Objective To determine if a low glycaemic index diet in pregnancy could reduce the incidence of macrosomia in an at risk group.

Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142) and intervention group (n = 138), who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle) were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age.

Objective: To determine the main dietary patterns of pregnant women during each of the three trimesters of pregnancy and to examine associated nutrient intakes. Design: Participants completed a 3 d food diary during each trimester of pregnancy. Thirty-six food groups were created and dietary patterns were derived using k-means cluster analysis. Setting: National Maternity Hospital, Dublin, Ireland. Subjects: Two hundred and eighty-five healthy pregnant women aged between 20 and 41 years. Results: Two dietary patterns were identified at each time point. They were labelled 'Unhealthy' (n 143, 150 and 155 at trimester 1, 2 and 3, respectively) and 'Health Conscious' (n 142, 135 and 130 at trimester 1, 2 and 3, respectively). Women in the 'Health Conscious' cluster were significantly older, had lower BMI and were higher educated than those in the 'Unhealthy' cluster. Of those in the 'Unhealthy' cluster in the first trimester (n 143), 103 (72?0 %) continued in this dietary pattern into trimester 2 and eighty-one (56?6 %) continued into trimester 3. Of those in the 'Health Conscious' cluster in trimester 1 (n 142), ninety-five (66?9 %) continued in this dietary pattern into trimester 2 and sixty-nine (48?6 %) continued into trimester 3. Conclusions: Cluster analysis produced two clearly defined dietary patterns at each stage of pregnancy. Knowledge of maternal dietary patterns is important for the development of pregnancy-specific dietary guidelines. Identifying women with an 'Unhealthy' dietary pattern in early pregnancy affords the opportunity for a dietary intervention which may positively impact both maternal and infant health.

BackgroundMaternal diet is known to impact pregnancy outcome. Following a low glycemic index (GI) diet during pregnancy has been shown to improve maternal glycemia and reduce infant birthweight and may be associated with a higher fibre intake. We assessed the impact of a low GI dietary intervention on maternal GI, nutritional intake and gestational weight gain (GWG) during pregnancy. Compliance and acceptability of the low GI diet was also examined.MethodEight hundred women were randomised in early pregnancy to receive low GI and healthy eating dietary advice or to receive standard maternity care. The intervention group received dietary advice at a group education session before 22 weeks gestation. All women completed a 3 day food diary during each trimester of pregnancy. Two hundred and thirty five women from the intervention arm and 285 women from the control arm returned complete 3x3d FDs and were included in the present analysis.ResultsMaternal GI was significantly reduced in the intervention group at trimester 2 and 3. The numbers of women within the lowest quartile of GI increased from 37% in trimester 1 to 52% in trimester 3 (P < 0.001) among the intervention group. The intervention group had significantly lower energy intake (P < 0.05), higher protein (% TE) (P < 0.01) and higher dietary fibre intake (P < 0.01) post intervention. Consumption of food groups with known high GI values were significantly reduced among the intervention group. Women in the intervention low GI group were less likely to exceed the Institute of Medicine’s GWG goals.ConclusionA dietary intervention in early pregnancy had a positive influence on maternal GI, food and nutrient intakes and GWG. Following a low GI diet may be particularly beneficial for women at risk of exceeding the GWG goals for pregnancy.Trial registrationCurrent Controlled Trials Registration Number: ISRCTN54392969.

Infant birth weight has increased in Ireland in recent years along with levels of childhood overweight and obesity. The present article reviews the current literature on maternal glycaemia and the role of the dietary glycaemic index (GI) and its impact on pregnancy outcomes. It is known that maternal weight and weight gain significantly influence infant birth weight. Fetal macrosomia (birth weight >4000 g) is associated with an increased risk of perinatal trauma to both mother and infant. Furthermore, macrosomic infants have greater risk of being obese in childhood, adolescence and adulthood compared to normal-sized infants. There is evidence that there is a direct relationship between maternal blood glucose levels during pregnancy and fetal growth and size at birth, even when maternal blood glucose levels are within their normal range. Thus, maintaining blood glucose concentrations within normal parameters during pregnancy may reduce the incidence of fetal macrosomia. Maternal diet, and particularly its carbohydrate (CHO) type and content, influences maternal blood glucose concentrations. However, different CHO foods produce different glycaemic responses. The GI was conceived by Jenkins in 1981 as a method for assessing the glycaemic responses of different CHO. Data from clinical studies in healthy pregnant women have documented that consuming a low-GI diet during pregnancy reduces peaks in postprandial glucose levels and normalises infant birth weight. Pregnancy is a physiological condition where the GI may be of particular relevance as glucose is the primary fuel for fetal growth.

Background/Objectives: Pregnancy is a critical period in a woman's life where nutrition is of key importance for optimal pregnancy outcome. The aim of this study was to assess maternal nutrient intakes during early pregnancy and to examine potential levels of energy underreporting. Subjects/Methods: Three-day food diaries were collected from 260 healthy pregnant women sampled from the control arm of a large Irish pregnancy cohort at 14 weeks gestation (range 12-20 weeks). Results: Up to 45% of pregnant women may be underreporting daily energy intake (EI). Multiple logistic regression analysis found that having a body mass index (BMI) of X25 kg/m 2 compared with a BMI o25 kg/m 2 (odds ratio, 4.4; 95% confidence interval, 2.5-7.7) was the main predictor of energy underreporting. Educational attainment is also an important predictor of energy underreporting. Women who underreport their EI tend to be less compliant with the current dietary recommendations for pregnancy. Conclusions: These data highlight the need for more education and public health interventions among pregnant women to achieve current dietary guidelines. In the analysis of dietary intakes, removal of extreme under reporters (Goldberg's ratio o0.9) may allow for more accurate assessment of nutritional intakes amongst pregnant women.

Objective: To compare maternal characteristics, obstetric outcomes and insulin resistance in a cohort of women subdivided into those who did and those who did not exceed the Institute of Medicine (IOM) gestational weight gain guidelines. Methods: This is a prospective study of 621 women without diabetes. Concentrations of glucose, insulin and leptin were measured in early pregnancy and at 28 weeks. Ultrasound at 34 weeks assessed fetal anthropometry including abdominal wall width (AAW). At delivery birthweight was recorded and fetal glucose, C-peptide and leptin measured in cord blood. Insulin resistance was calculated using the HOMA equation. Outcomes in those who did and did not exceed IOM guidelines were compared. Results: Overall, 267 women (43%) exceeded IOM guidelines and 354 (57%) did not. On 34-week ultrasound women with excessive weight gain had higher fetal weights (2681 6 356 g vs. 2574 6 331, P 5 0.001) and fetal adiposity (AAW) (5.29 6 1.3 vs. 4.8 6 1.2, P 5 0.001). Infant birthweight and birthweight centiles were also higher in those who exceeded the guidelines. There was no difference between the two groups in maternal insulin resistance in early pregnancy, but by 28 weeks those with excessive weight gain had higher maternal HOMA indices and higher maternal leptin concentrations. Conclusion: Excessive maternal gestational weight gain has significant implications for infant growth and adiposity, with potential implications for later adult health.

BackgroundMicronutrients are necessary for fetal growth. However increasingly pregnant women are nutritionally replete and little is known about the effect of maternal micronutrient intakes on fetal adiposity in mothers with increased BMI. The aim of this study was to examine the association of maternal dietary micronutrient intake with neonatal size and adiposity in a cohort at risk of macrosomia.MethodsThis was a cohort analysis of 554 infants from the ROLO study. Three day food diaries from each trimester were collected. Neonatal weight, length, circumferences and skinfold thicknesses were measured at birth. Multiple linear regression was used to identify associations between micronutrient intakes and neonatal anthropometry.ResultsBirthweight was negatively associated with maternal trimester 3 vitamin D intake and positively associated with trimester 3 vitamin B12 intake R2adj 19.8 % (F = 13.19, p <0.001). Birth length was positively associated with trimester 3 magnesium intake R2adj 12.9 % (F = 8.06, p <0.001). In terms of neonatal central adiposity; abdominal circumference was positively associated with maternal trimester 3 retinol intake and negatively associated with trimester 3 vitamin E and selenium intake R2adj 11.9 % (F = 2.93, p = 0.002), waist:length ratio was negatively associated with trimester 3 magnesium intake R2adj 20.1 % (F = 3.92, p <0.001) and subscapular:triceps skinfold ratio was negatively associated with trimester 1 selenium intake R2adj7.2 % (F = 2.00, p = 0.047).ConclusionsMaternal micronutrient intake was associated with neonatal anthropometry even in women not at risk of malnutrition. Further research is necessary to determine optimal micronutrient intake in overweight and obese pregnant women.Trial registrationCurrent Controlled Trials ISRCTN54392969.Electronic supplementary materialThe online version of this article (doi:10.1186/s12937-015-0095-z) contains supplementary material, which is available to authorized users.