc, mg 13.5 ± 0.75

Analysis of actual diets of study subjects was showed in Table 8.5% of the total dietary energy. The cholesterol intake
4. Total dietary energy was 1841.7±92.2kcal and energy level 299.2± 41.6mg/day.
of 29.5±1.5kcal/kg body weight. The carbohydrate intake
Analysis of the ration of some vitamins and minerals showed
(243.4±16.5g/day) constituted 52.3±2.0% of total dietary
that the iron in the diet of gestational diabetes was
energy. The protein intake of the respondents was
14.5±0.9mg/day. Amount intake of folate, calcium, vitamin
84.3±3.9g/day (equivalent to 18.7±0.67% total dietary
D, vitamin B12 and zinc were 403.5µg/day, 707mg/day,
energy). Amount of lipid intake was 59.1±4.2g/day,
21.3IU/day, 2.3µg/day and 13.5mg/day respectively.
constituted 29.0±1.6% of the total dietary energy. In which,
the SFA fat constituted 7.5% and the MUFA fat constituted
 148 Nutritional Status, Eating Habits and Foods Intake by Gestational Diabetes Patients in National Hospital…

Table 5: Foods frequency of consumption of the subjects

Number of times consumed
Food Item Daily 3-5 per 1-2 per 1-2 per Sometime No
week week month
Carbohydrate group

Rice 100% - - - - -

Potato, sweet potato 6.7% 16.7% 46.7% 30% - -

Noodles - 23.3% 43.3% 33.3% - -
Bread, dumplings 10% 33.3% 46.7% 10% - -
Cakes, ice-cream, … 23.3% 20% 46.7% 10% - -
Protein group

Meats 100% - - - - -
Seafoods 10% 43.3% 43.3% 3.3% - -

Beans - 30% 70.0% - - -

Eggs 10% 46.7% 40% 3.3% - -
Lipid group

Vegetable oils 86.7% 10% 3.3% - - -

Animal fat 3.3% 3.3% 13,3% - 80% -

Peannut/ Sesame 6.7% 3.3% 60% 30% - -

Nuts 6.7% - - - 93.3% -

Vitamin and Mineral group

Green vegetables 96.7% 3.3% - - - -

Ripe fruits 96.7% 3.3% - - - -

Milk and Drink group

Milks 86.7% 6.7% 6.7% - - -

Diabetic milk 10% - - - 90.0% -
Soft drinks 3.3% 3.3% 90% 3.3% - -
Beer, wine - - - - 3.3% 93.3%

As for high carbohydrate foods, the frequency of rice According to many studies as well as published by the
consumption was daily, all kinds of potatoes, noodles, cakes American College of Obstetricians and Gynecologists,
consumed with a frequency of once or twice per week were pregnant mothers under the age of 25 years are considered to
46.7%. Among those, for high protein foods, the daily be less at risk of gestational diabetes. The higher the age,
consumption of meats (of poultry and livestock) was 100%, the greater the risk. Pregnant women between the ages of 25
seafood and aquatic products about 3 to 5 times a week, and 35 are considered to be moderate risk factors and 35 and
43.3%, and legumes once or twice per week was 70%, eggs older are considered high risk factors [33]. This study has
with frequency of 3-5 times per week was 46.7%. With high shown that about 63.3% of women with gestational diabetes
lipid foods, the daily oil consumption frequency was 86.7%, between the ages of 25 and 35 and about 30% of pregnant
the use of animal fats was seldom 80%, and the seldom use of
women with gestational diabetes are over 35 years old. The
fatty nuts (walnuts, cashews ...) was 93.3%. To turn to, foods
study of Jane E. Hirst et al. showed that the average age of
rich in vitamins and minerals, the daily consumption of ripe
pregnant women with gestational diabetes was 31.21 ± 4.16
green vegetables and fruits was 96.7%. Some types of drinking
higher than the non-gestational group. 27.85 ± 4.73 [34].
water are seen. 86.7% of pregnant diabetic women drink milk
Research by Ostlund also shows that mother age ≥ 25 risk of
every day, drink soft drinks once or twice per week is 90% and
gestational diabetes increased 3.37 times compared to the
consume beer/alcohol seldom 3.3%.
group <25 years old [35]. Regarding the educational level of
DISCUSSION patients with gestational diabetes, the study showed that the
majority of pregnant women with
Currently there are many studies and standards on gestational
secondary/college/university education accounted for 76.7%.
diabetes. However, in order to update and properly assess
The results of the study are similar to those of La Thi Thanh
the status of gestational diabetes in Vietnam, like recent
Tam et al. [36] and the study of Nguyen Khoa Dieu Van et al
epidemiological studies, we apply the criteria for evaluating
[3].
gestational diabetes according to the American Diabetes
Association ADA 2017 [32]. The average gestational age of patients with gestational
diabetes is about 31 weeks (31.1 ± 0.7) from the 2nd and
Nguyen Trong Hung et al. 149

early 3rd trimester. According to the American Diabetes diabetes also clearly indicate the nutritional status of pre-
Association ADA (2011) and the American College of pregnancy women is one of the risk factors that are easily
Obstetricians and Gynecologists (2010) recommends screening encountered in pregnant women with diabetes mellitus.
for gestational diabetes for women from 24-28 weeks Obese people with insulin resistance are susceptible to
gestation. The number of pregnancies ≥ 3 times was 43.7%. diabetes. Doherty and et al found that obesity pre-pregnancy
History of gestational diabetes in previous pregnancies was was a risk factor for gestational diabetes [39]. Ta Van Binh et
3.3%, history of glucose tolerance was 6.7%. Family history of al. showed that the prevalence of gestational diabetes
parents of siblings with diabetes is 33.3%. Our research between BMI <23 and BMI ≥23 difference was statistically
results are consistent with the results of other authors [34], significant [40]. Torloni's study, compared the group with
[37]. Ostlund also showed that mothers with a history of normal BMI, the risk of gestational diabetes decreased in the
gestational diabetes increased the risk of gestational diabetes low-weight group, overweight group, moderate obesity and
by 5.59 times [35]. A study by Jane E. Hirst et al showed obesity increased OR = 1.97 (95% CI = 1.77-2.19), OR = 3.01
that: the rate of pregnant women with a history of stillbirth (95% CI = 2.34-3.87), OR = 5.55 (95% CI = 4.27-7.21)
in gestational diabetes was 2.97%, in gestational diabetes was respectively [38].
3.8%, the difference is statistically significant [34].
Analysis of nutritional habits, we noted in the study of
Diagnosis of gestational diabetes when patients have one of diabetic women divided into several meals a day: 3 meals and
the serum glucose values: fasting blood glucose ≥5.1 mmol/l, 2-3 snacks to distribute glucose consumption and reduce
blood glucose after 1 hour of legal testing ≥ 10.0 mmol/l and glucose fluctuations serum after eating, better control serum
blood glucose after 2 hours of solution testing ≥ 8.5 mmol/l. glucose [41], [42].
The results of the study indicate that the blood glucose test
Conducting an analysis of the diet of pregnant women with
after the fasting glucose test after 1 hour of legal testing and
diabetes we recorded: The total dietary energy was about
after 2 hours solution test were 56.7%, 73.3% and 76.7%
1841.7±92.2kcal/day with an energy level of about
respectively. The HbA1C index is a measure of the stability of
29.5±1.5kcal/kg body weight. The amount of glucose in the
blood sugar in the last 3 months. According to the ADA 2017,
daily diet was 243.4±16.5g/day, accounting for more than
the HbA1C is recommended for women with diabetes in early
50% of the total dietary energy (52.3±2.0%). The amount of
pregnancies with a goal of <6-6.5%. If the mother is at risk of
protein in the daily diet was 84.3±3.9g/day accounting for
hypoglycemia, it is up to the individual patient to set the
more than 18% of the total dietary energy (18.7±0.67%) with
target HbA1 <7%. In the 2nd and 3rd pregnancy should
protein of 1.36±0.07g/kg body weight/day, 59.1±4.2g/day
optimize HbA1C <6% and should check the HBA1C index
accounting for about 30% of the total dietary energy
monthly. According to the results of the above study, the
(29.0±1.6%). In particular, the amount of SFA fat accounts for
HbA1C in these patients is about 5.4 ± 0.08, meaning that the
more than 7.5% of the total dietary energy, the amount of
target is at the optimal level.
MUFA fat accounts for more than 8.5% of the total dietary
Monitoring pregnant women Gestational diabetes not only energy and the amount of cholesterol was about 300mg/day.
monitors blood glucose indicators, it was important to control The ratio of three thermogenesis substances in the diet of
and monitor the weight of pregnant women. According to IOM pregnant women Gestational diabetes in our study was
2009 recommendations for weight gain in women Diabetes, Protein:Lipid:Carbohydrate = 18:30:52. However, according
the weight gain of pregnant women depends on weight before to the recommendations of the American Abstinence
pregnancy. A pregnant woman before malnutrition in the Association (2012) and the American Society of Obstetrics and
state of malnutrition, the total weight need to increase from Gynecology (2017), the diet for pregnant women with
12.5-18 kg with the rate of weight gain in the 2nd and 3rd gestational diabetes needs to control specific carbohydrates:
pregnancy at about 0.45-0.59kg/week. Pregnant women The energy requirement was 30-35kcal/kg/day, of which, 20%
before pregnancy in normal nutritional status, the total protein, 40-45% carbohydrate and 35-40% lipid. The amount
weight needs to increase from 11.3 to15.8 kg with the rate of of saturated fat was less than 10% of the total fat. We noted
weight gain in the 2nd and 3rd pregnancy was 0.36- that the energy demand of pregnant women with gestational
0.45kg/week. When pregnant, overweight and obese diabetes of 30kcal/kg/day was also consistent with the
nutrition, the total weight need to increase from 5-10 kg with recommendations of the 2017 ADA but on the ratio of the
the rate of weight gain in the 2nd and 3rd pregnancy was three triggers, but we found that some of the following
0.23-0.32 kg/week. However, our research results show that issues: First, the nutritional habits of Vietnamese people with
the rate of weight gain in pregnant women with normal the highest lipid rate were approximately 30% lower than the
nutritional status and overweight in 2nd and 3rd trimester is ADA 2017 recommendations for pregnant women with
much higher than the recommendations. Some previous diabetes. Secondly, according to the ADA's guidelines on
studies have shown that excessive weight gain during nutrition for diabetics and the guidelines for nutrition for
pregnancy also causes the risk of diabetes for mothers and diabetics in Vietnam, the recommended carbohydrate rate of
babies [15], [16], [38]. 50-55% was also suitable. Consistent with nutritional habits in
Vietnam. Thirdly, pregnant women often have a condition of
In addition, epidemiological studies on the risk of gestational
dyslipidemia, so the question was whether to follow the
 150 Nutritional Status, Eating Habits and Foods Intake by Gestational Diabetes Patients in National Hospital…

recommendations of the American Abstinence Association CONCLUSION

(2012) and the American Society of Obstetricians and
Gynecologists (2017). For pregnant women with gestational The nutritional diet of women with gestational diabetes with
diabetes need to control specific carbohydrates: 20% protein, the ratio of 3 thermogenic substances was not consistent with
40-45% carbohydrate and 35-40% lipid can increase the guidelines of the American Diabetes Association 2017 but
dyslipidemia. Fat quality was also an important nutritional also quite consistent with the nutritional facts and habits in
issue that was mentioned in the advice of pregnant women Vietnam. The amount of cholesterol in the daily diet was
with diabetes. Previous studies showed that one of the risk high. The recommended levels of dietary micronutrients such
factors for gestational diabetes was a high-fat diet [43], [44]. as Calcium, Vitamin D, Zinc, B12, and Folate are about 60%,
Fatty (high in saturated fatty acids, low in unsaturated fatty 10%, 94% and 70% respectively. Diabetic women have good
acids), high in cholesterol [20]. Our study noted that SFA fat nutritional habits of sharing small meals, but choosing a
accounts for more than 7.5% of total dietary energy, MUFA fat variety of sugary foods such as sugary milk, confectionery,
accounts for more than 8.5% of total energy intake and high and ripe fruit leads to the risk of hyperglycemia. The status
cholesterol was about 300mg/day. This study found that of weight gain more than recommended in pregnant women
diabetic pregnant diets with saturated fat content of 8.5% of with nutritional status before pregnancy BMI>23 overweight,
total dietary energy in accordance with recommendations of obesity. The features of a history of gestational diabetes,
the American Abstinence Association (2012) and ADA (2017). impaired glucose tolerance, history of gestational
Analysis of diet of some vitamins and minerals illustrated that enlargement, stillbirth, family history of siblings with
the amount of iron in diet of patients with gestational diabetes are consistent with epidemic studies in Vietnam and
diabetes was 14.5 ± 0.9mg/day. The amount of folate was internationally.
400mcg/day, calcium in the diet was 700mg/day, vitamin D in
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