Diet and Exercise Reduce Gestational Weight Gain, Not Neonatal Adiposity

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The diet and exercise intervention group had reductions in glucose level and gestational weight gain.
The diet and exercise intervention group had reductions in glucose level and gestational weight gain.

This article is part of Endocrinology Advisor's coverage of the American Diabetes Association's 77th Scientific Sessions (ADA 2017), taking place in San Diego, CA. Our staff will report on medical research and technological advances in diabetes and diabetes education, conducted by experts in the field. Check back regularly for more news from ADA 2017.


According to findings of a randomized trial presented at the American Diabetes Association (ADA) 77th Scientific Sessions, a diet and exercise intervention in women with obesity or overweight  led to reductions in glucose levels and gestational weight gain (GWG) but not neonatal adiposity.1

Hyperglycemia, obesity, and excessive weight gain in pregnancy have been linked with elevated neonatal adiposity, which has been found to increase the risk for childhood obesity.2

In the present study, researchers from the Northwestern University Feinberg School of Medicine in Chicago investigated whether a diet and lifestyle intervention in women with obesity or overweight would help limit GWG to target ranges recommended by the Institute of Medicine guidelines.

Before their 16th week of pregnancy, women with a body mass index of 25 to 40 kg/m2 were randomly assigned to either standard care (n=104) or diet and exercise intervention (n=118) guided by a dietitian. Treating physicians and data collectors for the study were blinded to each patient's group assignment. Groups did not differ in terms of maternal age, race, baseline body mass index, or neonatal gestational age and sex.

The results showed that the intervention group had lower mean glucose levels on the 50-g test compared with the standard-care group (100.6 vs 107.6 mg/dL, P =.037) and on the oral glucose tolerance test (fasting 75.0 vs 81.9 mg/dL, P =.004). The intervention group also had lower rates of GWG vs those in the standard-care group (0.89 vs 1.05 lb/wk, P =.017).

However, neonates of the 2 groups did not differ in terms of birthweight, fat mass, body fat percentage, and sum of skinfolds, even after adjustment for maternal race, rate of GWG, and gestational age.

"In summary, diet and lifestyle intervention resulted in improved glucose tolerance and less GWG, yet no difference in birth weight or neonatal adiposity," the researchers wrote. "Whether future adiposity differences emerge requires further follow-up."


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References

  1. Josefson JL, Peaceman AM, Kwasny MJ, Gernhofer N, Vincent E, Van Horn L. Glucose tolerance and neonatal adiposity in women enrolled in a randomized diet and lifestyle clinical trial to prevent excess gestational weight gain. Poster 1450. Presented at: the American Diabetes Association 77th Scientific Sessions. June 9-13, 2017; San Diego, CA.
  2. Badon SE, Dyer AR, Josefson JL; for the HAPO Study Cooperative Research Group. Gestational weight gain and neonatal adiposity in the Hyperglycemia and Adverse Pregnancy Outcome Study-North American Region. Obesity (Silver Spring). 2014;22:1731-1738. doi:10.1002/oby.20742
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