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Effectiveness of Low Glycemic Index Diet Consultations Through a Diet Glycemic Assessment App Tool on Maternal and Neonatal Insulin Resistance: A Randomized Controlled Trial.

JMIR mHealth and uHealth
April 18, 2019
Yi Zhang et al. (13 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to examine the effectiveness of individualized low-glycemic-index (LGI) diet consultations on maternal and neonatal insulin resistance levels and diet behavior changes in overweight and obese pregnant women.

Results Summary

The study found no significant differences in maternal serum insulin levels, incidence of gestational diabetes mellitus (GDM), or neonatal cord blood C-peptide levels between the intervention and control groups. The intervention group showed greater fiber intake but similar diet glycemic index (GI) compared to controls.

Population

Overweight and obese pregnant women recruited before 16 weeks of gestation.

Effective Dosage

Not specified (individualized dietary GL assessments and LGI diet instructions provided at early, middle, and late gestation).

Duration

From early gestation (before 16 weeks) to late gestation.

Interactions

None mentioned

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
individualized LGI diet consultations based on the accurate diet glycemic load (GL) assessment tool
no change
maternal or neonatal insulin resistance
overweight and obese pregnant women
no significant difference
failed to make a significant difference
#1
individualized LGI diet consultations
no change
maternal serum insulin levels
overweight and obese pregnant women
13.2 [9.3-13.2] uU/mL vs 12.4 [10.5-12.4] uU/mL
no significant differences
#2
individualized LGI diet consultations
no change
incidence of gestational diabetes mellitus (GDM)
overweight and obese pregnant women
45 [22.5%] vs 43 [21.5%]
no significant differences
#3
individualized LGI diet consultations
no change
cord blood C-peptide levels
neonates
mean 0.9ng/mL [SD 0.7] vs mean 0.8ng/mL [SD 0.6]
no significant differences
#4
individualized LGI diet consultations
no change
diet GI at late gestation
overweight and obese pregnant women
mean 63.2 [SD 10.4] vs mean 64.3 [SD 10.4]
similar
#5
individualized LGI diet consultations
increase
diet fiber intake
overweight and obese pregnant women
mean 11.6 grams [SD 8.0] vs mean 9.0 grams [SD 5.6]; P=.006
greater
#6
individualized LGI diet consultations
no change
adherence measurements
overweight and obese pregnant women
no significant difference
did not significantly differ
#7
Abstract

BACKGROUND: Low glycemic index (LGI) diet has shown to be effective in reducing maternal and neonatal complications in high-risk pregnancies. OBJECTIVE: This trial aimed to examine the effectiveness of individualized LGI diet consultations based on the accurate diet glycemic load (GL) assessment tool on maternal and neonatal insulin resistance levels and diet behavior changes in overweight and obese pregnant women. METHODS: Overweight and obese pregnant women were recruited before 16 weeks of gestation and randomized to the LGI diet arm or the control arm. All participants received standard dietary education according to the Chinese Dietary Guide for Pregnant Women. In the intervention arm, additional individualized dietary GL assessments were performed using an app and instructions of lowering diet glycemic index (GI) to achieve LGI diet were provided by a clinical dietitian at early, middle, and late gestation. Primary outcomes were serum insulin at late gestation, incidence of gestational diabetes mellitus (GDM) for mothers, and cord blood C-peptide level of neonates. RESULTS: In total, 400 subjects were randomized and received different interventions. There were no significant differences in maternal serum insulin levels (13.2 [9.3-13.2] uU/mL vs 12.4 [10.5-12.4] uU/mL), incidence of GDM (45 [22.5%] vs 43 [21.5%]), or cord blood C-peptide levels (mean 0.9ng/mL [SD 0.7] vs mean 0.8ng/mL [SD 0.6]) in the intervention group compared with the controls. The diet GI at late gestation was similar (mean 63.2 [SD 10.4] vs mean 64.3 [SD 10.4]), whereas greater diet fiber intake was observed in the intervention group (mean 11.6 grams [SD 8.0] vs mean 9.0 grams [SD 5.6]; P=.006). Adherence measurements did not significantly differ between 2 groups. CONCLUSIONS: Individualized LGI diet consultations for overweight and obese pregnant women failed to make a significant difference in maternal or neonatal insulin resistance compared with the standard gestational diet consultation. TRIAL REGISTRATION: ClinicalTrials.gov NCT01628835; http://clinicaltrials.gov/ct2/show/NCT01628835 (Archived by WebCite at http://www.webcitation.org/77LHgWP0k).

Medical Subject Headings (MeSH)
AdultChild Health ServicesChinaDiet TherapyFemaleGlycemic IndexHumansInfant, NewbornInsulin ResistanceMaleMaternal Health ServicesMobile ApplicationsReferral and Consultation
Study Links
Quality Scores
Safety85
Efficacy30/10
Quality80/10
Citation Metrics
Total Citations15
Citations/Year2.5
Relative Citation Ratio1.17
NIH Percentile56.1%
Research Impact Scores
APT Score0.75
Weight Score2.23
Normalized Score0.62
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