The influence of a low glycemic index dietary intervention on maternal dietary intake, glycemic index and gestational weight gain during pregnancy: a randomized controlled trial

Abstract

BackgroundMaternal diet is known to impact pregnancy outcome. Following a low glycemic index (GI) diet during pregnancy has been shown to improve maternal glycemia and reduce infant birthweight and may be associated with a higher fibre intake. We assessed the impact of a low GI dietary intervention on maternal GI, nutritional intake and gestational weight gain (GWG) during pregnancy. Compliance and acceptability of the low GI diet was also examined.MethodEight hundred women were randomised in early pregnancy to receive low GI and healthy eating dietary advice or to receive standard maternity care. The intervention group received dietary advice at a group education session before 22 weeks gestation. All women completed a 3 day food diary during each trimester of pregnancy. Two hundred and thirty five women from the intervention arm and 285 women from the control arm returned complete 3x3d FDs and were included in the present analysis.ResultsMaternal GI was significantly reduced in the intervention group at trimester 2 and 3. The numbers of women within the lowest quartile of GI increased from 37% in trimester 1 to 52% in trimester 3 (P < 0.001) among the intervention group. The intervention group had significantly lower energy intake (P < 0.05), higher protein (% TE) (P < 0.01) and higher dietary fibre intake (P < 0.01) post intervention. Consumption of food groups with known high GI values were significantly reduced among the intervention group. Women in the intervention low GI group were less likely to exceed the Institute of Medicine’s GWG goals.ConclusionA dietary intervention in early pregnancy had a positive influence on maternal GI, food and nutrient intakes and GWG. Following a low GI diet may be particularly beneficial for women at risk of exceeding the GWG goals for pregnancy.Trial registrationCurrent Controlled Trials Registration Number: ISRCTN54392969.

Bagaimana Gizi Sejak Massa Konsepsi Dapat Mempengaruhi Kesehatan Biologis Anak?

“…It acts as an anorexogenic hormone in the brain, controlling feeding behavior by specifically decreasing appetite and therefore food intake 1 . Fetal hyperleptinemia might be induced from maternal obesity or maternal weightgain during pregnancy and arguably have significant influences on the fetal hypothalamus and on energy balance in the later life 5 . Among women at higher risk of exceeding the GWG goals as proposed by IOM in 2009, recommendation to follow a low GI diet might be particularly beneficial as a primary prevention of above mention fetal origin hypothesis 5 .…”

“…Fetal hyperleptinemia might be induced from maternal obesity or maternal weightgain during pregnancy and arguably have significant influences on the fetal hypothalamus and on energy balance in the later life 5 . Among women at higher risk of exceeding the GWG goals as proposed by IOM in 2009, recommendation to follow a low GI diet might be particularly beneficial as a primary prevention of above mention fetal origin hypothesis 5 . We also recommend mother to check the pregnancy for risk of gestational diabetes mellitus (GDM).…”

“…We also recommend mother to check the pregnancy for risk of gestational diabetes mellitus (GDM). If the mothers have a mild to high risk of GDM we recommend adjusting lifestyle especially in the diet of food with low glycemic index 5 . Environmental exposure in utero such as high glucose (in mother with gestational diabetes mellitus) or maternal obesity and overfeeding during pregnancy alter the programming of genes by epigenetic markings, resulting in a long-term imprint on gene expression last into adulthood 1 .…”

“…Targeting pregnant women considered impactful since they appear to be motivated to improve their diet during pregnancy 5,6 . Beter outcome for mother and child could be achieved when women weight within the normal BMI range prior to conception and able to maintain or gain weight within ranges suggested by the Institute of Medicine (IOM) for ideal weight for pregnant women 7 .…”

Bagaimana Gizi Sejak Massa Konsepsi Dapat Mempengaruhi Kesehatan Biologis Anak?

“…If the mothers have a mild to high risk of GDM we recommend adjusting lifestyle especially in the diet of food with low glycemic index 5 . Environmental exposure in utero such as high glucose (in mother with gestational diabetes mellitus) or maternal obesity and overfeeding during pregnancy alter the programming of genes by epigenetic markings, resulting in a long-term imprint on gene expression last into adulthood 1 .…”