OP16.04: Effect of metformin in addition to an antenatal diet and lifestyle intervention on fetal growth and adiposity: the GRoW randomised trial

2019 ◽  
Vol 54 (S1) ◽  
pp. 138-138
Author(s):  
A.J. Poprzeczny ◽  
J. Louise ◽  
A. Deussen ◽  
J. Dodd
Keyword(s):  
Lifestyle Intervention ◽  
Fetal Growth ◽  
Randomised Trial ◽  
Diet And Lifestyle

scholarly journals Effect of metformin in addition to an antenatal diet and lifestyle intervention on fetal growth and adiposity: the GRoW randomised trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amanda J. Poprzeczny ◽  
Jennie Louise ◽  
Andrea R. Deussen ◽  
Jodie M. Dodd
Keyword(s):  
Lifestyle Intervention ◽  
Fetal Growth ◽  
Trial Registration ◽  
Fetal Biometry ◽  
Treatment Groups ◽  
Increased Risk ◽  
Maternity Hospitals ◽  
Z Scores ◽  
Diet And Lifestyle ◽  
In Pregnancy

Abstract Background The infants born to women who are overweight or obese in pregnancy are at an increased risk of being born macrosomic or large for gestational age. Antenatal dietary and lifestyle interventions have been shown to be ineffective at reducing this risk. Our aim was to examine the effects of metformin in addition to a diet and lifestyle intervention on fetal growth and adiposity among women with a BMI above the healthy range. Methods Women who had a body mass index ≥25 kg/m2 in early pregnancy, and a singleton gestation, were enrolled in the GRoW trial from three public maternity hospitals in metropolitan Adelaide. Women were invited to have a research ultrasounds at 28 and 36 weeks’ gestation at which ultrasound measures of fetal biometry and adiposity were obtained. Fetal biometry z-scores and trajectories were calculated. Measurements and calculations were compared between treatment groups. This secondary analysis was pre-specified. Results Ultrasound data from 511 women were included in this analysis. The difference in femur length at 36 weeks’ gestation was (0.07 cm, 95% CI 0.01–0.14 cm, p = 0.019) and this was was statistically significant, however the magnitude of effect was small. Differences between treatment groups for all other fetal biometry measures, z-scores, estimated fetal weight, and adiposity measures at 28 and 36 weeks’ gestation were similar. Conclusions The addition of metformin to dietary and lifestyle advice in pregnancy for overweight and obese women has no clinically relevant effect on ultrasound measures of fetal biometry or adiposity. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12612001277831).

scholarly journals Lifestyle intervention improves Left atrial strain in type 2 diabetes: results from the DIASTOLIC randomised trial

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Alfuhied ◽  
G S Gulsin ◽  
E M Brady ◽  
K Parke ◽  
L Athithan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Aerobic Exercise ◽  
Lifestyle Intervention ◽  
Left Atrial ◽  
Randomised Trial ◽  
Routine Care ◽  
Low Energy ◽  
Aerobic Exercise Training ◽  
Significant Change

Abstract Introduction Left atrial (LA) strain has been shown to be an independent predictor of cardiovascular events in many conditions and superior to conventional measures of LA function (LA volumes and emptying fraction). The effects of low-energy diet or exercise on cardiovascular function in younger adults with type 2 diabetes (DIASTOLIC) study has previously demonstrated an improvement in left ventricle peak early diastolic strain rate in response to aerobic exercise in patients with type-2 diabetes (T2D). However, the effect of lifestyle intervention on LA function, assessed by cardiac magnetic resonance (CMR) imaging, is unknown. Methods The DIASTOLIC study was a prospective, randomised, open-label, blind endpoint trial, that randomised 90 obese participants with T2D (aged 18–65 years) to a 12-week intervention of: (i) routine care, (ii) aerobic exercise training, or (iii) low energy (≈810kcal/day) meal replacement plan (MRP). CMR was performed at baseline and week-12. Images were analysed using Medis v3.1. LA strain (LAS) was assessed using Feature Tracking (QStrain v2.0), corresponding to LA reservoir (LAS-r), conduit (LAS-cd), and booster pump (LAS-bp) using 4- and 2-chamber standard steady-state free precession cine images, and average values calculated. LA emptying fraction (LAEF) was calculated using biplane area-length method (QMass v8.1) for total, passive and active EF. Results 73 participants with T2D completed the trial and had analysable LA images (28 routine care, 22 exercise and 23 MRP). There was no significant change in CMR measured standard LA volumetric function (LAV/LAEF) and echocardiogram measured LV filling pressures (E/e') in any groups. The routine care arm showed no significant change in body mass index (BMI) or LAS (see Table). In the MRP group, there were significant reductions in BMI (4.8 kg/m2), mean systolic blood pressure (SBP) (13mmHg), and a significant increase in LAS-r and LAS-bp (29.9±7.0 to 32.3±7.0,p=0.036 and 14.6±5.3 to 17.2±3.7,p=0.034). The exercise arm showed a small reduction in BMI (0.8kg/m2), with no significant change in BP or LAS. Conclusion There was significant improvement in LAS post-lifestyle intervention in young adults with T2D, despite no change in volumetric measurements. MRP led to weight loss and improved SBP, with associated improved LA filling and contraction. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute for Health Research (NIHR) a career development fellowship.

Assessing dietary intake in a population undergoing a rapid transition in diet and lifestyle: the Arctic Inuit in Nunavut, Canada

2009 ◽  
Vol 103 (5) ◽  
pp. 749-759 ◽  
Author(s):  
Sangita Sharma ◽  
Xia Cao ◽  
Cindy Roache ◽  
Annie Buchan ◽  
Rhonda Reid ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Lifestyle Intervention ◽  
Nutritional Intervention ◽  
The Arctic ◽  
Traditional Foods ◽  
Intervention Programme ◽  
Nutritional Intervention Programme ◽  
Nutritional Transition ◽  
Rapid Transition ◽  
Diet And Lifestyle

The aims of the present study were to (1) characterise the diets of adult Inuit; (2) highlight foods for a nutritional and lifestyle intervention programme; (3) develop a quantitative FFQ (QFFQ) to evaluate the programme and monitor changes in dietary intake in this population over time. A dietary survey using single 24-h dietary recalls was conducted among Inuit aged between 19 and 87 years in two communities in Nunavut, Canada. Eighty-seven subjects completed the recalls (response rate was approximately 73 %). The mean energy intake for men and women was 9530 and 6939 kJ, respectively. The intakes of dietary fibre and the majority of vitamins and minerals (especially vitamins A, D, and E, total folate and Ca) were far below the recommendations. Traditional foods contributed 40 and 42 %, respectively, to protein and Fe intakes. Non-nutrient-dense store-bought foods were consumed much more frequently than the nutrient-dense traditional foods. Foods high in fat and sugar were highlighted, and will be replaced by healthier, more nutrient-dense alternatives to address the dietary inadequacies for the nutritional intervention programme. A 154-item QFFQ was developed and pilot tested in the Arctic Inuit. The present study highlighted foods to be targeted for a nutritional and lifestyle intervention programme not previously undertaken in this population. This QFFQ is culturally appropriate and specific for evaluating the effectiveness of the programme, as well as monitoring nutritional transition in this population.

scholarly journals Changes in dietary intake following a culturally adapted lifestyle intervention among Iraqi immigrants to Sweden at high risk of type 2 diabetes: a randomised trial

2017 ◽  
Vol 20 (15) ◽  
pp. 2827-2838 ◽  
Author(s):  
Faiza Siddiqui ◽  
Vicky Winther ◽  
Azra Kurbasic ◽  
Emily Sonestedt ◽  
Katarina Balcker Lundgren ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Total Energy ◽  
Lifestyle Intervention ◽  
Statistical Significance ◽  
Randomised Trial ◽  
Intervention Group ◽  
Control Group ◽  
Fat Intake ◽  
Culturally Adapted ◽  
Increased Risk

AbstractObjectiveTo investigate the effectiveness of a culturally adapted lifestyle intervention for changing dietary intake, particularly energy, fat and fibre intakes, in the intervention group (IG) compared with the control group (CG).DesignRandomised controlled trial.SettingIG (n 50) and CG (n 46). The IG was offered seven group sessions, including one cooking class, over a period of 4 months. The participants filled out 4 d food diaries at the start, mid and end of the study.SubjectsIraqi-born residents of Malmö, Sweden, at increased risk for developing diabetes.ResultsAt baseline, participants’ fat intake was high (40 % of total energy intake (E%)). The predefined study goals of obtaining <30 E% from fat and ≥15 g fibre/4184 kJ (1000 kcal) were met by very few individuals. In the IG v. the CG, the proportion of individuals obtaining <40 E% from fat (48·4 v. 34·6 %, P=0·65), <10 E% from saturated fat (32·3 v. 11·5 %, P=0·14) and ≥10 g fibre/4184 kJ (45·2 v. 26·9 %, P=0·46) appeared to be higher at the last visit, although the differences were statistically non-significant. A trend towards decreased mean daily intakes of total energy (P=0·03), carbohydrate (P=0·06), sucrose (P=0·02) and fat (P=0·02) was observed within the IG. Differences in changes over time between the groups did not reach statistical significance.ConclusionsAlthough no significant differences were observed in the two groups, our data indicate that this culturally adapted programme has the potential to modify dietary intake in Middle Eastern immigrants. The high fat intake in this group should be addressed.

The importance of type 2 diabetes prevention: The Norfolk Diabetes Prevention Study

2011 ◽  
Vol 11 (6) ◽  
pp. 308-313 ◽  
Author(s):  
Nikki J Murray ◽  
Sara Abadi ◽  
Aliceon Blair ◽  
Melanie Dunk ◽  
Mike J Sampson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Lifestyle Intervention ◽  
Diabetes Prevention ◽  
Controlled Trial ◽  
Activity Levels ◽  
Prevention Study ◽  
Diabetes Prevention Study ◽  
Diet And Lifestyle

Many large studies have investigated the prevention of type 2 diabetes in people at high risk of the condition, usually with changes in diet and physical activity levels. It is estimated that 2.25 million people in the UK have type 2 diabetes, with significant personal and healthcare costs, and the value of preventative measures in tackling this enormous public health challenge are well described. The Norfolk Diabetes Prevention Study (Norfolk DPS) will screen 10,000 people at risk of type 2 diabetes over five years, randomising 950 people with ‘pre-diabetes’ into a 36-month randomised controlled trial (three-armed study) of a novel diet and lifestyle intervention. The Norfolk DPS team is multidisciplinary and the intervention will be delivered by healthcare professionals in group settings. One arm will be part delivered by lay mentors who have existing type 2 diabetes. There is no UK-validated diet and lifestyle intervention for the prevention of type 2 diabetes in high risk groups that has been tested in a controlled trial, and an intervention delivered by those with existing type 2 diabetes has not been studied. The Norfolk DPS will provide further evidence in these areas.

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