Background Environmental exposures, such as pesticides, during pregnancy have been associated with several adverse pregnancy outcomes, including miscarriage and shorter gestational length at birth. However, their relationship with gestational diabetes (GDM) is uncertain. The objective of this study was to analyze first-trimester urinary herbicide concentrations for their associations with GDM. Methods This was a nested case-control study analysis of the Nulliparous Pregnancy Outcomes Study- Monitoring Mothers-to-be (nuMoM2b) study. The study included participants at the three midwestern study sites. We analyzed individuals according to whether they developed GDM. Urinary herbicide concentration at the upper quartile was the exposure of interest. To assess the association of first-trimester urine glyphosate and metabolites with GDM, conditional logistic regression was used for matched pairs models. To test whether the association of herbicides with GDM was modified by BMI, an interaction term of herbicide (dichotomous variable) * BMI was included. Results The 118 cases of nuMoM2b participants with GDM were matched with 118 randomly selected age-matched controls who had no adverse pregnancy outcomes. Participants with GDM were less likely to be Non-Hispanic White (26.3% vs. 40.7%; p = 0.02), had a higher mean BMI (30.7 ± 8.3 vs. 26.1 ± 6.3; p < 0.01), and were less likely to have graduated from college (55.1% vs. 72.0%; p = 0.007). Glyphosate concentrations were above the limit of detection (LOD) in 93.6% of analyzable samples. In the adjusted conditional logistic regression for the matched pairs model, participants with glyphosate in the upper quartile had significantly higher odds of having GDM (odds ratio [OR] 3.27, 95% confidence interval [CI] 1.04–10.3), with the OR of 1.23 (95% CI 1.02–1.47) for the interaction with BMI. Compared to participants with BMI < 25 kg/m2, the adjusted odds of GDM for participants with obese BMI (≥ 30 kg/m2) was elevated (OR 8.52, 95% CI 1.27–57.2). Conclusion First trimester urinary glyphosate concentrations were associated with development of GDM, and the magnitude of this association increased at higher BMI. Trial registry NCT01322529.

Background Extensive academic research has documented the tobacco industry's manipulation of science. Recently, scholars have begun examining the sugar industry’s use of similar tactics to downplay sugar’s role in obesity, diabetes, cardiovascular disease, and tooth decay. Archival records show sugar-industry-funded scientists criticized evidence linking sugar to these harms and deflected attention to other risk factors. Sugar’s connection to tooth decay has been the most difficult harm for the industry to deny. Evidence is emerging that the industry turned to promoting fluoride as the solution to tooth decay thereby averting calls for reducing sugar consumption. Newly accessible sugar and dental industry documents enable investigation into whether fluoride research was manipulated to deflect from sugar’s role in tooth decay, and later to defend fluoride when evidence of fluoride’s own harmful effects arose. Method Internal documents from sugar and dental organizations were examined and compared to the published scientific record. The Industries Documents collection at the University of California San Francisco was the main source of records. Analysis was in the context of the current understanding of how vested interests manipulate science to defend their products. Results Records dating back to the 1930s demonstrate the sugar industry, sometimes in cooperation with dental interests, exaggerated fluoride’s effectiveness and downplayed safety concerns. The sugar industry’s science manipulation campaign preceded the better-known tobacco industry campaign defending cigarettes. Key leaders of the sugar industry’s campaign transferred to the tobacco industry, which then adopted many of the sugar industry’s tactics and financed research from some of the same sugar-conflicted scientists. Currently, a prominent safety issue with fluoride is developmental neurotoxicity. Evidence indicates that researchers with undisclosed conflicts of interest with sugar and allied industries produced biased reviews downplaying this risk. Conclusion Recently available records reveal a long history of the sugar industry distorting fluoride science. Many of the sugar industry's tactics were later adopted by the tobacco industry and mirrored by industries involved in asbestos, lead, pesticides, climate change denial, and others. Researchers and policymakers should be aware of the distorted scientific record regarding fluoride effectiveness and toxicity.

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