Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy.
Walsh, Jennifer M Mahony, Rhona M Canty, Gillian Foley, Michael E McAuliffe, Fionnuala M
Walsh, Jennifer M
Mahony, Rhona M
Canty, Gillian
Foley, Michael E
McAuliffe, Fionnuala M
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Editors
Other Contributors
Date
2014-08-28
Date Submitted
Keywords
DIET
NUTRITION
PREGNANCY
NUTRITION
PREGNANCY
Other Subjects
Subject 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
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
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
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.
Language
en
ISSN
1475-2662
eISSN
ISBN
DOI
10.1017/S000711451400110X
PMID
24896237