Prevention of Gestational Diabetes: The Role of Dietary Intake, Physical Activity, and Weight before, during, and between Pregnancies

Abstract

Gestational diabetes mellitus (GDM) is the most common complication of pregnancy and a significant clinical and public health problem with lifelong and intergenerational adverse health consequences for mothers and their offspring. The preconception, early pregnancy, and interconception periods represent opportune windows to engage women in preventive and health promotion interventions. This review provides an overview of findings from observational and intervention studies on the role of diet, physical activity, and weight (change) during these periods in the primary prevention of GDM. Current evidence suggests that supporting women to increase physical activity and achieve appropriate weight gain during early pregnancy and enabling women to optimize their weight and health behaviors prior to and between pregnancies have the potential to reduce rates of GDM. Translation of current evidence into practice requires further development and evaluation of co-designed interventions across community, health service, and policy levels to determine how women can be reached and supported to optimize their health behaviors before, during, and between pregnancies to reduce GDM risk.

Postpartum nutrition: Guidance for general practitioners to support high-quality care

“…GPs are well placed to provide postpartum weight management care and support for women with interconception care. 13 However, women report that postpartum visits are often focused on child-related health than targeted to the woman's health. 7 Supportive, consistent messages to support weight management within GP consultations is feasible.…”

“…GPs are ideally placed to identify women during the postpartum (or interconception) period to play a part in supporting healthy behaviours and weight management. 13 These strategies contribute to providing a continuum of care before, during and between pregnancies and reducing women's elevated chronic disease risk. Effective approaches to engage women in screening are paramount, as women's motivation to engage in healthy lifestyle behaviours often dramatically reduce once GDM resolves.…”

The preconception period as a platform for preventing diabetes and non‐communicable diseases

“…25,26 However, achieving a healthy BMI and improving diet quality and physical activity level before pregnancy, or between pregnancies, can reduce the risk of GDM, improve fertility, and reduce the risk of pre-eclampsia, macrosomia and stillbirth. [27][28][29][30] It may be more realistic to achieve than during pregnancy, and measuring BMI is a simple method to identify high-risk women at this time. 30,31 Physical activity, and indeed any leisure-time physical activity has shown benefit for the prevention of GDM.…”

Physical Activity in High-Risk Pregnancies

“…In addition, it is advised that the amount of time spent sedentary be reduced, by replacing it with physical activity of any intensity [1,2]. Research has proven that physical activity before and during pregnancy is associated with several health benefits for the mother as well as for the fetus [2][3][4][5][6][7]. Barker and colleagues suggest several environmental determinants that modify in utero fetal development, causing alterations in metabolism and in vulnerability to chronic diseases in adulthood [8].…”