Effects of a low-glycemic load diet in overweight and obese pregnant women: A pilot randomized controlled trial

Division of Endocrinology, Children's Hospital Boston, Boston, MA, USA.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 10/2010; 92(6):1306-15. DOI: 10.3945/ajcn.2010.30130
Source: PubMed


The optimal diet for pregnancy that is complicated by excessive weight is unknown.
We aimed to examine the effects of a low-glycemic load (low-GL) diet in overweight and obese pregnant women.
We randomly assigned 46 overweight or obese pregnant women to receive a low-GL or a low-fat diet. Participants received carbohydrate-rich foods, fats, and snack foods through home delivery or study visits. The primary outcome was birth weight z score. Other endpoints included infant anthropometric measurements, gestational duration, maternal weight gain, and maternal metabolic parameters.
There were no significant differences in birth weight z score or other measures of infant adiposity between groups. However, in the low-GL compared with the low-fat group, gestational duration was longer (mean ± SD: 39.3 ± 1.1 compared with 37.9 ± 3.1 wk; P = 0.05) and fewer deliveries occurred at ≤ 38.0 wk (13% compared with 48%, P = 0.02; with exclusion of planned cesarean deliveries: 5% compared with 53%; P = 0.002). Adjusted head circumference was greater in the low-GL group (35.0 ± 0.8 compared with 34.2 ± 1.3 cm, P = 0.01). Women in the low-GL group had smaller increases in triglycerides [median (interquartile range): 49 (19, 70) compared with 93 (34, 129) mg/dL; P = 0.03] and total cholesterol [13 (0, 36) compared with 33 (22, 56) mg/dL, P = 0.04] and a greater decrease in C-reactive protein [-2.5 (-5.5, -0.7) compared with -0.4 (-1.4, 1.5) mg/dL, P = 0.007].
A low-GL diet resulted in longer pregnancy duration, greater infant head circumference, and improved maternal cardiovascular risk factors. Large-scale studies are warranted to evaluate whether dietary intervention during pregnancy aimed at lowering GL may be useful in the prevention of prematurity and other adverse maternal and infant outcomes. This trial is registered at as NCT00364403.

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Available from: Henry A. Feldman, Mar 26, 2014
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    • "Clapp (1997) and Moses et al. (2006) documented that those women in the low GI groups had a lower prevalence of large-for-gestational-age infants than did those on a high GI diet. Although Rhodes et al. (2010) and more recently, Walsh et al. (2010) found little or no effect on an infant's birth weight in obese women or in a group of women at risk of foetal macrosomia, respectively, an improvement in maternal outcomes was an encouraging finding after a low GI dietary intervention. "
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    • "A possible limitation of the current study was that the low GI advice was only delivered once during pregnancy. All previous clinical trials of low GI diet and pregnancy delivered advice on a number of occasions [6,32]. Despite this, having a successful once-off dietary intervention would be more feasible to carry out on a larger scale. "
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    • "Associations of maternal dietary intake during pregnancy with neonatal head circumference are not necessarily consistent with those for birth weight. In a small randomized trial, the offspring of mothers receiving a low glycemic index diet had similar birth weight but increased head circumference relative to those receiving a low-fat diet (Rhodes et al., 2010). Whilst the evidence remains preliminary, these studies collectively offer support for the hypothesis that the emergence of agricultural diets, with higher glycemic load and lower protein content than typical forager diet, could have impacted each of maternal size and neonatal mass and brain size, and may therefore have exacerbated the obstetric dilemma. "
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