First trimester gestational weight gain may need more clinical attention, as it has been identified as an independent and significant risk factor for GDM independent of traditional risk factors, including preconception obesity.

Entering pregnancy with overweight, obesity or gaining excessive gestational weight could increase the risk of gestational diabetes mellitus (GDM), which is associated with negative consequences for both the mother and the offspring. The objective of this article was to review scientific evidence regarding the association between obesity and GDM, and how weight management through nutritional prevention strategies could prove successful in reducing the risk for GDM. Studies published between January 1975 and January 2009 on the relationship between GDM, pre-pregnancy body mass index (BMI), gestational weight gain and nutritional prevention strategies were included in this review. Results from these reports suggest that maternal obesity assessed by pre-pregnancy BMI is associated with an increased risk of GDM. They also show an association between gestational weight gain and increased risk for GDM. Higher dietary fat and lower carbohydrate intakes during pregnancy appear to be associated with a higher risk for GDM, independent of pre-pregnancy BMI. Some studies showed that restricting energy and carbohydrates could minimize gestational weight gain. However, a firm conclusion on the most effective nutritional intervention for the control of gestational weight gain and glycaemic responses could not be reached based on available studies. In light of the studies reviewed, we conclude that weight management through nutritional prevention strategies could be successful in reducing the risk of GDM. Further studies are required to identify the most effective diet composition to prevent GDM and excessive gestational weight gain.

Purpose: To 1) compare dietary intakes of pregnant women with previous bariatric surgery with the Dietary reference intakes (DRIs); 2); compare their dietary intakes as well as their diet quality with a control group of pregnant women with no history of bariatric surgery.Methods: Twenty-eight (28) pregnant women with previous surgery (sleeve gastrectomy, n=7 and biliopancreatic diversion with duodenal switch, n=21) were matched for pre-pregnancy body mass index with 28 pregnant women with no history of surgery. In at least one trimester, participants completed a minimum of 2 Web-based 24-h dietary recalls from which energy, macro-and micronutrient intakes as well as the Canadian Healthy Eating Index (C-HEI) were derived.Results: No differences were observed for energy intake between groups. All women had protein intakes within the recommended range, but most women with previous surgery had carbohydrate (67 %) and dietary ber intakes (98 %) below recommendations. In both groups, mean total fat, saturated fatty acids, free sugars and sodium intakes were above recommendations, as opposed to mean vitamin D, folic acid and iron dietary intakes below recommendations for most women. Compared with the control group, pregnant women with previous bariatric surgery had lower overall C-HEI scores.Conclusion: These results suggest that pregnant women with previous bariatric surgery would bene t from a nutritional follow-up throughout their pregnancy.

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Purpose: To 1) compare dietary intakes of pregnant women with previous bariatric surgery with the Dietary reference intakes (DRIs); 2); compare their dietary intakes as well as their diet quality with a control group of pregnant women with no history of bariatric surgery. Methods: Twenty-eight (28) pregnant women with previous surgery (sleeve gastrectomy, n=7 and biliopancreatic diversion with duodenal switch, n=21) were matched for pre-pregnancy body mass index with 28 pregnant women with no history of surgery. In at least one trimester, participants completed a minimum of 2 Web-based 24-h dietary recalls from which energy, macro- and micronutrient intakes as well as the Canadian Healthy Eating Index (C-HEI) were derived. Results: No differences were observed for energy intake between groups. All women had protein intakes within the recommended range, but most women with previous surgery had carbohydrate (67 %) and dietary fiber intakes (98 %) below recommendations. In both groups, mean total fat, saturated fatty acids, free sugars and sodium intakes were above recommendations, as opposed to mean vitamin D, folic acid and iron dietary intakes below recommendations for most women. Compared with the control group, pregnant women with previous bariatric surgery had lower overall C-HEI scores. Conclusion: These results suggest that pregnant women with previous bariatric surgery would benefit from a nutritional follow-up throughout their pregnancy.Level of evidenceLevel III: Evidence obtained from well-designed cohort or case-control analytic studies