The influence of a low glycemic index dietary intervention on maternal dietary intake, glycemic index and gestational weight gain during pregnancy: a randomized controlled trial A Randomized Controlled Trial Investigating the Effects of a Low–Glycemic Index Diet on Pregnancy Outcomes in Gestational Diabetes Mellitus Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot Effect of Physical Activity and/or Healthy Eating on GDM Risk: The DALI Lifestyle Study. Low glycaemic index diet in pregnancy to prevent macrosomia (ROLO study): randomised control trial Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy. Randomized Controlled Trial Investigating the Effects of a Low–Glycemic Index Diet on Pregnancy Outcomes in Women at High Risk of Gestational Diabetes Mellitus: The GI Baby 3 Study The effect of diet on pregnancy outcomes among pregnant with abnormal glucose challenge test. Can a Low–Glycemic Index Diet Reduce the Need for Insulin in Gestational Diabetes Mellitus? Glyburide in Women With Mild Gestational Diabetes: A Randomized Controlled Trial Randomized trial of diet versus diet plus cardiovascular conditioning on glucose levels in gestational diabetes. Effect of Treatment of Mild Gestational Diabetes on Long-Term Maternal Outcomes. Women With Gestational Diabetes Mellitus Randomized to a Higher–Complex Carbohydrate/Low-Fat Diet Manifest Lower Adipose Tissue Insulin Resistance, Inflammation, Glucose, and Free Fatty Acids: A Pilot Study Pregnancy and Glycemic Index Outcomes study: effects of low glycemic index compared with conventional dietary advice on selected pregnancy outcomes. Effect of a low glycaemic index diet on blood glucose in women with gestational hyperglycaemia. Effect of low glycemic load diet with and without wheat bran on glucose control in gestational diabetes mellitus: A randomized trial Intake of Sweets, Snacks and Soft Drinks Predicts Weight Gain in Obese Pregnant Women: Detailed Analysis of the Results of a Randomised Controlled Trial
Background Maternal diet is known to impact pregnancy outcome . Following a low glycemic index ( GI ) diet during pregnancy has been shown to improve maternal glycemia and reduce infant birthweight and may be associated with a higher fibre intake . We assessed the impact of a low GI dietary intervention on maternal GI , nutritional intake and gestational weight gain ( GWG ) during pregnancy . Compliance and acceptability of the low GI diet was also examined . Method Eight hundred women were r and omised in early pregnancy to receive low GI and healthy eating dietary advice or to receive st and ard maternity care .  The intervention group received dietary advice at a group education session before 22 weeks gestation . All women completed a 3 day food diary during each trimester of pregnancy . Two hundred and thirty five women from the intervention arm and 285 women from the control arm returned complete 3x3d FDs and were included in the present analysis . Results Maternal GI was significantly reduced in the intervention group at trimester 2 and 3 . The numbers of women within the lowest quartile of GI increased from 37 % in trimester 1 to 52 % in trimester 3 ( P < 0.001 ) among the intervention group . The intervention group had significantly lower energy intake ( P < 0.05 ) , higher protein ( % TE ) ( P < 0.01 ) and higher dietary fibre intake ( P < 0.01 ) post intervention . Consumption of food groups with known high GI values were significantly reduced among the intervention group . Women in the intervention low GI group were less likely to exceed the Institute of Medicine ’s GWG goals . Conclusion A dietary intervention in early pregnancy had a positive influence on maternal GI , food and nutrient intakes and GWG . Following a low GI diet may be particularly beneficial for women at risk of exceeding the GWG goals for pregnancy . Trial registration Current Controlled Trials Registration Number : IS RCT N54392969 OBJECTIVE The prevalence of gestational diabetes mellitus ( GDM ) is rising . There is little evidence to demonstrate the effectiveness of one dietary therapy over another . We aim ed to investigate the effect of a low – glycemic index ( LGI ) versus a conventional high-fiber diet on pregnancy outcomes , neonatal anthropometry , and maternal metabolic profile in GDM . RESEARCH DESIGN AND METHODS Ninety-nine women ( age 26–42 years ; mean ± SD prepregnancy BMI 24 ± 5 kg/m2 ) diagnosed with GDM at 20–32 weeks ’ gestation were r and omized to follow either an LGI ( n = 50 ; target glycemic index [ GI ] ~50 ) or a high-fiber moderate-GI diet ( HF ) ( n = 49 ; target GI ~60 ) . Dietary intake was assessed by 3-day food records . Pregnancy outcomes were collected from medical records . RESULTS The LGI group achieved a modestly lower GI than the HF group ( mean ± SEM 47 ± 1 vs. 53 ± 1 ; P < 0.001 ) . At birth , there was no significant difference in birth weight ( LGI 3.3 ± 0.1 kg vs. HF 3.3 ± 0.1 kg ; P = 0.619 ) , birth weight centile ( LGI 52.5 ± 4.3 vs. HF 52.2 ± 4.0 ; P = 0.969 ) , prevalence of macrosomia ( LGI 2.1 % vs. HF 6.7 % ; P = 0.157 ) , insulin treatment ( LGI 53 % vs. HF 65 % ; P = 0.251 ) , or adverse pregnancy outcomes . CONCLUSIONS In intensively monitored women with GDM , an LGI diet and a conventional HF diet produce similar pregnancy outcomes OBJECTIVE Ways to prevent gestational diabetes mellitus ( GDM ) remain unproven . We compared the impact of three lifestyle interventions ( healthy eating [ HE ] , physical activity [ PA ] , and both HE and PA [ HE+PA ] ) on GDM risk in a pilot multicenter r and omized trial . RESEARCH DESIGN AND METHODS Pregnant women at risk for GDM ( BMI ≥29 kg/m2 ) from nine European countries were invited to undertake a 75-g oral glucose tolerance test before 20 weeks ' gestation . Those without GDM were r and omized to HE , PA , or HE+PA . Women received five face-to-face and four optional telephone coaching sessions , based on the principles of motivational interviewing . A gestational weight gain ( GWG ) < 5 kg was targeted . Coaches received st and ardized training and an intervention toolkit . Primary outcome measures were GWG , fasting glucose , and insulin sensitivity ( HOMA ) at 35–37 weeks . RESULTS Among the 150 trial participants , 32 % developed GDM  by 35–37 weeks and 20 % achieved GWG < 5 kg . HE women had less GWG ( −2.6 kg [ 95 % CI −4.9 , −0.2 ] ; P = 0.03 ) and lower fasting glucose ( −0.3 mmol/L [ −0.4 , −0.1 ] ; P = 0.01 ) than those in the PA group at 24–28 weeks . HOMA was comparable . No significant differences between HE+PA and the other groups were observed . CONCLUSIONS An antenatal HE intervention is associated with less GWG and lower fasting glucose compared with PA alone . These findings require a larger trial for confirmation but support the use of early HE interventions in obese pregnant women Context Lifestyle approaches for preventing gestational diabetes mellitus ( GDM ) have produced mixed results . Objective The aim of the present study was to compare the effectiveness of 3 lifestyle interventions [ healthy eating ( HE ) , physical activity ( PA ) , and both HE and PA ( HE+PA ) ] with usual care ( UC ) in reducing GDM risk . Design The present study was a multicenter r and omized controlled trial conducted from 2012 to 2014 [ the DALI ( vitamin D and lifestyle intervention for GDM prevention ) lifestyle study ] . Setting The study occurred at antenatal clinics across 11 centers in 9 European countries . Patients Consecutive pregnant women at < 20 weeks of gestation with a body mass index ( BMI ) of ≥29 kg/m2 and without GDM using the International Association of Diabetes and Pregnancy Study Group criteria ( n = 436 ) . For the intervention , women were r and omized , stratified by site , to UC , HE , PA , or HE+PA . The women received 5 face-to-face and ≤4 telephone coaching sessions using the principles of motivational interviewing . A gestational weight gain ( GWG ) < 5 kg was targeted . The coaches received st and ardized training and an intervention toolkit tailored to their culture and language . Main Outcome Measures The endpoints were the GWG at 35 to 37 weeks and the fasting glucose and insulin sensitivity [ homeostasis model assessment insulin resistance ( HOMA-IR ) ] at 24 to 28 weeks . Results We r and omized 108 women to HE+PA , 113 to HE , 110 to PA , and 105 to UC . In the HE+PA group , but not HE or PA alone , women achieved substantially less GWG than did the controls ( UC ) by 35 to 37 weeks ( -2.02 ; 95 % confidence interval , -3.58 to -0.46 kg ) . Despite this reduction , no improvements were seen in fasting or postload glucose levels , insulin concentrations , or HOMA-IR . The birthweights and large and small for gestational age rates were similar . Conclusions The combined HE+PA intervention was able to limit GWG but did not reduce fasting glycemia . Thus , lifestyle changes alone are unlikely to prevent GDM among women with a BMI of ≥29 kg/m2 Objective To determine if a low glycaemic index diet in pregnancy could reduce the incidence of macrosomia in an at risk group . Design R and omised controlled trial . Setting Maternity hospital in Dublin , Irel and . Participants 800 women without diabetes , all in their second pregnancy between January 2007 to January 2011 , having previously delivered an infant weighing greater than 4 kg . Intervention Women were r and omised to receive no dietary intervention or start on a low glycaemic index diet from early pregnancy . Main outcomes The primary outcome measure was difference in birth weight . The secondary outcome measure was difference in gestational weight gain . Results No significant difference was seen between the two groups in absolute birth weight , birthweight centile , or ponderal index . Significantly less gestational weight gain occurred in women in the intervention arm ( 12.2 v 13.7 kg ; mean difference −1.3 , 95 % confidence interval −2.4 to −0.2 ; P=0.01 ) . The rate of glucose intolerance was also lower in the intervention arm : 21 % ( 67/320 ) compared with 28 % ( 100/352 ) of controls had a fasting glucose of 5.1 mmol/L or greater or a 1 hour glucose challenge test result of greater than 7.8 mmol/L ( P=0.02 ) . Conclusion A low glycaemic index diet in pregnancy did not reduce the incidence of large for gestational age  infants in a group at risk of fetal macrosomia . It did , however , have a significant positive effect on gestational weight gain and maternal glucose intolerance . Trial registration Current Controlled Trials IS RCT N54392969 The present study is a secondary analysis of the ROLO study , a r and omised 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 OBJECTIVE Dietary interventions can improve pregnancy outcomes in women with gestational diabetes mellitus ( GDM ) . We compared the effect of a low – glycemic index ( GI ) versus a conventional high-fiber ( HF ) diet on pregnancy outcomes , birth weight z score , and maternal metabolic profile in women at high risk of GDM . RESEARCH DESIGN AND METHODS One hundred thirty-nine women [ mean ( SD ) age 34.7 ( 0.4 ) years and prepregnancy BMI 25.2 ( 0.5 ) kg/m2 ] were r and omly assigned to a low-GI ( LGI ) diet ( n = 72 ; target GI ∼50 ) or a high-fiber , moderate-GI ( HF ) diet ( n = 67 ; target GI ∼60 ) at 14–20 weeks ’ gestation .  Diet was assessed by 3-day food records and infant body composition by air-displacement plethysmography , and pregnancy outcomes were assessed from medical records . RESULTS The LGI group achieved a lower GI than the HF group [ mean ( SD ) 50 ( 5 ) vs. 58 ( 5 ) ; P < 0.001 ] . There were no differences in glycosylated hemoglobin , fructosamine , or lipids at 36 weeks or differences in birth weight [ LGI 3.4 ( 0.4 ) kg vs. HF 3.4 ( 0.5 ) kg ; P = 0.514 ] , birth weight z score [ LGI 0.31 ( 0.90 ) vs. HF 0.24 ( 1.07 ) ; P = 0.697 ] , ponderal index [ LGI 2.71 ( 0.22 ) vs. HF 2.69 ( 0.23 ) kg/m3 ; P = 0.672 ] , birth weight centile [ LGI 46.2 ( 25.4 ) vs. HF 41.8 ( 25.6 ) ; P = 0.330 ] , % fat mass [ LGI 10 ( 4 ) vs. HF 10 ( 4 ) ; P = 0.789 ] , or incidence of GDM . CONCLUSIONS In intensively monitored women at risk for GDM , a low-GI diet and a healthy diet produce similar pregnancy outcomes OBJECTIVES Gestational diabetes mellitus ( GDM ) is defined as glucose intolerance , first time detected in pregnancy . Diagnostic criteria for GDM have changed over the decades . The aim of the study was to examine the effect of diet on birth weight , number of large for gestational age ( LGA ) ( birth weight  > 90th percentile ) babies  , total maternal weight gain , gestational age and route of delivery among patients with positive 50 g glucose challenge test ( GCT ) and negative 100 g oral glucose tolerance test ( OGTT ) . PATIENTS AND METHODS A prospect i ve r and omized controlled study was conducted among patients with positive 50 g GCT and negative 100 g OGTT . A plasma glucose value of 140 mg/dL was used as the threshold to define an abnormal GCT result . In group 1 50 patients were given a caloric diet and compared with group 2 with 50 patients without a given diet .  Patients were followed up until delivery and evaluated for birth weight , number of LGA babies , total maternal weight gain , gestational age and route of delivery . RESULTS There were no significant differences between the groups in maternal age , parity , body mass index and gestational age at delivery . There were significant differences in birth weight , number of LGA babies , total maternal weight gain during pregnancy . The mean gestational age at delivery was 38.7±1.2 weeks in group 1 and 38.9±1.1 weeks in group 2 ( p = 0.615 ) . The mean birth weight in group 1 was 3328±399 g and 3623±485 g in group 2 ( p = 0.007 ) , cesarean rate was 32 % in group 1 and 40 % in group 2 ( p = 0.405 ) . CONCLUSIONS In the management of patients with positive 50 g GCT and negative 100 g OGTT , patients who were prescribed medical nutrition therapy by a dietitian experienced in GDM management had better perinatal outcomes OBJECTIVE A low – glycemic index diet is effective as a treatment for individuals with diabetes and has been shown to improve pregnancy outcomes when used from the first trimester . A low – glycemic index diet is commonly advised as treatment for women with gestational diabetes mellitus ( GDM ) . However , the efficacy of this advice and associated pregnancy outcomes have not been systematic ally examined . The purpose of this study was to determine whether prescribing a low – glycemic index diet for women with GDM could reduce the number of women requiring insulin without compromise of pregnancy outcomes . RESEARCH DESIGN AND METHODS All women with GDM seen over a 12-month period were considered for inclusion in the study . Women ( n = 63 ) were r and omly assigned to receive either a low – glycemic index diet or a conventional high-fiber ( and higher glycemic index ) diet . RESULTS Of the 31 women r and omly assigned to a low – glycemic index diet , 9 ( 29 % ) required insulin . Of the women r and omly assigned to a higher – glycemic index diet , a significantly higher proportion , 19 of 32 ( 59 % ) , met the criteria to commence insulin treatment ( P = 0.023 ) . However , 9 of these 19 women were able to avoid insulin use by changing to a low – glycemic index diet . Key obstetric and fetal outcomes were not significantly different . CONCLUSIONS Using a low – glycemic index diet for women with GDM effectively halved the number needing to use insulin , with no compromise of obstetric or fetal outcomes OBJECTIVE : To evaluate whether the addition of glyburide to diet therapy modifies pregnancy outcomes in women with mild gestational diabetes . METHODS : Women with at least two abnormal values on a 3-hour , 100-g oral glucose tolerance test according to National Diabetes Data Group criteria and fasting values less than 105 mg/dL between 24 and 30 weeks of gestation were r and omized to blinded glyburide or placebo study drug . All women were placed on a 35-kcal/kg diet and recorded four times daily capillary glucose measurements . The study drug was titrated based on weekly maternal capillary glucose values with targets of less than 95 mg/dL ( 5.3 mmol/L ) and 120 mg/dL ( 6.7 mmol/L ) for fasting and 2-hour postpr and ial glucose measurements , respectively . The primary study outcome was a 200-g birth weight decrement in neonates of women treated with glyburide . The sample size estimate for this outcome was 334 total r and omized women with a one-to-one allocation . RESULTS : A total of 395 women were enrolled at a single center between September 2008 and October 2012 . Women treated with glyburide had a significantly greater decline in fasting glucose values over the course of therapy . However , there was no difference in the primary study outcome . Specifically , the mean birth weight was 33 g lower in the group treated with glyburide ( P=.52 ) . Although not powered to examine all outcomes associated with gestational diabetes , treatment with glyburide did not affect need for operative delivery , shoulder dystocia , clavicular fracture , Erb 's palsy , or neonatal hypoglycemia . Four women in each group required insulin . CONCLUSION : The addition of glyburide to diet therapy significantly improved maternal glycemic control over time when compared with placebo . However , adding glyburide to diet did not decrease birth weight or improve maternal or neonatal outcomes in women with mild gestational diabetes . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00744965 . LEVEL OF EVIDENCE : We studied the impact of a training program on glucose tolerance in gestational diabetes mellitus . Women with gestational diabetes mellitus ( N = 19 ) were r and omized into either group I , a 6-week diet alone group ( 24 to 30 kcal/kg/24 hours ; 20 % protein , 40 % carbohydrate , 40 % fat ) , or group II , which followed the same diet plus exercise ( 20 minutes three times a week for 6 weeks ) . An arm ergometer was used to maintain heart rate in the training range . Glycemic response was monitored by glycosylated hemoglobin , a 50 gm oral glucose challenge with a fasting and 1-hour plasma glucose , and blood glucose self-monitoring , fasting and 1 hour  after meals .  Week 1 glycemic parameters were the same for both groups . Week 6 data ( mean + /- SD ) were as follows : group I glycosylated hemoglobin , 4.7 % + 0.2 % versus group II , 4.2 % + /- 0.2 % ; p less than 0.001 . The group I glucose challenge fasting value was 87.6 + /- 6.2 versus 70.1 + /- 6.6 mg/dl , p less than 0.001 for group II . The group I 1-hour plasma glucose challenge result was 187.5 + /- 12.9 mg/dl versus 105.9 + /- 18.9 mg/dl for group II , p less than 0.001 . The glycemic levels diverged between the groups at week 4 . We conclude that arm ergometer training is feasible in women with gestational diabetes mellitus and results in lower glycosylated hemoglobin , fasting , and 1-hour plasma glucose concentrations than diet alone . Arm ergometer training may provide a useful treatment option for women with gestational diabetes mellitus and may obviate insulin treatment OBJECTIVE The main purpose of this article is to evaluate whether identification and treatment of women with mild gestational diabetes mellitus ( GDM ) during pregnancy affects subsequent maternal body mass index ( BMI ) , anthropometry , metabolic syndrome , and risk of diabetes . STUDY DESIGN This is a follow-up study of women who participated in a r and omized controlled treatment trial for mild GDM . Women were enrolled between 5 and 10 years after their index pregnancy . Participants underwent  blood pressure , height , weight , and anthropometric measurements by trained nursing personnel using a st and ardized approach . A nurse-assisted question naire regarding screening and treatment of diabetes or hypercholesterolemia , diet , and physical activity was completed . Laboratory evaluation included fasting serum glucose , fasting insulin , oral glucose tolerance test , and a lipid panel . Subsequent diabetes , metabolic syndrome , obesity , and adiposity in those diagnosed with mild GDM and r and omized to nutritional counseling and medical therapy ( treated ) were compared with those who underwent routine pregnancy management ( untreated ) . Multivariable analyses were performed adjusting for race/ethnicity and years between r and omization and follow-up visit . RESULTS Four-hundred fifty-seven women with mild GDM during the index pregnancy were included in this analysis ( 243 treated ; 214 untreated ) and evaluated at a median 7 years after their index pregnancy . Baseline and follow-up characteristics were similar between treatment groups . Frequency of diabetes ( 9.2 vs. 8.5 % , p = 0.80 ) , metabolic syndrome ( 32.2 vs. 34.3 % , p = 0.63 ) , as well as adjusted mean values of homeostasis model assessment for insulin resistance ( 2.5 vs. 2.3 , p = 0.11 ) and BMI ( 29.4 vs. 29.1 kg/m2 , p = 0.67 ) were also not different . CONCLUSION Identification and treatment of women with mild GDM during pregnancy had no discernible impact on subsequent diabetes , metabolic syndrome , or obesity 7 years after delivery OBJECTIVE Diet therapy in gestational diabetes mellitus ( GDM ) has focused on carbohydrate restriction but is poorly substantiated . In this pilot r and omized clinical trial , we challenged the conventional low-carbohydrate/higher-fat ( LC/CONV ) diet , hypothesizing that a higher – complex carbohydrate/lower-fat ( CHOICE ) diet would improve  maternal insulin resistance ( IR ) , adipose tissue ( AT ) lipolysis , and infant adiposity . RESEARCH DESIGN AND METHODS At 31 weeks , 12 diet-controlled overweight/obese women with GDM were r and omized to an isocaloric LC/CONV ( 40 % carbohydrate/45 % fat/15 % protein ; n = 6 ) or CHOICE ( 60%/25%/15 % ; n = 6 ) diet . All meals were provided . AT was biopsied at 37 weeks . RESULTS After ∼7 weeks , fasting glucose ( P = 0.03 ) and free fatty acids ( P = 0.06 ) decreased on CHOICE , whereas fasting glucose increased on LC/CONV ( P = 0.03 ) . Insulin suppression of AT lipolysis was improved on CHOICE versus LC/CONV ( 56 vs. 31 % , P = 0.005 ) , consistent with improved IR . AT expression of multiple proinflammatory genes was lower on CHOICE ( P < 0.01 ) . Infant adiposity trended lower with CHOICE ( 10.1 ± 1.4 vs. 12.6 ± 2 % , respectively ) . CONCLUSIONS A CHOICE diet may  improve maternal IR and infant adiposity  , challenging recommendations for a LC/CONV diet BACKGROUND Eating carbohydrate foods with a high glycemic index ( GI ) has been postulated to result in fetoplacental overgrowth and higher infant body fat . A diet with a low glycemic index ( LGI ) has been shown to reduce birth percentiles and the ponderal index ( PI ) . OBJECTIVES We investigated whether offering LGI dietary advice at the first antenatal visit would result in a lower fetal birth weight , birth percentile , and PI than providing healthy eating ( HE ) advice . This advice had to be presented within the re sources of routine antenatal care . DESIGN The Pregnancy and Glycemic Index Outcomes study was a 2-arm , parallel- design , r and omized , controlled trial that compared the effects of LGI dietary advice with HE advice on pregnancy outcomes . Eligible volunteers who attended for routine antenatal care at < 20 wk of gestation were r and omly assigned to either group . RESULTS A total of 691 women were enrolled , and 576 women had final data considered . In the LGI group , the GI was reduced from a mean ( ± SEM ) of 56 ± 0.3 at enrollment to 52 ± 0.3 ( P < 0.001 ) at the final assessment . There were no significant differences in primary outcomes of fetal birth weight , birth percentile , or PI . In a multivariate regression analysis , the glycemic load was the only significant dietary predictor ( P = 0.046 ) of primary outcomes but explained < 1 % of all variation . CONCLUSION A low-intensity dietary intervention with an LGI diet compared with an HE diet in pregnancy did not result in any significant differences in birth weight , fetal percentile , or PI AIM The objectives of this pilot study were to determine the feasibility and effect on glycaemic control of a low-glycaemic-index ( GI ) diet in women with gestational diabetes or impaired glucose tolerance of pregnancy . METHODS participants , recruited from the Diabetes-in-Pregnancy Clinic of an inner-city teaching hospital serving a predominantly non-Caucasian population , were r and omized to a low-GI ( n=23 ) or control ( n=24 ) diet and followed from 28 weeks gestation until delivery .  Self-monitored-blood-glucose ( SMBG ) , maternal and infant weight were collected from medical charts .  Dietary intakes were assessed using diet records and question naires . RESULTS diet GI on control ( 58 , 95 % CI : 56,60 ) was significantly higher than on low-GI ( 49 , 95 % CI : 47,51 ; p=0.001 ) . Glycaemic control improved on both diets , but more postpr and ial glucose values were within target on low-GI ( 58.4 % of n=1891 ) than control ( 48.7 % of n=1834 ; p<0.001 ) . SMBG post-breakfast was directly related to pre-pregnancy BMI in the control , but not the low-GI group ( BMI * diet interaction ; p=0.021 ) . Participants accepted the study foods and were willing to consume them post-intervention . CONCLUSIONS a low-GI diet was feasible and acceptable in this sample and facilitated control of postpr and ial glucose . A larger study is needed to determine the effect of a low-GI diet on maternal and infant outcomes Background : A low-glycemic index diet is effective in blood glucose control of diabetic subjects , reduces insulin requirement in women with gestation diabetes mellitus ( GDM ) and improves pregnancy outcomes when used from beginning of the second trimester . However there are limited reports to examine the effect of low glycemic load ( LGL ) diet and fiber on blood glucose control and insulin requirement of women with GDM . Therefore , the aim of this study was to examine the effect of low glycemic load diet with and without fiber on reducing the number of women with GDM requiring insulin . Material s and Methods : All GDM women ( n = 31 ) were r and omly allocated to consume either a LGL diet with Fiber or LGL diet . Results : We found that 7 ( 38.9 % ) of 18 women with GDM in Fiber group and 10 ( 76.9 % ) in “ Without Fiber ” group required insulin treatment . Conclusion : The LGL diet with added fiber for women with GDM dramatically reduced the number needing for insulin treatment Background Lifestyle interventions targeting obese pregnant women often result in modest reduction in gestational weight gain , pregnancy complications and related risk factors . Examining adherence to the intervention can , however , provide valuable information on the importance of the different factors targeted . Objective To evaluate improvements and relevance of different dietary factors targeted with respect to gestational weight gain in a 3-arm R and omised Controlled Trial ( n=342 ) among obese pregnant women with BMI ≥30 kg/m2 . Methods R and omisation 1:1:1 to either hypocaloric Mediterranean type of diet and physical activity intervention ( D+PA ) ; physical activity intervention alone ( PA ) ; or control ( C ) . Diet was assessed at baseline ( weeks 11–14 ) and endpoint ( weeks 36–37 ) using a vali date d food frequency question naire . Results During the intervention women in the D+PA group significantly lowered their intakes of added sugars and saturated fat and increased their protein intake by ~1 % of total energy compared to controls . Of these dietary variables only intakes of added sugar appeared to be related to GWG , while no association was observed for saturated fat or protein . Further analyses revealed that foods that contributed to intake of added sugars , including sweets , snacks , cakes , and soft drinks were strongly associated with weight gain , with women consuming sweets ≥2/day having 5.4 kg ( 95 % CI 2.1 - 8.7 ) greater weight gain than those with a low ( < 1wk ) intake . The results for soft drinks were more conflicting , as women with high weight gain tended to favour artificially sweetened soft drinks . Conclusion In our sample of obese pregnant women , craving for sweets , snacks , and soft drinks strongly predicts GWG . Emphasis on reducing intakes of these foods may be more relevant for limiting gestational weight gain than encouraging strict compliance to more specific diets . Trial Registration Clinical Trials.gov
In general , when given alongside gestational weight gain advice , fasting glucose improved in most diets compared to diets that gave gestational weight gain advice only .
However , fasting glucose increased in high unsaturated or monounsaturated fatty acids diets .
In the absence of gestational weight gain advice , fasting glucose improved in DASH-style diets compared to st and ard of care .
Although most were non-significant , similar trends were observed for these same diets for the other glycemic outcomes .
/INTERPRETATION Alongside with gestational weight gain advice , most diets , with the exception of a high unsaturated or a high monounsaturated fatty acid diet , demonstrated a fasting glucose improvement compared with gestational weight gain advice only .
When gestational weight gain advice was not given , the DASH-style diet appeared optimal on fasting glucose .
However , a small number of trials were identified and most dietary comparisons were underpowered to detect differences in glycemic outcomes .
AIMS Evidence to support dietary modifications to improve glycemia during pregnancy is limited , and the benefits of diet beyond limiting gestational weight gain is unclear .
Therefore , a systematic review and network meta- analysis of r and omized trials was conducted to compare the effects of various common diets , stratified by the addition of gestational weight gain advice , on fasting glucose and insulin , hemoglobin A1c ( HbA1c ) , and homeostatic model assessment for insulin resistance ( HOMA-IR ) in pregnant women .