Abstract

The increased prevalence of obese, pregnant women who have a higher risk of glucose intolerance warrants the need for nutritional interventions to improve maternal glucose homeostasis. In this study, the effect of a low-glycemic load (GL) (n = 28) was compared to a high-GL (n = 34) dietary intervention during the second half of pregnancy in obese women (body mass index (BMI) > 30 or a body fat >35%). Anthropometric and metabolic parameters were assessed at baseline (20 week) and at 28 and 34 weeks gestation. For the primary outcome 3h-glucose-iAUC (3h-incremental area under the curve), mean between-group differences were non-significant at every study timepoint (p = 0.6, 0.3, and 0.8 at 20, 28, and 34 weeks, respectively) and also assessing the mean change over the study period (p = 0.6). Furthermore, there was no statistically significant difference between the two intervention groups for any of the other examined outcomes (p ≥ 0.07). In the pooled cohort, there was no significant effect of dietary GL on any metabolic or anthropometric outcome (p ≥ 0.2). A post hoc analysis comparing the study women to a cohort of overweight or obese pregnant women who received only routine care showed that the non-study women were more likely to gain excess weight (p = 0.046) and to deliver large-for-gestational-age (LGA) (p = 0.01) or macrosomic (p = 0.006) infants. Thus, a low-GL diet consumed during the last half of pregnancy did not improve pregnancy outcomes in obese women, but in comparison to non-study women, dietary counseling reduced the risk of adverse outcomes.

Highlights

  • The prevalence of obesity in pregnancy is increasing worldwide and the health consequences are substantial for both the mother and her newborn

  • These physiological adjustments may be enhanced in obese, pregnant women as elevated levels of insulin resistance preconception and in early gestation will increase the risk of glucose intolerance and fetal overgrowth in late gestation [11]

  • In a study comparing pregnancy outcomes in lean and obese women, we found that the obese women had a significantly greater postprandial glucose and insulin response to a high glycemic index (GI) breakfast compared to a low glycemic meal [18]

Read more

Summary

Introduction

The prevalence of obesity in pregnancy is increasing worldwide and the health consequences are substantial for both the mother and her newborn. Pregnancy involves a progressive increase in insulin resistance beginning mid-gestation that reduces maternal glucose utilization and, facilitates glucose uptake by the fetal-placental compartment to promote fetal growth [8,9,10]. These physiological adjustments may be enhanced in obese, pregnant women as elevated levels of insulin resistance preconception and in early gestation will increase the risk of glucose intolerance and fetal overgrowth in late gestation [11]. Several meta-analyses have associated a high GL diet with an increased risk of type 2 diabetes [13,14,15,16]

Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call