Food glycemic index changes in overweight/obese pregnant women enrolled in a lifestyle program: a randomized controlled trial

Abstract

BACKGROUND:The calculation of the glycemic index of food mirrors a rise in blood sugar levels. A loweglycemic index carbohydrate diet in pregnancy has been associated with normal infant birthweight. Thus, strategies to lower the food glycemic index could be successful in improving pregnancy outcomes. OBJECTIVE: The purpose of this study was to compare different prescribed diets on food glycemic index intake and its relationship with rate of large-for-gestational-age infants. STUDY DESIGN: At the 9the12th week of gestation (with a gynecologist and a dietitian both present), 273 Italian women with a body mass index of !25 kg/m 2 were assigned randomly either to a customized loweglycemic index diet that was detailed by a dietitian (customized intervention; n¼139 women; 1800 kcal/dþ30 minutes walking 4 times/ wk) or to generic lifestyle advice (standard care; n¼134 women) with counseling about a prudent diet and physical activity, according to Italian guidelines. At enrollment and at the 36th week of gestation, the food frequency questionnaire was completed. In 73 Italian foods, the glycemic index was assessed with the use of a classic formula (available carbo-hydrateÂglycemic index prescribed/total carb content of the meal) then was subdivided according to meal pattern. The main outcome was the change in foode glycemic index. RESULTS: Sociodemographic features were similar between the groups. One hundred fifty-six women completed the study (customized intervention¼81; standard care¼75). The mean daily glycemic index decreased from 58.4AE19 to 52.5AE11.2 (P¼.008) in the customized intervention group although it remained unchanged in the standard care group. After the intervention, women in the customized intervention group reported a significant decrease in the diet glycemic index at dinner compared with both lunch and breakfast values (P<.02). Lower birthweight and fewer large-for-gestational-age infants were observed in the customized intervention group. CONCLUSION: A customized loweglycemic index, calorie-restricted diet that was associated with constant physical activity effectively reduced the food glycemic index. This reduced food glycemic index is associated with lower rate of large-for-gestational-age newborn infants.

An update on the use of inositols in preventing gestational diabetes mellitus (GDM) and neural tube defects (NTDs)

“…Moreover, a secondary analysis from three trials reported that the same dose of MI supplementation in women at risk for GDM affected birthweight, reducing the rate of both macrosomic newborns and LGA babies [67]. Such neonatal impact agrees with the evidence that dietary glycemic index directly correlates with LGA in newborns [68] and indirectly demonstrate that MI supplementation improves glycemic control in those pregnancies. Finally, in a condition where insulin-resistance is pathogenetic like PCOS, the beneficial effects of MI supplementation on hormonal and reproductive disturbances [20] were specifically reported also in pregnancy, where GDM rate was reduced [69].…”

The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women

“…The lifestyle intervention implemented in this study included a low glycemic index, a low-fat hypocaloric diet, moderate physical activity, and specific timing of meals. These interventions were proven to effectively reduce the diet glycemic index (GI) of pregnant women [11]. GI is a measure repeatedly associated with improved perinatal outcomes [21,22].…”

“…According to comprehensive meta-analysis, clinical relevance was of minor impact, mainly due to variations in the quality of trials, characteristics of the interventions, and assessed populations and outcome definitions between trials [9]. In two previously reported small trials, a hypocaloric-low-glycemic-index diet associated with increased physical activity significantly reduced gestational weight gain (GWG) and GDM rate in overweight/obese women [10,11]. In this study, we aim to evaluate if those clinical improvements could also benefit perinatal outcomes in the subgroup of women showing insulin resistance.…”

Do Lifestyle Interventions in Pregnant Women with Overweight or Obesity Have an Effect on Neonatal Adiposity? A Systematic Review with Meta-Analysis

“…After eliminating duplicate articles, the titles and abstracts were read by two researchers independently (Naiara Franco Baroni and Nayara Ragi Baldoni), minimizing possible bias in the selection and exclusion of the studies. In this stage, contact was made via e-mail with the authors to formally request the publications in full [32,33]. In the eligibility stage, a third researcher (Lívia Castro Crivellenti.)…”