Effectiveness of Low Glycemic Index Diet Consultations Through a Diet Glycemic Assessment App Tool on Maternal and Neonatal Insulin Resistance: A Randomized Controlled Trial

Abstract

Background Low glycemic index (LGI) diet has shown to be effective in reducing maternal and neonatal complications in high-risk pregnancies. Objective This trial aimed to examine the effectiveness of individualized LGI diet consultations based on the accurate diet glycemic load (GL) assessment tool on maternal and neonatal insulin resistance levels and diet behavior changes in overweight and obese pregnant women. Methods Overweight and obese pregnant women were recruited before 16 weeks of gestation and randomized to the LGI diet arm or the control arm. All participants received standard dietary education according to the Chinese Dietary Guide for Pregnant Women. In the intervention arm, additional individualized dietary GL assessments were performed using an app and instructions of lowering diet glycemic index (GI) to achieve LGI diet were provided by a clinical dietitian at early, middle, and late gestation. Primary outcomes were serum insulin at late gestation, incidence of gestational diabetes mellitus (GDM) for mothers, and cord blood C-peptide level of neonates. Results In total, 400 subjects were randomized and received different interventions. There were no significant differences in maternal serum insulin levels (13.2 [9.3−13.2] uU/mL vs 12.4 [10.5−12.4] uU/mL), incidence of GDM (45 [22.5%] vs 43 [21.5%]), or cord blood C-peptide levels (mean 0.9ng/mL [SD 0.7] vs mean 0.8ng/mL [SD 0.6]) in the intervention group compared with the controls. The diet GI at late gestation was similar (mean 63.2 [SD 10.4] vs mean 64.3 [SD 10.4]), whereas greater diet fiber intake was observed in the intervention group (mean 11.6 grams [SD 8.0] vs mean 9.0 grams [SD 5.6]; P =.006). Adherence measurements did not significantly differ between 2 groups. Conclusions Individualized LGI diet consultations for overweight and obese pregnant women failed to make a significant difference in maternal or neonatal insulin resistance compared with the standard gestational diet consultation. Trial Registration ClinicalTrials.gov NCT01628835; http://clinicaltrials.gov/ct2/show/NCT01628835 (Archived by WebCite at http://www.webcitation.org/77LHgWP0k)

Dietary Intervention With α-Amylase Inhibitor in White Kidney Beans Added Yogurt Modulated Gut Microbiota to Adjust Blood Glucose in Mice

“…Over the decades, microbiological studies proposed that intestinal flora could cause diabetes by regulating lipid metabolism to increase energy storage ( 12 ), producing short-chain fatty acids to mediate the release of intestinal hormones ( 13 ), and regulating bile acid metabolism to influence intestinal barrier function ( 14 ). Imbalance of intestinal flora has great influences on the host metabolism which eventually lead to occur and develop diabetes under a certain diet habit ( 15 ).…”

Higher Serum Bilirubin Levels in Response to Higher Carbohydrate Intake During Early Pregnancy and Lower Gestational Diabetes Mellitus Occurrence in Overweight and Obese Gravidae

“…This study was a secondary data analysis using a historical cohort (ClinicalTrials.gov registry: NCT01628835). Details of the previous study design, recruitment, methods and responses could be found elsewhere ( 14 ). Briefly, overweight or obese gravidae [BMI ≥24 kg/m 2 according to national consensus of BMI cut-off for Chinese adults ( 15 )] aged 20–45 years old were recruited at first antenatal visit ≤ 14 gestational weeks in two hospitals [Kunshan Maternity and Child Care Center (Kunshan city, Jiangsu province, China) and the International Peace Maternity and Child Health Hospital of China Welfare Institute (Shanghai, China)] from June 2012 to October 2015.…”

The role of maternal diet on offspring hyperinsulinaemia and adiposity after birth: a systematic review of randomised controlled trials

“…Five studies recruited women in their first trimester with a BMI ≥ 25 kg/m 2 . [28][29][30][31][32] Mean participant BMI for these studies ranged between 28.0 and 34.4 kg/m 2 , which was reported pre-pregnancy 28,31 or from first-trimester body weight. 29,30,32 In the DALI study women were selected with a pre-pregnancy BMI ≥ 29 kg/m 2 , 33 and UPBEAT study, participants had a pre-pregnancy BMI ≥ 30 kg/m 2 .…”

“…28,33 The UPBEAT study involved eight weekly health-trainer led sessions on reducing dietary GL without restricting dietary energy intake. 34,35 Compliance checks in addition to study visits were food diaries 39,40 or 24-h food recall, 28,39,41 telephone interviews, 30,31,[33][34][35] and a logbook with weekly goals in one study. 34,35 Comparison group Most studies described control groups as receiving usual care that included standard periodic antenatal visits and referral for medical care as indicated (i.e.…”

“…28,29 Five studies compared two dietary interventions where the intensity of the treatment was similar between both groups. These included a low GL vs non-low GL dietary intervention, 30 modestly lower-vs moderate-carbohydrate diet, 41 low GI vs high fibre, higher GI, 39 energy-restricted and non-energy restricted diet, 40 and a low GI vs a low fat diet. 32…”