Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 2, 2018
Open Peer Review Period: Sep 7, 2018 - Nov 2, 2018
Date Accepted: Feb 17, 2019
(closed for review but you can still tweet)
Effectiveness of Low-Glycemic Diet Consultations through Assessment APP tool on Maternal and Neonatal Insulin Resistance: a Randomized Controlled Trial
ABSTRACT
Background:
Low glycemic index (LGI) diet showed effective in reducing maternal and neonatal clinical complications in high risk pregnancies. Hoever, it is not clear if a diet consultation about low glycemic diet based on a smart phone APP will impact maternal or neonatal insulin resistance in overweight or obese pregnant woman .
Objective:
This trial aimed to examine the effectiveness of individualized LGI diet consutation based on accurate diet glycemic load assessment tool on maternal and neonatal insulin resistance levels and diet behavior changes in overweight/obese pregnant women.
Methods:
Overweight/obese pregnant women were recruited before 16 weeks of gestation and randomized to the LGI diet arm or the control arm. All participants received a standard dietary education according to Chinese Dietary Guide for Pregnant Women. In the intervention arm, additional individualized dietary glycemic load assessment were performed using a APP and instruction of lowering diet glycemic to achiieve LGI diet were provided by clinical dietitian at early, middle and late gestation. Primary outcomes were serum insulin at late gestation, incidence of GDM for mothers, and cord blood C-peptide level of neonates.
Results:
Four hundred subjects were randomized and received the intervention. There were no significant differences in maternal serum insulin (13.2[9.3,13.2] vs. 12.4[10.5,12.4) uU/mL), incidence of GDM (22.5% vs. 21.5%) or cord blood C-peptide levels (0.9±0.7 vs. 0.8±0.6 ng/mL) in the intervention group compared with the controls. The diet glycemic index at late gestation was similar (63.2±10.4 vs. 64.3±10.4), whereas greater diet fiber intake was observed in the intervention group (11.6±8.0 vs. 9.0±5.6g, P=0.006). Adherence measurements did not significantly differ between two groups.
Conclusions:
Individualized LGI diet consultations to overweight/obese pregnant women failed to make significant difference in maternal or neonatal insulin resistance compared with the standard gestational diet consultation. Clinical Trial: ClinicalTrials.gov registry Number: NCT01628835.
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