Effect of a low glycaemic index diet in gestational diabetes mellitus on post‐natal outcomes after 3 months of birth: a pilot follow‐up study

Abstract

A low glycaemic index (LGI) diet during pregnancy complicated by gestational diabetes mellitus (GDM) may offer benefits to the mother and infant pair beyond those during pregnancy. We aimed to investigate the effect of an LGI diet during pregnancy complicated with GDM on early post-natal outcomes. Fifty-eight women (age: 23-41 years; mean ± SD pre-pregnancy body mass index: 24.5 ± 5.6 kg m(-2) ) who had GDM and followed either an LGI diet (n = 33) or a conventional high-fibre diet (HF; n = 25) during pregnancy had a 75-g oral glucose tolerance test and blood lipid tests at 3 months post-partum. Anthropometric assessments were conducted for 55 mother-infant pairs. The glycaemic index of the antenatal diets differed modestly (mean ± SD: 46.8 ± 5.4 vs. 52.4 ± 4.4; P < 0.001), but there were no significant differences in any of the post-natal outcomes. In conclusion, an LGI diet during pregnancy complicated by GDM has outcomes similar to those of a conventional healthy diet. Adequately powered studies should explore the potential beneficial effects of LGI diet on risk factors for chronic disease.

Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age—Analysis from the ROLO Randomised Controlled Trial

“…The finding that maternal BMI was significantly higher in the intervention group at 6 months of age was unexpected. Very few studies have examined the effect of low GI diet during pregnancy on maternal diet or weight postpartum except two studies of euglycaemic women [ 49 , 63 ] and three studies of women with gestational diabetes [ 46 , 47 , 48 ]. While the study by Moses et al [ 64 ] did not examine maternal anthropometry at 2 years postpartum , it found that women had reverted to pre-intervention dietary intakes.…”

“…However, dietary intake was not examined at 3 months postpartum . Studies of women with gestational diabetes have observed poor adherence to dietary change postpartum with one study finding that low GI dietary advice vs. traditional high fibre advice resulted in no significant difference in maternal weight at 3 months postpartum [ 48 ], another finding that healthy dietary changes were not sustained at 6 months postpartum [ 46 ] and another finding that although women reported being concerned about developing type II diabetes, more women had gained weight than had lost weight at 11–42 months postpartum although the number of women reporting consuming a high fat diet had decreased from that reported pre-pregnancy [ 47 ]. The finding of the current study that women in the intervention group had higher BMI at 6 months postpartum may be a chance finding as, unlike the total cohort, the intervention group of this follow-up cohort did not have significantly lower gestational weight gain than the control group and there was a high percentage of women lost to follow-up as unfortunately the 6 months study was not possible to begin until many of the infants were over 9 months of age and no longer eligible.…”

“…There has been little research into the effect of low GI healthy eating interventions in pregnancy on maternal weight postpartum except in the case of gestational diabetes interventions which have shown little success after pregnancy [ 46 , 47 , 48 ]. Women from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet versus no dietary intervention to prevent recurrence of fetal macrosomia) study were found to have reduced weight gain and greater reported dietary health behaviours such as food label reading diet at 3 months postpartum but there was no significant difference in weight or BMI between the control and intervention groups at this time point [ 49 ].…”

High protein diet promotes body weight loss among Brazilian postpartum women

“…Furthermore, the literature has shown the benefits of a high protein diet on weight change (Castro et al, ; Soenen et al, ; Wycherley, Moran, Clifton, Noakes, & Brinkworth, ), diet‐induced thermogenesis (Westerterp, ), and a satiating effect, which could be important factors for weight loss and weight management during the postpartum period (Cuenca‐Sánchez, Navas‐Carrillo, & Orenes‐Piñero, ; Pesta & Samuel, ). Moreover, a high protein diet has a lower glycaemic index that seems to be more effective for body weight loss (Horan, McGowan, Gibney, Donnelly, & McAuliffe, ; Radulian, Rusu, Dragomir, & Posea, ); however, this finding is still controversial (Louie, Markovic, Ross, Foote, & Brand‐Miller, ). According to a study conducted by Thomas, Elliott, Fau, Baur, and Baur (), lowering the glycaemic load in the diet appears to be a more effective method of promoting weight loss and improving lipid profiles and can be more easily incorporated into a person's lifestyle when compared with conventional and highly restricted energy and low‐fat diets.…”

“…This result indicates that protein intake may be an important dietary tool to increase weight loss during the postpartum period. Future studies should be performed to evaluate whether this difference persists over a longer postpartum period (Louie et al, ). With our results, we were able to verify a higher body weight loss during the postpartum period.…”