A systematic review of dietary interventions for gestational weight gain and gestational diabetes in overweight and obese pregnant women

Abstract

PurposeThe number of overweight and obese women is increasing in the obstetric population. The aim of this study was to review studies that reported results related to the efficacy of dietary interventions on gestational weight gain (GWG) or the prevention of gestational diabetes (GDM) in overweight and obese women.MethodsThe search was performed using the CINAHL, PubMed, Scopus and Medic electronic databases and limited to the years between 2000 and March 2016. This systematic review includes 15 research articles of which 12 were randomized controlled trials, and three were controlled trials. Three main categories emerged as follows: (1) the types of interventions, (2) the contents of the interventions and (3) the efficacy of the intervention on GWG and the prevention of GDM. The quality of the selected studies was evaluated using the AHRQ Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews.ResultsOf the selected 15 studies, eight included a specified diet with limited amounts of nutrients or energy, and the others included a dietary component along with other components. Ten studies reported significant differences in the measured outcomes regarding GWG or the prevention of GDM between the intervention and the control groups.ConclusionsThis review confirms the variability in the strategies used to deliver dietary interventions in studies aiming to limit GWG and prevent GDM in overweight and obese women. Inconsistency in the provider as well as the content of the dietary interventions leaves the difficulty of summarizing the components of effective dietary interventions.

Estimated global overweight and obesity burden in pregnant women based on panel data model

“…According to the Institute of Medicine, the recommend GWG for overweight pregnant women is 7–11.9 kg and for obese pregnant women is 5–9 kg [ 48 ]. Dietary interventions and physical activity interventions were recommended to limit GWG and prevent GDM in overweight and obese pregnant women [ 49 , 50 , 51 ]. However, a randomised controlled trail in UK found that dietary and physical interventions in pregnant women with obesity were not adequate to prevent GDM or large-for-gestational-age infants, and a recent study in Australia also reported no significant differences in GDM between the behavioural nutrition intervention group and the control group after adjusting confounding factors [ 52 , 53 ].…”

The Role of Dietary Carbohydrates in Gestational Diabetes

“…In their systematic review, Lammimpaa and coauthors concluded that variability in the delivery of dietary interventions is a key factor affecting study outcomes in GDM. Thus, additional research on the benefits of dietary CHO, with or without other nutritional factors, should also pay attention to the consistency of its delivery [70].…”

The association between dietary patterns before and in early pregnancy and the risk of gestational diabetes mellitus (GDM): Data from the Malaysian SECOST cohort

“…The precise underlying mechanisms between pre-pregnancy and early pregnancy DPs with the risk of GDM, however, remains to be elucidated. Nevertheless, the available evidence seems to support that women planning for pregnancy or in early pregnancy should be the target of lifestyle intervention for preventing GDM [60][61][62].…”