A pregnancy lifestyle intervention to prevent gestational diabetes risk factors in overweight Hispanic women: a feasibility randomized controlled trial

Abstract

AIMS: To pilot the feasibility of a prenatal lifestyle intervention to modify physical activity and diet among pregnant overweight and obese Hispanic women, with the aim of reducing risk factors for gestational diabetes mellitus. METHODS: Women were randomized either to a lifestyle intervention (n = 33, 48.5%), consisting of a culturally and linguistically modified, motivationally targeted, individually tailored 6-month prenatal programme, or to standard care (n = 35, 51.5%). Bilingual and bicultural health educators encouraged women to achieve guidelines for physical activity, decrease saturated fat and increase dietary fibre. Outcomes included gestational weight gain, infant birth weightand biomarkers associated with insulin resistance. RESULTS: Patient retention up to delivery was 97% in both study groups. The lifestyle intervention attenuated the pregnancy-associated decline in moderate-intensity physical activity, but differences between groups were not significant (mean +/- se -23.4 +/- 16.6 vs -27.0 +/- 16.2 metabolic equivalent of task h/week; P = 0.88). Vigorous-intensity activity increased during the course of pregnancy in the lifestyle intervention group (mean +/- se 1.6 +/- 0.8 metabolic equivalent of task h/week) and declined in the standard care group (-0.8 +/- 0.8 metabolic equivalent of task h/week; P = 0.04). The lifestyle intervention group also had slightly lower gestational weight gain and infant birth weights compared with the standard care group; however, these differences were not statistically significant. There were no statistically significant differences in biomarkers of insulin resistance between groups. CONCLUSIONS: Findings suggest that a motivationally matched lifestyle intervention is feasible and may help attenuate pregnancy-related decreases in vigorous physical activity in a population of overweight and obese Hispanic women. The intervention protocol can readily be translated into clinical practice in underserved and minority populations

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials

“…67686970717273747576777879808182838485868788 A further 45 trials (9945 women)8990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133 were identified after the IPD acquisition timeline until February 2017.…”

Glucose responses to acute and chronic exercise during pregnancy: a systematic review and meta-analysis

“…Of these studies, two were RCTs that included exercise only 57 60. One study included women with obesity prior to pregnancy,57 and the other included women at high risk of developing GDM 60. In both studies, glycaemic control was not different between the exercise and control groups postintervention.…”

Preventing Obesity Across Generations: Evidence for Early Life Intervention

“…Several studies and review articles over the past 10-15 years ( 129 , 130 ) have suggested that women who routinely participate in exercise during pregnancy have better glucose control (among women with gestational diabetes mellitus) ( 31 ), have less GWG ( 91 , 120 ), have less postpartum weight retention ( 91 ), and give birth to infants that are smaller (but within the normal weight range) than those who do not exercise ( 61 ). Hawkins et al ( 56 ) have demonstrated the benefits of a clinically feasible exercise intervention in diverse populations. Mourtakos et al ( 92 ) found that moderate PA during pregnancy, as well as GWG and smoking status, were significantly associated with offspring obesity at age 8 years.…”