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Nutrition for Gestational Diabetes

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (31 December 2019) | Viewed by 97481

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Special Issue Editor

Dr. Clive J. Petry

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Guest Editor

School of Clinical Medicine, Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
Interests: diabetes; metabolism; hypertension; growth; development; imprinted genes; biomarkers; nutritional therapies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Gestational diabetes mellitus (GDM) is one of the most common adverse medical conditions that occurs during pregnancy, and its prevalence is rising as part of a diabetes pandemic. Nutrition plays a key role in GDM, whether (1) as part of an ‘unhealthy’ diet, which contributes to its cause, or (2) as part of changes in dietary intake, which act as the frontline treatment for GDM (sometimes supplemented with exercise and pharmacological intervention). Dietary changes, therefore, can alter the risk of developing GDM in the first place, and once GDM has emerged during pregnancy, dietary changes can mitigate the risk of developing GDM-related complications, such as macrosomia, respiratory distress, hypoglycemia and jaundice in the neonate, pre‑eclampsia, increased need for caesarean section and placental abruption in the mother. In this Special Issue, we aim to highlight the role of nutrition in the aetiology of GDM, whether directly or indirectly through weight gain and obesity, and in its role as a GDM treatment to lower hyperglycemia and the risk of the aforementioned complications.

Dr. Clive J. Petry
Guest Editor

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Keywords

diabetes
pregnancy
carbohydrate
glycemic index
fat
protein
fiber
vitamins
epidemiology
treatment

Published Papers (14 papers)

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Editorial

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6 pages, 204 KiB

Open AccessEditorial

Nutrition for Gestational Diabetes—Progress and Potential

by Clive J. Petry

Nutrients 2020, 12(9), 2685; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12092685 - 03 Sep 2020

Cited by 4 | Viewed by 3540

Abstract

Gestational diabetes (GDM), traditionally defined as any form of glucose intolerance first detected in pregnancy [...] Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

Research

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9 pages, 418 KiB

Open AccessArticle

Self-Reported Eating Speed and Incidence of Gestational Diabetes Mellitus: the Japan Environment and Children’s Study

by Jia-Yi Dong, Satoyo Ikehara, Takashi Kimura, Meishan Cui, Yoko Kawanishi, Tadashi Kimura, Kimiko Ueda, Hiroyasu Iso and the Japan Environment and Children’s Study Group

Nutrients 2020, 12(5), 1296; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12051296 - 02 May 2020

Cited by 7 | Viewed by 3214

Abstract

There is little evidence linking eating speed to gestational diabetes mellitus (GDM) incidence. We therefore aimed to evaluate the prospective association of eating speed with GDM incidence. Overall, 97,454 pregnant women were recruited between January 2011 and March 2014. Singleton pregnant women who did not have GDM, heart disease, stroke, cancer, type 1 diabetes, and/or type 2 diabetes at the time of study enrollment were eligible. Each woman was asked about her eating speed at that time via a questionnaire. Odds ratios of GDM in relation to eating speed were obtained using logistic regression. Among the 84,811 women eligible for analysis, 1902 cases of GDM were identified in medical records. Compared with women who reported slow eating speed, the age-adjusted odds ratios (95% confidence interval) of GDM for women who reported medium, relatively fast, or very fast eating speed were 1.03 (0.90, 1.18), 1.07 (0.94, 1.23), and 1.28 (1.05, 1.58), respectively. Adjustment for demographic, lifestyle-related, and dietary factors including dietary fat, dietary fiber, and energy intakes yielded similar results. The association was attenuated and no longer significant after further adjustment for pre-pregnancy body mass index. The mediation analysis showed that being overweight accounted for 64% of the excess risk of GDM associated with eating speed. In conclusion, women who reported very fast eating speed, compared with those reporting slow eating speed, were associated with an increased incidence of GDM, which may be largely mediated by increased body fat. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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12 pages, 991 KiB

Open AccessArticle

Methylglyoxal, Glycated Albumin, PAF, and TNF-α: Possible Inflammatory and Metabolic Biomarkers for Management of Gestational Diabetes

by Gabriele Piuri, Katia Basello, Gabriele Rossi, Chiara Maria Soldavini, Silvia Duiella, Giulia Privitera, Angela Spadafranca, Andrea Costanzi, Emiliana Tognon, Mattia Cappelletti, Paola Antonia Corsetto, Angela Maria Rizzo, Attilio Francesco Speciani and Enrico Ferrazzi

Nutrients 2020, 12(2), 479; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12020479 - 14 Feb 2020

Cited by 22 | Viewed by 5192

Abstract

Background: In gestational diabetes mellitus (GDM), pancreatic β-cell breakdown can result from a proinflammatory imbalance created by a sustained level of cytokines. In this study, we investigated the role of specific cytokines, such as B-cell activating factor (BAFF), tumor necrosis factor α (TNF-α), and platelet-activating factor (PAF), together with methylglyoxal (MGO) and glycated albumin (GA) in pregnant women affected by GDM. Methods: We enrolled 30 women whose inflammation and metabolic markers were measured at recruitment and after 12 weeks of strict dietetic therapy. We compared these data to the data obtained from 53 randomly selected healthy nonpregnant subjects without diabetes, hyperglycemia, or any condition that can affect glycemic metabolism. Results: In pregnant women affected by GDM, PAF levels increased from 26.3 (17.4–47.5) ng/mL to 40.1 (30.5–80.5) ng/mL (p < 0.001). Their TNF-α levels increased from 3.0 (2.8–3.5) pg/mL to 3.4 (3.1–5.8) pg/mL (p < 0.001). The levels of methylglyoxal were significantly higher in the women with GDM (p < 0.001), both at diagnosis and after 12 weeks (0.64 (0.46–0.90) μg/mL; 0.71 (0.47–0.93) μg/mL, respectively) compared to general population (0.25 (0.19–0.28) μg/mL). Levels of glycated albumin were significantly higher in women with GDM (p < 0.001) only after 12 weeks from diagnosis (1.51 (0.88–2.03) nmol/mL) compared to general population (0.95 (0.63–1.4) nmol/mL). Conclusion: These findings support the involvement of new inflammatory and metabolic biomarkers in the mechanisms related to GDM complications and prompt deeper exploration into the vicious cycle connecting inflammation, oxidative stress, and metabolic results. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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12 pages, 857 KiB

Open AccessArticle

Effect of High Versus Low Carbohydrate Intake in the Morning on Glycemic Variability and Glycemic Control Measured by Continuous Blood Glucose Monitoring in Women with Gestational Diabetes Mellitus—A Randomized Crossover Study

by Louise Rasmussen, Maria Lund Christensen, Charlotte Wolff Poulsen, Charlotte Rud, Alexander Sidelmann Christensen, Jens Rikardt Andersen, Ulla Kampmann and Per Glud Ovesen

Nutrients 2020, 12(2), 475; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12020475 - 13 Feb 2020

Cited by 22 | Viewed by 6927

Abstract

Carbohydrate is the macronutrient that has the greatest impact on blood glucose response. Limited data are available on how carbohydrate distribution throughout the day affects blood glucose in women with gestational diabetes mellitus (GDM). We aimed to assess how a high-carbohydrate morning-intake (HCM) versus a low-carbohydrate-morning-intake (LCM), affect glycemic variability and glucose control. In this randomized crossover study continuous glucose monitoring (CGM) was performed in 12 women with diet treated GDM (75 g, 2-h OGTT ≥ 8.5 mmol/L), who went through 2 × 3 days of HCM and LCM. A within-subject-analysis showed a significantly higher mean amplitude of glucose excursions (MAGE) (0.7 mmol/L, p = 0.004) and coefficient of variation (CV) (5.1%, p = 0.01) when comparing HCM with LCM, whereas a significantly lower mean glucose (MG) (−0.3 mmol/L, p = 0.002) and fasting blood glucose (FBG) were found (−0.4 mmol/L, p = 0.01) on the HCM diet compared to the LCM diet. In addition, insulin resistance, expressed as Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), decreased significantly during HCM. Results indicate that a carbohydrate distribution of 50% in the morning favors lower blood glucose and improvement in insulin sensitivity in women with GDM, but in contrary gives a higher glycemic variability. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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12 pages, 728 KiB

Open AccessArticle

Influence of GDM Diagnosis and Treatment on Weight Gain, Dietary Intake and Physical Activity in Pregnant Women with Obesity: Secondary Analysis of the UPBEAT Study

by La’Shay Atakora, Lucilla Poston, Louise Hayes, Angela C. Flynn and Sara L. White

Nutrients 2020, 12(2), 359; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12020359 - 30 Jan 2020

Cited by 13 | Viewed by 3536

Abstract

Obesity during pregnancy is associated with the development of gestational diabetes (GDM). This study aimed to assess if the result of an oral glucose tolerance test (OGTT) for GDM influences health (diet and physical activity) behaviours of pregnant women with obesity. In total, 1031 women who participated in the UK Pregnancies Better Eating and Activity Trial (UPBEAT) of a lifestyle intervention from early pregnancy were included. Changes in weight gain, dietary intake and physical activity following an OGTT undertaken between 27⁺⁰ and 28⁺⁶ weeks’ and 34 and 36 weeks’ gestation were examined using linear regression with appropriate adjustment for confounders. Obese women without GDM (IADPSG criteria) gained 1.9 kg (95% CI −2.2, −1.5, p < 0.001) more weight than women with GDM. Women with GDM demonstrated greater reductions in energy (–142kcal, 95%CI −242.2, −41.9, p = 0.006), carbohydrate intake (−1.5%E 95%CI –2.8, −0.3, p = 0.016) and glycaemic load (–15.2, 95%CI −23.6, –6.7, p < 0.001) and a greater increase in protein intake (2%E, 95%CI 1.3, 2.7, p < 0.001), compared to women without GDM. Trial intervention allocation did not influence any associations observed. The findings emphasise the need for strategies to optimise the health behaviours of pregnant women with obesity, following a negative OGTT for GDM. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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18 pages, 1847 KiB

Open AccessArticle

The Role of Glycemic Index and Glycemic Load in the Development of Real-Time Postprandial Glycemic Response Prediction Models for Patients with Gestational Diabetes

by Evgenii Pustozerov, Aleksandra Tkachuk, Elena Vasukova, Aleksandra Dronova, Ekaterina Shilova, Anna Anopova, Faina Piven, Tatiana Pervunina, Elena Vasilieva, Elena Grineva and Polina Popova

Nutrients 2020, 12(2), 302; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12020302 - 23 Jan 2020

Cited by 14 | Viewed by 19828

Abstract

The incorporation of glycemic index (GI) and glycemic load (GL) is a promising way to improve the accuracy of postprandial glycemic response (PPGR) prediction for personalized treatment of gestational diabetes (GDM). Our aim was to assess the prediction accuracy for PPGR prediction models with and without GI data in women with GDM and healthy pregnant women. The GI values were sourced from University of Sydney’s database and assigned to a food database used in the mobile app DiaCompanion. Weekly continuous glucose monitoring (CGM) data for 124 pregnant women (90 GDM and 34 control) were analyzed together with records of 1489 food intakes. Pearson correlation (R) was used to quantify the accuracy of predicted PPGRs from the model relative to those obtained from CGM. The final model for incremental area under glucose curve (iAUC120) prediction chosen by stepwise multiple linear regression had an R of 0.705 when GI/GL was included among input variables and an R of 0.700 when GI/GL was not included. In linear regression with coefficients acquired using regularization methods, which was tested on the data of new patients, R was 0.584 for both models (with and without inclusion of GI/GL). In conclusion, the incorporation of GI and GL only slightly improved the accuracy of PPGR prediction models when used in remote monitoring. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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15 pages, 1239 KiB

Open AccessArticle

Dietary Patterns and Dietary Adaptations in Women With and Without Gestational Diabetes: Evidence From the Growing Up in New Zealand Study

by Robyn L. Lawrence, Clare R. Wall and Frank H. Bloomfield

Nutrients 2020, 12(1), 227; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12010227 - 15 Jan 2020

Cited by 5 | Viewed by 4126

Abstract

Diet is a cornerstone of the management of gestational diabetes (GDM). We investigated differences in dietary patterns and dietary adaptations among pregnant women with and without GDM participating in the Growing Up in New Zealand study. Presence of GDM was determined using coded clinical data and plasma glucose results meeting the New Zealand Society for the Study of Diabetes diagnostic criteria. Women answered a food frequency questionnaire and questions regarding dietary changes and information received during pregnancy. Women with GDM had lower adherence scores than those without GDM for ‘Junk’ (mean (SD) score −0.28 (0.95) versus 0.02 (1.01) p < 0.0005) and ‘Traditional/White bread’ dietary patterns (−0.18 (0.93) versus 0.01 (1.01) p = 0.002). More women with GDM reported avoiding foods high in fat or sugar (25.3% versus 5.7%, p < 0.05) compared to women without GDM. A greater proportion of women with GDM compared with those without GDM received information from dietitians or nutritionists (27.0% versus 1.7%, p < 0.05) or obstetricians (12.6% versus 7.5%, p < 0.05). More women diagnosed before the antenatal interview received advice from dietitians or nutritionists compared with those diagnosed after (46.9% versus 6.0%, p < 0.05). Women with GDM appear to make positive changes to their diet in response to advice received from health care professionals. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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15 pages, 806 KiB

Open AccessCommunication

Influence of Diabetes during Pregnancy on Human Milk Composition

by Chiara Peila, Diego Gazzolo, Enrico Bertino, Francesco Cresi and Alessandra Coscia

Nutrients 2020, 12(1), 185; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12010185 - 09 Jan 2020

Cited by 42 | Viewed by 5870

Abstract

Human milk (HM) is a unique nourishment believed to contain biological factors contributing to both short and long-term benefits. Considering that a mother’s own milk is often considered the first choice for nutrition of neonates, an aspect of increased interest is the possible effect of diabetes on the mammary gland and therefore on breast milk composition. This article aims to review the published literature on this topic, and to offer additional insights on the role of this disease on the composition of HM. This review was performed by searching the MEDLINE, EMBASE, CINHAL and Cochrane Library databases. A total of 50 articles were selected, focused specifically on one of the two types of diabetes: gestational diabetes mellitus (21 studies) and insulin-dependent diabetes mellitus (8 studies). Overall, the findings from the literature suggest that diabetes can alter the composition of HM. Nevertheless, the studies in this field are scarce, and the related protocols present some limitations, e.g., evaluating the variability of just a few specific milk biochemical markers in association with this syndrome. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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16 pages, 433 KiB

Open AccessArticle

Temporal Trends in Maternal Food Intake Frequencies and Associations with Gestational Diabetes: The Cambridge Baby Growth Study

by Clive J. Petry, Ken K. Ong, Ieuan A. Hughes, Carlo L. Acerini and David B. Dunger

Nutrients 2019, 11(11), 2822; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11112822 - 19 Nov 2019

Cited by 8 | Viewed by 4324

Abstract

Previous studies have suggested that in the first decade of this century the incidence of gestational diabetes (GDM) in pregnancy rose worldwide. In the Cambridge Baby Growth Study cohort we observed that this temporal trend was associated with an index of multiple deprivation and reductions in indices of insulin secretion. Deprivation level was not directly associated with GDM, suggesting that the temporal trend may relate more to other factors linked to it, such as dietary composition. In this study we investigated temporal trends in perceived food intake frequencies, derived from a qualitative, short questionnaire, in 865 pregnant Cambridge Baby Growth Study (CBGS) recruits. A number of food frequency ranks showed both temporal trends and associations with GDM, but of note is the frequency of egg consumption (negative temporal trend p = 0.03, slope = −6.2 ranks/year; negative association with GDM p = 3.0 × 10⁻⁸, slope = −0.002 increased risk/rank) as it was also positively associated with the insulin disposition index (p = 1.17 × 10⁻³, slope = 0.42 ranks. L/mmoL). These results are consistent with a potential protective effect of factors related to the frequency of egg consumption in pregnancy. Such factors may have contributed to the observed temporal trend in GDM risk but the overall detectable effect appears to have been small. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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10 pages, 1623 KiB

Open AccessArticle

Ketonuria Is Associated with Changes to the Abundance of Roseburia in the Gut Microbiota of Overweight and Obese Women at 16 Weeks Gestation: A Cross-Sectional Observational Study

by Helen Robinson, Helen Barrett, Luisa Gomez-Arango, H. David McIntyre, Leonie Callaway and Marloes Dekker Nitert

Nutrients 2019, 11(8), 1836; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11081836 - 08 Aug 2019

Cited by 11 | Viewed by 3722

Abstract

The gut microbiome in pregnancy has been associated with various maternal metabolic and hormonal markers involved in glucose metabolism. Maternal ketones are of particular interest due to the rise in popularity of low-carbohydrate diets. We assessed for differences in the composition of the gut microbiota in pregnant women with and without ketonuria at 16 weeks gestation. Fecal samples were obtained from 11 women with fasting ketonuria and 11 matched controls. The samples were analyzed to assess for differences in gut microbiota composition by 16S rRNA sequencing. Supervised hierarchical clustering analysis showed significantly different beta-diversity between women with and without ketonuria, but no difference in the alpha-diversity. Group comparisons and network analysis showed that ketonuria was associated with an increased abundance of the butyrate-producing genus Roseburia. The bacteria that contributed the most to the differences in the composition of the gut microbiota included Roseburia, Methanobrevibacter, Uncl. RF39, and Dialister in women with ketonuria and Eggerthella, Phascolarctobacterium, Butyricimonas, and Uncl. Coriobacteriaceae in women without ketonuria. This study found that the genus Roseburia is more abundant in the gut microbiota of pregnant women with ketonuria. Roseburia is a butyrate producing bacterium and may increase serum ketone levels. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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Review

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18 pages, 1052 KiB

Open AccessReview

Leptin and Nutrition in Gestational Diabetes

by Antonio Pérez-Pérez, Teresa Vilariño-García, Pilar Guadix, José L. Dueñas and Víctor Sánchez-Margalet

Nutrients 2020, 12(7), 1970; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12071970 - 02 Jul 2020

Cited by 45 | Viewed by 10375

Abstract

Leptin is highly expressed in the placenta, mainly by trophoblastic cells, where it has an important autocrine trophic effect. Moreover, increased leptin levels are found in the most frequent pathology of pregnancy: gestational diabetes, where leptin may mediate the increased size of the placenta and the fetus, which becomes macrosomic. In fact, leptin mediates the increased protein synthesis, as observed in trophoblasts from gestational diabetic subjects. In addition, leptin seems to facilitate nutrients transport to the fetus in gestational diabetes by increasing the expression of the glycerol transporter aquaporin-9. The high plasma leptin levels found in gestational diabetes may be potentiated by leptin resistance at a central level, and obesity-associated inflammation plays a role in this leptin resistance. Therefore, the importance of anti-inflammatory nutrients to modify the pathology of pregnancy is clear. In fact, nutritional intervention is the first-line approach for the treatment of gestational diabetes mellitus. However, more nutritional intervention studies with nutraceuticals, such as polyphenols or polyunsaturated fatty acids, or nutritional supplementation with micronutrients or probiotics in pregnant women, are needed in order to achieve a high level of evidence. In this context, the Mediterranean diet has been recently found to reduce the risk of gestational diabetes in a multicenter randomized trial. This review will focus on the impact of maternal obesity on placental inflammation and nutrients transport, considering the mechanisms by which leptin may influence maternal and fetal health in this setting, as well as its role in pregnancy pathologies. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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15 pages, 483 KiB

Open AccessReview

Bisphenol A and Phthalates in Diet: An Emerging Link with Pregnancy Complications

by Tiziana Filardi, Francesca Panimolle, Andrea Lenzi and Susanna Morano

Nutrients 2020, 12(2), 525; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12020525 - 19 Feb 2020

Cited by 62 | Viewed by 8366

Abstract

Endocrine-disrupting chemicals (EDCs) are exogenous substances that are able to interfere with hormone action, likely contributing to the development of several endocrine and metabolic diseases. Among them, Bisphenol A (BPA) and phthalates contaminate food and water and have been largely studied as obesogenic agents. They might contribute to weight gain, insulin resistance and pancreatic β-cell dysfunction in pregnancy, potentially playing a role in the development of pregnancy complications, such as gestational diabetes mellitus (GDM), and adverse outcomes. Pregnancy and childhood are sensitive windows of susceptibility, and, although with not univocal results, preclinical and clinical studies have suggested that exposure to BPA and phthalates at these stages of life might have an impact on the development of metabolic diseases even many years later. The molecular mechanisms underlying this association are largely unknown, but adipocyte and pancreatic β-cell dysfunction are suspected to be involved. Remarkably, transgenerational damage has been observed, which might be explained by epigenetic changes. Further research is needed to address knowledge gaps and to provide preventive measure to limit health risks connected with exposure to EDCs. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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17 pages, 337 KiB

Open AccessReview

The Role of Dietary Carbohydrates in Gestational Diabetes

by Vikkie A. Mustad, Dieu T.T. Huynh, José M. López-Pedrosa, Cristina Campoy and Ricardo Rueda

Nutrients 2020, 12(2), 385; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12020385 - 31 Jan 2020

Cited by 36 | Viewed by 12008

Abstract

Gestational diabetes (GDM) is hyperglycemia that is recognized for the first time during pregnancy. GDM is associated with a wide range of short- and long-term adverse health consequences for both mother and offspring. It is a complex disease with a multifactorial etiology, with disturbances in glucose, lipid, inflammation and gut microbiota. Consequently, its management is complex, requiring patients to self-manage their diet, lifestyle and self-care behaviors in combination with use of insulin. In addition to nutritional recommendations for all pregnant women, special attention to dietary carbohydrate (CHO) amount and type on glucose levels is especially important in GDM. Dietary CHO are diverse, ranging from simple sugars to longer-chain oligo- and poly- saccharides which have diverse effects on blood glucose, microbial fermentation and bowel function. Studies have established that dietary CHO amount and type can impact maternal glucose and nutritional recommendations advise women with GDM to limit total intake or choose complex and low glycemic CHO. However, robust maternal and infant benefits are not consistently shown. Novel approaches which help women with GDM adhere to dietary recommendations such as diabetes-specific meal replacements (which provide a defined and complete nutritional composition with slowly-digested CHO) and continuous glucose monitors (which provide unlimited monitoring of maternal glycemic fluctuations) have shown benefits on both maternal and neonatal outcomes. Continued research is needed to understand and develop tools to facilitate patient adherence to treatment goals, individualize interventions and improve outcomes. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

17 pages, 595 KiB

Open AccessReview

How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses

by Delphine Mitanchez, Cécile Ciangura and Sophie Jacqueminet

Nutrients 2020, 12(2), 353; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12020353 - 29 Jan 2020

Cited by 20 | Viewed by 4971

Abstract

Gestational diabetes (GDM) has deleterious effects on the offspring. Maternal obesity and excessive gestational weight gain (GWG), often associated with diabetes, also contribute to these adverse outcomes. Objectives: To assess the benefit for the offspring of maternal lifestyle interventions, including diets and physical activity, to prevent or to improve GDM and to limit excessive GWG. Method: Systematic review of meta-analyses published in English between December 2014 and November 2019. Results: Lifestyle interventions to reduce the risk of GDM reported a decreased risk of 15% to 40%, with a greater effect of exercise compared to diet. Combined lifestyle interventions specifically designed to limit GWG reduced GWG by 1.6 kg in overweight and obese women, and on average by 0.7 to 1 kg in all pregnant women. In these trials, adverse neonatal outcomes were poorly studied. Combined lifestyle interventions in women with GDM significantly reduced fetal growth. Altogether, lifestyle interventions reduced the risk of preterm birth and shoulder dystocia, but individually, diets or exercise alone had no effect on neonatal adverse outcomes. Conclusion: Specific maternal, neonatal and offspring benefits of lifestyle interventions during pregnancy to prevent or improve GDM control or to limit GWG still require clarification. Full article

(This article belongs to the Special Issue Nutrition for Gestational Diabetes)

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