Dietary patterns in obese pregnant women; influence of a behavioral intervention of diet and physical activity in the UPBEAT randomized controlled trial

Flynn, Angela C.; Seed, Paul; Patel, Nashita; Barr, Suzanne; Bell, Ruth; Briley, Annette; Godfrey, Keith M.; Nelson, Scott M.; Oteng‐Ntim, Eugene; Robinson, Siân; Sanders, Tom; Sattar, Naveed; Wardle, Jane; Poston, Lucilla; Goff, Louise

doi:10.1186/s12966-016-0450-2

Cited by 54 publications

(53 citation statements)

References 51 publications

(41 reference statements)

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“…The fatty acid profile in GDM obese women was similar to that seen in a previous study of dysglycaemia in Finnish men using this platform [32]: a predominance of saturated and monounsaturated fatty acids and lower concentrations of polyunsaturated fatty acids in GDM vs non-GDM women. This may reflect the unhealthy dietary pattern termed 'processed foods' that we recently reported amongst women who developed GDM in the same cohort [33].…”

Section: Discussionmentioning

confidence: 77%

Metabolic profiling of gestational diabetes in obese women during pregnancy

et al. 2017

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Aims/hypothesis Antenatal obesity and associated gestational diabetes (GDM) are increasing worldwide. While pre-existing insulin resistance is implicated in GDM in obese women, the responsible metabolic pathways remain poorly described. Our aim was to compare metabolic profiles in blood of obese pregnant women with and without GDM 10 weeks prior to and at the time of diagnosis by OGTT. Methods We investigated 646 women, of whom 198 developed GDM, in this prospective cohort study, a secondary analysis of UK Pregnancies Better Eating and Activity Trial (UPBEAT), a multicentre randomised controlled trial of a complex lifestyle intervention in obese pregnant women. Multivariate regression analyses adjusted for multiple testing, and accounting for appropriate confounders including study intervention, were performed to compare obese women with GDM with obese non-GDM women. We measured 163 analytes in serum, plasma or whole blood, including 147 from a targeted NMR metabolome, at time point 1 (mean gestational age 17 weeks 0 days) and time point 2 (mean gestational age 27 weeks 5 days, at time of OGTT) and compared them between groups. Results Multiple significant differences were observed in women who developed GDM compared with women without GDM (false discovery rate corrected p values <0.05). Most were evident prior to diagnosis. Women with GDM demonstrated raised lipids and lipoprotein constituents in VLDL subclasses, greater triacylglycerol enrichment across lipoprotein particles, higher branched-chain and aromatic amino acids and different fatty acid, ketone body, adipokine, liver and inflammatory marker profiles compared with those without GDM. Conclusions/interpretation Among obese pregnant women, differences in metabolic profile, including exaggerated dyslipidaemia, are evident at least 10 weeks prior to a diagnosis of GDM in the late second trimester.

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Section: Discussionmentioning

confidence: 77%

Metabolic profiling of gestational diabetes in obese women during pregnancy

et al. 2017

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“…We have previously reported the maternal dietary patterns of 1023 women obtained during the UPBEAT study in which four distinct patterns were identified: “snacks,” “processed,” “fruit and veg,” and “African/Caribbean.” Whilst only three patterns were identified in this analysis of the diets of their children, they were broadly similar to those of their mothers 3 years previously, highlighting commonality of diet within families, as reported previously in the UK Southampton Women's Survey …”

Section: Discussionmentioning

confidence: 99%

“…We have previously reported the maternal dietary patterns of 1023 women obtained during the UPBEAT study 40…”

Section: Discussionmentioning

confidence: 99%

Associations between dietary patterns, eating behaviours, and body composition and adiposity in 3‐year‐old children of mothers with obesity

et al. 2019

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Summary Background The relationships between eating habits, behaviours, and the development of obesity in preschool children is not well established. Objective As children of mothers with obesity are themselves at risk of obesity, we examined these relationships in a cohort of 482 three‐year‐old children of mothers with obesity from the UK Pregnancy Better Eating and Activity Trial (UPBEAT). Method Dietary patterns were derived using factor analysis of an 85‐item food frequency questionnaire (FFQ). Eating behaviours were assessed using the Children's Eating Behaviour Questionnaire (CEBQ). Measures of body composition included age‐specific BMI cut‐offs, WHO z scores, sum of skinfolds, waist and arm circumferences, and body fat percentage. Using adjusted regression analysis, we examined associations between dietary patterns, eating behaviours, and measures of body composition. Results Three distinct dietary patterns were defined: “healthy/prudent,” “African/Caribbean,” and “processed/snacking.” The “processed/snacking” pattern was associated with greater odds of obesity; OR 1.53 (95% CI, 1.07‐2.19). The “African/Caribbean” and the “healthy/prudent” patterns were associated with a lower arm circumference (β = −0.23 cm [−0.45 to −0.01]) and sum of skinfolds (β = −1.36 cm [−2.88 to −0.37]), respectively. Lower enjoyment of food and food responsiveness, and greater slowness in eating and satiety, were associated with lower arm and waist circumferences, WHO z scores, and obesity (all P < .05). Conclusion In children of mothers with obesity, those who had higher scores on a “processed/snacking” dietary pattern had greater odds of obesity. In contrast, slowness in eating was associated with lower measures of body composition. These novel findings highlight modifiable behaviours in high‐risk preschool children which could contribute to public health strategies for prevention of childhood obesity.

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“…A semi-quantitative food frequency questionnaire (FFQ) adapted from one used in the UK arm of the European Prospective Investigation into Cancer Study (EPIC) was used to assess the diet of the participants for the preceding month. Glycaemic load was estimated based on the glycaemic index and carbohydrate content of each food, as reported previously [18]. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) [16].…”

Section: Data Collectionmentioning

confidence: 99%

Influence of GDM Diagnosis and Treatment on Weight Gain, Dietary Intake and Physical Activity in Pregnant Women with Obesity: Secondary Analysis of the UPBEAT Study

et al. 2020

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Obesity during pregnancy is associated with the development of gestational diabetes (GDM). This study aimed to assess if the result of an oral glucose tolerance test (OGTT) for GDM influences health (diet and physical activity) behaviours of pregnant women with obesity. In total, 1031 women who participated in the UK Pregnancies Better Eating and Activity Trial (UPBEAT) of a lifestyle intervention from early pregnancy were included. Changes in weight gain, dietary intake and physical activity following an OGTT undertaken between 27 +0 and 28 +6 weeks' and 34 and 36 weeks' gestation were examined using linear regression with appropriate adjustment for confounders. Obese women without GDM (IADPSG criteria) gained 1.9 kg (95% CI −2.2, −1.5, p < 0.001) more weight than women with GDM. Women with GDM demonstrated greater reductions in energy (-142kcal, 95%CI −242.2, −41.9, p = 0.006), carbohydrate intake (−1.5%E 95%CI -2.8, −0.3, p = 0.016) and glycaemic load (-15.2, 95%CI −23.6, -6.7, p < 0.001) and a greater increase in protein intake (2%E, 95%CI 1.3, 2.7, p < 0.001), compared to women without GDM. Trial intervention allocation did not influence any associations observed. The findings emphasise the need for strategies to optimise the health behaviours of pregnant women with obesity, following a negative OGTT for GDM.

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Dietary patterns in obese pregnant women; influence of a behavioral intervention of diet and physical activity in the UPBEAT randomized controlled trial

Cited by 54 publications

References 51 publications

Metabolic profiling of gestational diabetes in obese women during pregnancy

Metabolic profiling of gestational diabetes in obese women during pregnancy

Associations between dietary patterns, eating behaviours, and body composition and adiposity in 3‐year‐old children of mothers with obesity

Influence of GDM Diagnosis and Treatment on Weight Gain, Dietary Intake and Physical Activity in Pregnant Women with Obesity: Secondary Analysis of the UPBEAT Study

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