Low glycaemic index diet in pregnancy to prevent macrosomia (ROLO study): randomised control trial

Abstract

Objective To determine if a low glycaemic index diet in pregnancy could reduce the incidence of macrosomia in an at risk group.

Gestational Diabetes Mellitus Can Be Prevented by Lifestyle Intervention: The Finnish Gestational Diabetes Prevention Study (RADIEL)

“…On the other hand, if overweight women or women with previous macrosomia had been recruited to the trial, the heterogeneity of the study group would have been increased markedly. This could also have had effects on the intervention results (24,26,28,29). We believe that in the RADIEL we have been able to identify a real high-risk group that is also the most likely to benefit from a lifestyle intervention during pregnancy.…”

“…One possible explanation is the high-risk status of the women recruited to the study. In several previous GDM and other lifestyle intervention studies during pregnancy (21)(22)(23)(24)26,28,29), the women recruited were only at a modest risk for the development of GDM. This kind of study setting would need a bigger sample size to reveal the effect of a lifestyle intervention.…”

“…Adherence to a healthy lifestyle before pregnancy is, however, associated with reduced GDM risk (20). Several lifestyle intervention trials targeted at limiting gestational weight gain or preventing obesity-related perinatal complications, including GDM, have been performed (21)(22)(23)(24)(25)(26)(27)(28)(29). However, the results have been inconsistent; some studies (22,25,27,28) have been successful in reducing gestational weight gain, but the effect on GDM incidence has been minor (23)(24)(25)(26)(27)(28)(29).…”

Effect of maternal obesity on pregnancy outcomes and long-term metabolic consequences

“…88 A low glycaemic index diet in pregnancy appears to have a significant positive effect on gestational weight gain and maternal glucose intolerance, although it does not reduce the incidence of large-for-gestational-age infants in women at risk for fetal macrosomia (having previously delivered an infant weighing more than 4 kg). 89 However, a low glycaemic index diet intervention in pregnancy was found to have a beneficial effect on neonatal central adiposity. 90 According to the NICE (National Institute for Health and Care Excellence) guidelines, pregnant women should base their meals on starchy foods, eat at least five portions of vegetables and fruits each day and consume fibre-rich foods instead of foods rich in fat and sugar.…”

An examination of whether associations exist between maternal and neonatal 25OHD and infant size and adiposity at birth, 6–9 months and 2–2.5 years of age – a longitudinal observational study from the ROLO study

“…However, some studies have reported no such associations between maternal 25OHD and offspring health [18][19][20][21][22][23]. The aim of this study was to examine the association between maternal and neonatal 25OHD levels and infant size and adiposity at birth, 6-9 months and 2-2.5 years of age in a cohort from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet versus no dietary intervention to prevent recurrence of fetal macrosomia) study [24]. In a previous analysis of a subgroup of the ROLO study, late maternal 25OHD above the cohort median was associated with significantly greater neonatal length than late maternal 25OHD below the median [25].…”