Glycemic control in women with GDM: insights from a randomized controlled pilot trial on plant-based Nordic healthy diet versus moderately carbohydrate restricted diet.
Study Goal
The researchers aimed to compare the effects of a plant-protein rich Healthy Nordic Diet (HND) and a moderately carbohydrate restricted diet (MCRD) on glucose control and newborn body composition in women with Gestational Diabetes Mellitus (GDM).
Results Summary
Both diets effectively maintained high time within the glucose target range, with no significant differences in glucose variability, lipid metabolism, gestational weight gain, or newborn body composition. The MCRD group had slightly lower mean glucose levels, while the HND group showed reduced meat intake and increased fish consumption.
Population
Women with Gestational Diabetes Mellitus (GDM) between gestational weeks 24+0 and 28+6.
Effective Dosage
Macronutrient composition for MCRD: fat 40.6 E%, carbohydrate 40.5 E%, protein 18.9 E%; for HND: fat 39.5 E%, carbohydrate 42.4 E%, protein 18.1 E%.
Duration
From gestational weeks 24+0-28+6 (baseline) until delivery.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
moderately carbohydrate restricted diet (MCRD) | decrease | mean glucose | women with GDM | 5.0 SD 1.03 vs. 5.2 SD 0.96 mmol/l | was lower | #1 |
Healthy Nordic Diet (HND) | no change | time in glucose target range (%TIR) | women with GDM | 99.3% | maintained | #2 |
moderately carbohydrate restricted diet (MCRD) | no change | time in glucose target range (%TIR) | women with GDM | 98.9% | maintained | #3 |
Healthy Nordic Diet (HND) | no change | glucose variability | women with GDM | - | no differences were observed | #4 |
moderately carbohydrate restricted diet (MCRD) | no change | glucose variability | women with GDM | - | no differences were observed | #5 |
Healthy Nordic Diet (HND) | no change | lipid metabolism | women with GDM | - | no differences were observed | #6 |
moderately carbohydrate restricted diet (MCRD) | no change | lipid metabolism | women with GDM | - | no differences were observed | #7 |
Healthy Nordic Diet (HND) | no change | gestational weight gain | women with GDM | - | no differences were observed | #8 |
moderately carbohydrate restricted diet (MCRD) | no change | gestational weight gain | women with GDM | - | no differences were observed | #9 |
Healthy Nordic Diet (HND) | no change | body composition | newborns | - | no differences were observed | #10 |
moderately carbohydrate restricted diet (MCRD) | no change | body composition | newborns | - | no differences were observed | #11 |
Healthy Nordic Diet (HND) | decrease | intake of meat | women with GDM | - | decreased | #12 |
Healthy Nordic Diet (HND) | increase | fish consumption | women with GDM | - | increased | #13 |
BACKGROUND: Gestational Diabetes Mellitus (GDM) prevalence is rising worldwide, but optimal dietary strategies remain unclear. The eMOM pilot RCT compared a plant-protein rich Healthy Nordic Diet (HND) and a moderately carbohydrate restricted diet (MCRD) and their potential effects on time in glucose target range (≤ 7.8 mmol/L, %TIR), and on newborn body composition. METHODS: Forty-two participants were randomized to either HND (n = 20) or MCRD (n = 22) face-to-face nutritional counseling from gestational weeks (GW) 24 + 0-28 + 6 (baseline) until delivery. The HND intervention had no restriction in carbohydrate intake and emphasized plant-based protein sources and Nordic food, while the MCRD had a moderate carbohydrate restriction (~ 40% in proportion to total daily energy consumption, E%). Continuous glucose monitoring was worn for 14 days to assess glucose levels and %TIR. Blood samples for glucose and lipid metabolism and 3-day food diaries were collected at baseline and at GW 34 + 0-35 + 6. Neonatal body composition was measured by air displacement plethysmography. Difference between groups were analysed with t-test and Wilcoxon test. RESULTS: Thirty-two women completed the study. Both groups maintained the %TIR during majority of the time (98.9 and 99.3% for MCRD and HND respectively, p = 0.921) in GW 34 + 0 - 35 + 6. The mean glucose was lower in the MCRD group compared to the HND group (5.0 SD 1.03 vs. 5.2 SD 0.96 mmol/l, p < 0.001). No differences were observed in glucose variability, lipid metabolism, gestational weight gain, or in the body composition of the newborns. HND had lower diet macronutrient adherence than the MCRD, resulting in similar macronutrient composition in both groups. The mean macronutrient intakes were fat: 40.6 vs. 39.5 E%, carbohydrate: 40.5 vs. 42.4 E%, protein: 18.9 vs. 18.1 E% for the MCRD and HND groups, respectively. The HND decreased intake of meat and increased fish consumption significantly compared to the MCRD. CONCLUSIONS: Both a moderately restricted carbohydrate diet and a diet focused on plant-based protein effectively maintained a large time within the treatment target range in women with GDM. Further research could explore the impact of protein quantity and sources in maternal diets on glycemic control and newborn outcomes. TRIAL REGISTRATION: The eMOM pilot trial is registered in Clinicaltrials.gov (21/09/2018, NCT03681054).