OBJECTIVETo assess whether gestational diabetes mellitus (GDM) can be prevented by a moderate lifestyle intervention in pregnant women who are at high risk for the disease. RESEARCH DESIGN AND METHODSTwo hundred ninety-three women with a history of GDM and/or a prepregnancy BMI of ‡30 kg/m 2 were enrolled in the study at <20 weeks of gestation and were randomly allocated to the intervention group (n = 155) or the control group (n = 138). Each subject in the intervention group received individualized counseling on diet, physical activity, and weight control from trained study nurses, and had one group meeting with a dietitian. The control group received standard antenatal care. The diagnosis of GDM was based on a 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation. RESULTSA total of 269 women were included in the analyses. The incidence of GDM was 13.9% in the intervention group and 21.6% in the control group ([95% CI 0.40-0.98%]; P = 0.044, after adjustment for age, prepregnancy BMI, previous GDM status, and the number of weeks of gestation). Gestational weight gain was lower in the intervention group (20.58 kg [95% CI 21.12 to 20.04 kg]; adjusted P = 0.037). Women in the intervention group increased their leisure time physical activity more and improved their dietary quality compared with women in the control group. CONCLUSIONSA moderate individualized lifestyle intervention reduced the incidence of GDM by 39% in high-risk pregnant women. These findings may have major health consequences for both the mother and the child. A slide set summarizing this article is available online.Clinical trial reg. no. NCT01698385, clinicaltrials.gov.

The authors developed a self-administered 181-item food frequency questionnaire (FFQ) to assess dietary intake during pregnancy for Finnish women from August 1995 to July 1996. In the validation study (n = 113), the data that were collected by using two 5-day food records completed during the eighth month of pregnancy were compared with FFQ data. The intake of foods and nutrients was higher as determined by FFQ than that assessed using food records. Pearson correlation coefficients for nutrients, after adjustment for energy, ranged from 0.19 (vitamin E) to 0.70 (thiamin) and, for foods, from 0.03 (high-fat milk) to 0.84 (low-fat milk). Energy adjustment improved the correlations for nutrients. Correction for attenuation improved correlations for both foods and nutrients. On average, 70% of the foods and 69% of the nutrients fell into the same or adjacent quintiles, according to the FFQ and the food record. In the reproducibility study, 111 women completed the FFQs twice at a 1-month interval. The intraclass correlation coefficients for nutrients ranged from 0.42 (ethanol) to 0.72 (sucrose, riboflavin, and calcium), and for foods, they ranged from 0.44 (ice cream) to 0.91 (coffee). The authors conclude that the FFQ has an acceptable reproducibility and represents a useful tool for categorizing pregnant women according to their dietary intake.

Maternal vitamin D intake from foods during pregnancy may be negatively associated with risk of asthma and AR in childhood.

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