Effect of gestational Mediterranean diet intervention on newborn fat mass and cord blood leptin level

Abstract Background Maternal nutritional status is an important determinant of intrauterine growth and neonatal size. No published surveys exist on maternal Mediterranean diet intakes and newborn adiposity. The aim of the study was to evaluate the impact of the individual maternal Mediterranean diet on the in-utero body fat formation and cord leptin level in newborns. Pregnant women with a pre-pregnancy body mass index (BMI) between 30 and 35 kg/m2 (n = 118) were assisted for individual dietary counseling based on the Mediterranean diet healthy eating. According to diet adherence, participants (paired mother and newborn) were divided into an intervention group (n = 57) and a control group (n = 61). We examined the association between diet modification and gestational weight gain, maternal, and cord leptin level together with newborn anthropometry (weight and fat mass %). Results Gestational weight gain, newborn birth weight, fat mass %, and cord leptin level lower in the intervention (12.22 ± 1.8 kg, 3.57 ± 0.35 kg, 9.27 ± 2.16 %, 11.78 ± 3.63 ng/ml, p = 000, respectively) than in control group (18.03 ± 3.25 kg, 4.02 ± 0.32 kg, 11.85 ± 2.30 %, 35.37 ± 11.14 ng/ml, respectively. Umbilical cord leptin levels strongly correlated with neonatal fat mass percent in both groups. However, maternal serum leptin did not correlate with the newborn parameters in the intervention group. Conclusion Maternal energy intake from healthy fat and diet intervention is probably associated with decreased fat mass and leptin levels in neonates.

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Resting energy expenditure guided intervention for gestational weight gain in obese and overweight women

10.21203/rs.2.16248/v1 ◽

2019 ◽

Author(s):

Xiuling Zhao ◽

Wei Ma ◽

Caixia Zhang ◽

Pili Xu ◽

Chunmei Zhang ◽

...

Keyword(s):

Weight Gain ◽

Energy Expenditure ◽

Gestational Weight Gain ◽

Intervention Group ◽

Resting Energy Expenditure ◽

Control Group ◽

Overweight Women ◽

Gestational Weight ◽

Beijing China ◽

Resting Energy

Abstract Background There is sparse in the literature on resting energy expenditure guided intervention to manage gestational weight gain in obese and overweight women.Methods We conducted a prospective cohort study in Beijing, China between May 1, 2017 and April 30, 2018. Obese/overweight women who visited the Department of Obstetrics and Gynecology at LuHe hospital of Capital Medical University, a tertiary care facility in Beijing, China, for their routine prenatal care at 10-13 weeks of gestation during the study period were recruited into the study after written consent was obtained. Women whose pre-pregnant body mass index was < 25Kg/m2 or who took steroid medication or those diagnosed with thyroid disease or affected by pre-pregnant diabetes mellitus or for other reasons could not participate in the study assessments were excluded. Participants who were recruited between May 1, 2017 and December 30, 2017 were the designated control group with diet recommendation based on pre-pregnancy body mass index and ideal weight, without resting energy expenditure monitoring. Those who were recruited between November 1, 2017 and April 30, 2018 were the intervention group, with resting energy expenditure guided diet recommendation to manage gestational weight gain. Gestational weight gain and perinatal outcomes between the two study groups were then compared.Results A total of 53 eligible women (32 in intervention group and 21 in control group) were recruited and included in the final analysis. There was no difference in baseline demographic and clinical characteristics between the two groups. Gestational weight gain in the intervention group (13.45±4.16 Kg) was lower than in the control group (18.20±4.84 Kg). Rate of macrosomia in the intervention group (3.12%) was also lower than in the control group (19.05%). There was no fetal growth restriction observed in either group.

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Effect of Educational Short Message Service (SMS) on Excessive Gestational Weight Gain (GWG)

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_076 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1004-1004

Author(s):

Hannah Holmes ◽

Cristina Palacios ◽

Yan Yan Wu ◽

Jinan Banna

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Intervention Group ◽

Text Messages ◽

Control Group ◽

Short Message ◽

Control Groups ◽

Gestational Weight ◽

Message Service ◽

And Control

Abstract Objectives The objective of this trial was to investigate the effect of educational short message service (SMS), or text messages, on gestational weight gain (GWG) in a low-income population. It was expected that the intervention group, which received text messages on nutrition and physical activity during pregnancy, would experience less GWG when compared to the control group. Methods Participants (n = 83) were recruited at WIC clinics on the island of O‘ahu, Hawai‘i at 15–20 weeks gestational age. Eligibility criteria were: body mass index (BMI) of 25–45 kg/m2 in the first trimester, 18 years of age or older at the time of recruitment, and possession of a cellular phone with the ability to receive text messages. After recruitment, participants were randomized into intervention (n = 42) and control (n = 41) groups. The intervention group received SMS on nutrition and physical activity during pregnancy per the Institute of Medicine and American College of Obstetricians and Gynecologists guidelines, respectively. The control group received SMS about general health topics during pregnancy. Both groups received one text message per week for eighteen weeks. GWG was defined as the difference between the last weight taken before delivery and participants’ self-reported weight before pregnancy. GWG in intervention and control groups was compared using a linear regression model. Results Women were age 27.7 ± 5.3y on average, 65.5% were Native Hawaiian, Pacific Islander or American Indian, 54.8% had some college or more and 37.8% were employed. The average weight before pregnancy was higher in the intervention group (80.6 + 17.7 kg) than that in the control group (76.2 + 15.9 kg), but this difference was not significant (P = 0.24). GWG was lower in the control group (14.1 + 11.4 kg) compared to the intervention group (15.5 + 11.6 kg), but this result was not significant (P = 0.58). Conclusions There was no significant difference in gestational weight gain between the intervention and control groups. Trials that begin earlier in pregnancy or before pregnancy with longer interventions and more frequent messages are needed. Funding Sources Mountain West Clinical Translational Research Infrastructure Network under a grant from the National Institute of General Medicine Sciences of the National Institutes of Health.

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Implementation of the Living Well During Pregnancy Telecoaching Program for Women at High Risk of Excessive Gestational Weight Gain: Protocol for an Effectiveness-Implementation Hybrid Study

JMIR Research Protocols ◽

10.2196/27196 ◽

2021 ◽

Vol 10 (3) ◽

pp. e27196

Author(s):

Susan de Jersey ◽

Nina Meloncelli ◽

Taylor Guthrie ◽

Hilary Powlesland ◽

Leonie Callaway ◽

...

Keyword(s):

Weight Gain ◽

Antenatal Care ◽

Gestational Weight Gain ◽

Program Implementation ◽

Health Service Delivery ◽

Control Group ◽

Dietary Counseling ◽

Gestational Weight ◽

Living Well ◽

Routine Antenatal Care

Background Despite comprehensive guidelines for healthy gestational weight gain (GWG) and evidence for the efficacy of dietary counseling coupled with weight monitoring on reducing excessive GWG, reporting on the effectiveness of interventions translated into routine antenatal care is limited. Objective This study aims to implement and evaluate the Living Well during Pregnancy (LWdP) program in a large Australian antenatal care setting. Specifically, the LWdP program will be incorporated into usual care and delivered to a population of pregnant women at risk of excessive GWG through a dietitian-delivered telephone coaching service. Methods Metrics from the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework will guide the evaluation in this hybrid effectiveness-implementation study. All women aged ≥16 years without pre-exiting diabetes with a prepregnancy BMI >25 kg/m2 and gaining weight above recommendations at <20 weeks’ gestation who are referred for dietetic care during the 12-month study period will be eligible for participation. The setting is a metropolitan hospital at which approximately 6% of the national births in Australia take place each year. Eligible participants will receive up to 10 telecoaching calls during their pregnancy. Primary outcomes will be service level indicators of reach, adoption, and implementation that will be compared with a retrospective control group, and secondary effectiveness outcomes will be participant-reported anthropometric and behavioral outcomes; all outcomes will be assessed pre- and postprogram completion. Additional secondary outcomes relate to the costs associated with program implementation and pregnancy outcomes gathered through routine clinical service data. Results Data collection of all variables was completed in December 2020, with results expected to be published by the end of 2021. Conclusions This study will evaluate the implementation of an evidence-based intervention into routine health service delivery and will provide the practice-based evidence needed to inform decisions about its incorporation into routine antenatal care. International Registered Report Identifier (IRRID) DERR1-10.2196/27196

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Focusing on Excessive Gestational Weight Gain through Weight Tracking Among Participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Southern California

Californian Journal of Health Promotion ◽

10.32398/cjhp.v15i3.1905 ◽

2017 ◽

Vol 15 (3) ◽

pp. 15-24 ◽

Cited By ~ 1

Author(s):

Maria Koleilat ◽

Loan P. Kim ◽

Shannon E. Whaley

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Intervention Group ◽

Infants And Children ◽

Control Group ◽

Supplemental Nutrition ◽

Nutrition Program ◽

Gestational Weight ◽

Excessive Gestational Weight Gain ◽

Supplemental Nutrition Program

Background and Purpose: Studies have shown that maternal obesity and excessive gestational weight gain (GWG) lead to adverse health outcomes for the mother and her offspring. Yet, knowledge of the best way to intervene is still lacking. The objective of this study was to develop, pilot and evaluate a sustainable intervention to prevent excessive GWG among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in southern California. Methods: We conducted a prospective cohort study where the intervention group received an individual education program that included a GWG tracker. The historical control group was a group of women from the same WIC site who gave birth before the start of the intervention, therefore did not receive the intervention. Chi-square tests and t-tests were used to compare characteristics of the control and intervention groups and the proportions of women exceeding the Institute of Medicine (IOM) recommendations for GWG. Results: The impact of the intervention was strongest for overweight women. 62.5% of the control group gained more than the recommended amount compared to 48.6% in the intervention group. Conclusion: A simple weight tracking intervention could be a cost-neutral way to help WIC participants avoid excessive GWG.

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A Promising Food-Coaching Intervention Program to Achieve Optimal Gestational Weight Gain in Overweight and Obese Pregnant Women: Pilot Randomized Controlled Trial of a Smartphone App (Preprint)

10.2196/preprints.13013 ◽

2018 ◽

Author(s):

Ling-Jun Li ◽

Izzuddin M Aris ◽

Wee Meng Han ◽

Kok Hian Tan

Keyword(s):

Weight Gain ◽

Pregnant Women ◽

Real Time ◽

Gestational Weight Gain ◽

Controlled Trial ◽

Intervention Group ◽

Smartphone App ◽

Control Group ◽

Gestational Weight ◽

Randomized Controlled

BACKGROUND Traditional dietary recommendations for achieving optimal gestational weight gain are ineffective for pregnant women due to the lack of real-time communication and tedious consultation processes. OBJECTIVE In this pilot study, we aimed to determine the feasibility of a novel food-coaching smartphone app for controlling gestational weight gain and macronutrient intake among overweight and obese pregnant women. METHODS We designed a randomized controlled trial and recruited 30 overweight and obese pregnant women (1:1 ratio) during 18-20 weeks of gestation and followed them up after 4 and 8 weeks, respectively. Both groups received standard pregnancy dietary orientation at recruitment, while the intervention group received 8 weeks of real-time food coaching via a smartphone app. This food-coaching smartphone app (Glycoleap, Holmusk, Singapore) aimed to improve care and outcomes for people with diabetes. Pregnant women using this app were able to upload food images (eg, a picture of a meal, a drink, or a dessert) and received real-time and detailed food-coaching comments and guidance provided by professional dietitians during the day (8 AM to 8 PM). We recorded detailed characteristics during recruitment and examined anthropometry at all visits. We compared the mean differences of the 8-week gestational weight gain and macronutrient intake between the two groups. RESULTS Upon study completion, three subjects dropped out from the intervention, and one gave birth prematurely in the control group. The acceptance rate of the smartphone app was 90%. More participants achieved optimal gestational weight gain per week in the intervention group (8/12, 67%) than in the control group (5/14, 36%). After the 8-week intervention, women in the intervention group appeared to have lower gestational weight gain (mean difference=–0.08 kg; 95% CI –1.80 to 1.63) and cholesterol intake (mean difference=–31.73 mg; 95% CI –102.91 to 39.45) than those in the control group. CONCLUSIONS Our findings showed that this food-coaching smartphone app is feasible and favorable for weight gain control and cholesterol intake control among overweight and obese pregnant women. Although our results were not significant (perhaps, attributed to the small sample size), it provided proof of concept for the feasibility of applying such technology in future randomized controlled trials with a larger sample size, an earlier intervention onset, and a longer follow-up for overweight and obese pregnant women.

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A Promising Food-Coaching Intervention Program to Achieve Optimal Gestational Weight Gain in Overweight and Obese Pregnant Women: Pilot Randomized Controlled Trial of a Smartphone App

JMIR Formative Research ◽

10.2196/13013 ◽

2019 ◽

Vol 3 (4) ◽

pp. e13013 ◽

Cited By ~ 1

Author(s):

Ling-Jun Li ◽

Izzuddin M Aris ◽

Wee Meng Han ◽

Kok Hian Tan

Keyword(s):

Weight Gain ◽

Pregnant Women ◽

Real Time ◽

Gestational Weight Gain ◽

Controlled Trial ◽

Intervention Group ◽

Smartphone App ◽

Control Group ◽

Gestational Weight ◽

Randomized Controlled

Background Traditional dietary recommendations for achieving optimal gestational weight gain are ineffective for pregnant women due to the lack of real-time communication and tedious consultation processes. Objective In this pilot study, we aimed to determine the feasibility of a novel food-coaching smartphone app for controlling gestational weight gain and macronutrient intake among overweight and obese pregnant women. Methods We designed a randomized controlled trial and recruited 30 overweight and obese pregnant women (1:1 ratio) during 18-20 weeks of gestation and followed them up after 4 and 8 weeks, respectively. Both groups received standard pregnancy dietary orientation at recruitment, while the intervention group received 8 weeks of real-time food coaching via a smartphone app. This food-coaching smartphone app (Glycoleap, Holmusk, Singapore) aimed to improve care and outcomes for people with diabetes. Pregnant women using this app were able to upload food images (eg, a picture of a meal, a drink, or a dessert) and received real-time and detailed food-coaching comments and guidance provided by professional dietitians during the day (8 AM to 8 PM). We recorded detailed characteristics during recruitment and examined anthropometry at all visits. We compared the mean differences of the 8-week gestational weight gain and macronutrient intake between the two groups. Results Upon study completion, three subjects dropped out from the intervention, and one gave birth prematurely in the control group. The acceptance rate of the smartphone app was 90%. More participants achieved optimal gestational weight gain per week in the intervention group (8/12, 67%) than in the control group (5/14, 36%). After the 8-week intervention, women in the intervention group appeared to have lower gestational weight gain (mean difference=–0.08 kg; 95% CI –1.80 to 1.63) and cholesterol intake (mean difference=–31.73 mg; 95% CI –102.91 to 39.45) than those in the control group. Conclusions Our findings showed that this food-coaching smartphone app is feasible and favorable for weight gain control and cholesterol intake control among overweight and obese pregnant women. Although our results were not significant (perhaps, attributed to the small sample size), it provided proof of concept for the feasibility of applying such technology in future randomized controlled trials with a larger sample size, an earlier intervention onset, and a longer follow-up for overweight and obese pregnant women.

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An eHealth-based intervention against metabolic risks during pregnancy: learnings and challenges

10.21203/rs.3.rs-58896/v1 ◽

2020 ◽

Author(s):

Xiaochun Wang ◽

Nan Huang ◽

Qiao Hua ◽

Dongtao Zhang ◽

Guanghui Li ◽

...

Keyword(s):

Weight Gain ◽

Prenatal Care ◽

Gestational Weight Gain ◽

Intervention Group ◽

First Trimester ◽

Controlled Study ◽

Control Group ◽

P Value ◽

Gestational Weight ◽

Maternal Overweight

Abstract Background Excessive gestational weight gain (eGWG) is one of the major metabolic risks for fetal macrosomia, maternal overweight, gestational diabetes mellitus (GDM), and gestational hypertension during pregnancy, which also increase the risk of postpartum weight retention. Gestational weight gain (GWG) management is rising to be attractive during prenatal care, however, there is still lack of effective tools to assist health care providers (HCPs) to efficiently and continuously implement intervention and monitor from the early phase of pregnancy. The current study tested a prototype eHealth solution aiming to assist clinicians to prevent eGWG and associated gestational metabolic complications. Methods A randomized controlled study was conducted in a private hospital in Beijing, China, with control group (N = 181) and intervention group (N = 181) recruited in rolling fashion. The control group received standard prenatal care, while the intervention group was additionally provided with the integrated prenatal care eHealth solution, Pregnancy Butler, which includes mobile application-enabled on-line service and off-line consultation session. The prevalence of eGWG, associated metabolic health parameters, and final pregnancy outcome were evaluated. Results Although mostly with normal pre-pregnancy BMI, the incidence for eGWG was high among the study subjects, at 35%. Engagement with the eHealth platform of the intervention group was stable after initial phase, but less than desired. Pregnancy Butler intervention showed significant benefit (p-value = 0.0496) in preventing eGWG among obese and overweight subjects. And highly engaged active users in the intervention group had more favorable GWG classification (p-value = 0.022). The time-course data collected indicated that the metabolic risks were largely set early in the first trimester already. Conclusions Our preliminary results indicated that the effectiveness of the eHealth intervention considerably depend on each participant’s engagement level and baseline risk factors. In order to achieve more consistent and impactful outcome improvement, focusing on those with pre-existing metabolic risks, increasing engagement and adherence level, and emphasizing intervention from the first trimester could be promising directions. Trial registration: This study was retrospectively registered as “Pregnancy Butler for gestational weight gain management” (ChiCTR1800014647) under the China Clinical Trial Registry in 2018-Jan-26. http://www.chictr.org.cn/showprojen.aspx?proj=24171

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Resting Energy Expenditure Guided Intervention for Gestational Weight Gain in Obese and Overweight Women

10.21203/rs.3.rs-38597/v1 ◽

2020 ◽

Author(s):

Xiuling Zhao ◽

Wei Ma ◽

Caixia Zhang ◽

Pili Xu ◽

Chunmei Zhang ◽

...

Keyword(s):

Weight Gain ◽

Energy Expenditure ◽

Gestational Weight Gain ◽

Intervention Group ◽

Resting Energy Expenditure ◽

Control Group ◽

Overweight Women ◽

Gestational Weight ◽

Beijing China ◽

Resting Energy

Abstract BackgroundThere is sparse in the literature on resting energy expenditure guided intervention to manage gestational weight gain in obese and overweight women. Methods We conducted a prospective cohort study in Beijing, China between May 1, 2017 and April 30, 2018. Obese/overweight women who visited the Department of Obstetrics and Gynecology at LuHe hospital of Capital Medical University, a tertiary care facility in Beijing, China, for their routine prenatal care at 10-13 weeks of gestation during the study period were recruited into the study after written consent was obtained. Pregnant women who took steroid medication or who were diagnosed with thyroid disease or affected by pre-pregnant diabetes mellitus or for other reasons could not participate in the study assessments were excluded. Women who were recruited between May 1, 2017 and November 30, 2017 were the designated control group with diet recommendation based on pre-pregnancy body mass index and ideal weight, without resting energy expenditure monitoring. Women who were recruited between December 1, 2017 and April 30, 2018 were the intervention group, with resting energy expenditure guided diet recommendation to manage gestational weight gain. Gestational weight gain and perinatal outcomes between the two groups were compared.ResultsA total of 53 eligible women (32 in intervention group and 21 in control group) were recruited and included in the final analysis. There was no difference in baseline demographic and clinical characteristics between the two groups. Gestational weight gain (GWG) in the intervention group (13.45±4.16 Kg) was lower than in the control group (18.20±4.84 Kg). Rate of excess GWG in the intervention group (37.59%) was also lower than in the control group (66.67%). The REE in women of the intervention group with excess GWG increased faster than women with appropriate GWG during pregnancy, especially from 1st trimester to 2nd trimester. Rate of macrosomia in the intervention group (3.12%) was lower than in the control group (19.05%). There was no fetal growth restriction observed in either group. Conclusion: Resting energy expenditure guided nutrition intervention during pregnancy may lower GWG and lower incidence of macrosomia, with no apparent impact on fetal growth restriction. Future studies with larger sample size and randomized controlled trial design are needed to confirm findings from this small-scale study.

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Lower education predicts poor response to dietary intervention in pregnancy, regardless of neighbourhood affluence: secondary analysis from the ROLO randomised control trial

Public Health Nutrition ◽

10.1017/s1368980017001951 ◽

2017 ◽

Vol 20 (16) ◽

pp. 2959-2969 ◽

Cited By ~ 10

Author(s):

Eileen C O’Brien ◽

Goiuri Alberdi ◽

Aisling A Geraghty ◽

Fionnuala M McAuliffe

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Dietary Intervention ◽

Randomised Control Trial ◽

Control Group ◽

Education Session ◽

Neighbourhood Deprivation ◽

Gestational Weight ◽

Dietary Education ◽

In Pregnancy

AbstractObjectiveTo determine if response to a low glycaemic index (GI) dietary intervention, measured by changes in dietary intake and gestational weight gain, differed across women of varying socio-economic status (SES).DesignSecondary data analysis of the ROLO randomised control trial. The intervention consisted of a two-hour low-GI dietary education session in early pregnancy. Change in GI was measured using 3 d food diaries pre- and post-intervention. Gestational weight gain was categorised as per the 2009 Institute of Medicine guidelines. SES was measured using education and neighbourhood deprivation.SettingThe National Maternity Hospital, Dublin, Ireland.SubjectsWomen (n 625) recruited to the ROLO randomised control trial.ResultsThe intervention significantly reduced GI and excess gestational weight gain (EGWG) among women with third level education residing in both disadvantaged (GI, mean (sd), intervention v. control: −3·30 (5·15) v. −0·32 (4·22), P=0·024; EGWG, n (%), intervention v. control: 7 (33·6) v. 22 (67·9); P=0·022) and advantaged areas (GI: −1·13 (3·88) v. 0·06 (3·75), P=0·020; EGWG: 41 (34·1) v. 58 (52·6); P=0·006). Neither GI nor gestational weight gain differed between the intervention and control group among women with less than third level education, regardless of neighbourhood deprivation.ConclusionsA single dietary education session was not effective in reducing GI or gestational weight gain among less educated women. Multifaceted, appropriate and practical approaches are required in pregnancy interventions to improve pregnancy outcomes for less educated women.

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