Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy.

Hdl Handle:
http://hdl.handle.net/10147/336225
Title:
Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy.
Authors:
Walsh, Jennifer M; Mahony, Rhona M; Canty, Gillian; Foley, Michael E; McAuliffe, Fionnuala M
Affiliation:
UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital,Dublin,Republic of Ireland.
Citation:
Walsh, J.M. et al., 2014. Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy,112 (4) pp583-9 Br. J. Nutr.
Journal:
British journal of nutrition
Issue Date:
28-Aug-2014
URI:
http://hdl.handle.net/10147/336225
DOI:
10.1017/S000711451400110X
PubMed ID:
24896237
Abstract:
The present study is a secondary analysis of the ROLO study, a randomised control trial of a low-glycaemic index (GI) diet in pregnancy to prevent the recurrence of fetal macrosomia. The objectives of the present study were to identify which women are most likely to respond to a low-GI dietary intervention in pregnancy with respect to three outcome measures: birth weight; maternal glucose intolerance; gestational weight gain (GWG). In early pregnancy, 372 women had their mid-upper arm circumference recorded and BMI calculated. Concentrations of glucose, insulin and leptin were measured in early pregnancy and at 28 weeks. At delivery, infant birth weight was recorded and fetal glucose, C-peptide and leptin concentrations were measured in the cord blood. Women who benefited in terms of infant birth weight were shorter, with a lower education level. Those who maintained weight gain within the GWG guidelines were less overweight in both their first and second pregnancies, with no difference being observed in maternal height. Women who at 28 weeks of gestation developed glucose intolerance, despite the low-GI diet, had a higher BMI and higher glucose concentrations in early pregnancy with more insulin resistance. They also had significantly higher-interval pregnancy weight gain. For each analysis, women who responded to the intervention had lower leptin concentrations in early pregnancy than those who did not. These findings suggest that the maternal metabolic environment in early pregnancy is important in determining later risks of excessive weight gain and metabolic disturbance, whereas birth weight is mediated more by genetic factors. It highlights key areas, which warrant further interrogation before future pregnancy intervention studies, in particular, maternal education level and inter-pregnancy weight gain.
Item Type:
Article
Language:
en
Keywords:
DIET; NUTRITION; PREGNANCY
MeSH:
Adiposity; Adult; Birth Weight; Body Mass Index; Cohort Studies; Diet, Carbohydrate-Restricted; Educational Status; Female; Fetal Blood; Fetal Macrosomia; Glucose Intolerance; Glycemic Index; Humans; Insulin; Insulin Resistance; Leptin; Maternal Nutritional Physiological Phenomena; Patient Education as Topic; Pregnancy; Pregnancy Complications; Recurrence; Weight Gain
ISSN:
1475-2662

Full metadata record

DC FieldValue Language
dc.contributor.authorWalsh, Jennifer Men_GB
dc.contributor.authorMahony, Rhona Men_GB
dc.contributor.authorCanty, Gillianen_GB
dc.contributor.authorFoley, Michael Een_GB
dc.contributor.authorMcAuliffe, Fionnuala Men_GB
dc.date.accessioned2014-11-27T10:35:12Z-
dc.date.available2014-11-27T10:35:12Z-
dc.date.issued2014-08-28-
dc.identifier.citationWalsh, J.M. et al., 2014. Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy,112 (4) pp583-9 Br. J. Nutr.en_GB
dc.identifier.issn1475-2662-
dc.identifier.pmid24896237-
dc.identifier.doi10.1017/S000711451400110X-
dc.identifier.urihttp://hdl.handle.net/10147/336225-
dc.description.abstractThe present study is a secondary analysis of the ROLO study, a randomised control trial of a low-glycaemic index (GI) diet in pregnancy to prevent the recurrence of fetal macrosomia. The objectives of the present study were to identify which women are most likely to respond to a low-GI dietary intervention in pregnancy with respect to three outcome measures: birth weight; maternal glucose intolerance; gestational weight gain (GWG). In early pregnancy, 372 women had their mid-upper arm circumference recorded and BMI calculated. Concentrations of glucose, insulin and leptin were measured in early pregnancy and at 28 weeks. At delivery, infant birth weight was recorded and fetal glucose, C-peptide and leptin concentrations were measured in the cord blood. Women who benefited in terms of infant birth weight were shorter, with a lower education level. Those who maintained weight gain within the GWG guidelines were less overweight in both their first and second pregnancies, with no difference being observed in maternal height. Women who at 28 weeks of gestation developed glucose intolerance, despite the low-GI diet, had a higher BMI and higher glucose concentrations in early pregnancy with more insulin resistance. They also had significantly higher-interval pregnancy weight gain. For each analysis, women who responded to the intervention had lower leptin concentrations in early pregnancy than those who did not. These findings suggest that the maternal metabolic environment in early pregnancy is important in determining later risks of excessive weight gain and metabolic disturbance, whereas birth weight is mediated more by genetic factors. It highlights key areas, which warrant further interrogation before future pregnancy intervention studies, in particular, maternal education level and inter-pregnancy weight gain.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to The British journal of nutritionen_GB
dc.subjectDIETen_GB
dc.subjectNUTRITIONen_GB
dc.subjectPREGNANCYen_GB
dc.subject.meshAdiposity-
dc.subject.meshAdult-
dc.subject.meshBirth Weight-
dc.subject.meshBody Mass Index-
dc.subject.meshCohort Studies-
dc.subject.meshDiet, Carbohydrate-Restricted-
dc.subject.meshEducational Status-
dc.subject.meshFemale-
dc.subject.meshFetal Blood-
dc.subject.meshFetal Macrosomia-
dc.subject.meshGlucose Intolerance-
dc.subject.meshGlycemic Index-
dc.subject.meshHumans-
dc.subject.meshInsulin-
dc.subject.meshInsulin Resistance-
dc.subject.meshLeptin-
dc.subject.meshMaternal Nutritional Physiological Phenomena-
dc.subject.meshPatient Education as Topic-
dc.subject.meshPregnancy-
dc.subject.meshPregnancy Complications-
dc.subject.meshRecurrence-
dc.subject.meshWeight Gain-
dc.titleIdentification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy.en_GB
dc.typeArticleen
dc.contributor.departmentUCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital,Dublin,Republic of Ireland.en_GB
dc.identifier.journalBritish journal of nutritionen_GB
dc.description.fundingNo fundingen
dc.description.provinceLeinsteren
dc.description.peer-reviewpeer-reviewen

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