Christie Jane Bennett1, Ruth Elizabeth Walker1, Michelle Louise Blumfield1, Stella-May Gwini2, Jianhua Ma3, Fenglei Wang4, Yi Wan4, Hayley Dickinson5, Helen Truby6. 1. Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia. 2. Biostatistics Platform, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Australia. 3. Institute of Nutrition and Food Hygiene, School of Public Health, Lanzhou University, China. 4. Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China. 5. The Richie Centre, Translational Research Facility, Hudson Institute of Medical Research, Clayton, Vic., Australia; Department of Obstetrics and Gynaecology, Monash University, Melbourne, Vic., Australia. 6. Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia. Electronic address: Helen.Truby@monash.edu.
Abstract
AIMS: To (i) evaluate the global impact of interventions designed to prevent excessive gestational weight gain (eGWG) on the incidence of gestational diabetes (GDM), and (ii) examine whether the effects differ by pre-conception body mass index (BMI) or ethnicity. METHODS: A systematic search of randomised controlled trials (RCTs) with a primary or secondary aim to reduce eGWG was conducted in seven international and three Chinese databases without date limits. Meta-analysis data are reported as relative risk (RR) for GDM incidence for interventions including: diet, physical activity (PA), and lifestyle (diet and PA). RESULTS: Forty-five studies were included, 37 in the meta-analyses. Diet and PA interventions reduced GDM risk by 44% (RR: 0.56, 95% CI: 0.36-0.87) and 38% (RR: 0.62, 95% CI: 0.50-0.78), respectively. Lifestyle interventions and BMI didn't significantly alter GDM risk. PA interventions from Southern-Europe reduced GDM risk by 37% (RR: 0.63, 95% CI: 0.50-0.80). Whereas, diet and lifestyle interventions conducted in Asia reduced GDM risk by 62% (RR: 0.38, 95% CI: 0.24-0.59) and 32% (RR: 0.68, 95% CI: 0.54-0.86), respectively. CONCLUSION: Diet and PA interventions designed to reduce GWG are more effective than standard care in reducing the incidence of GDM, although the effect varies by region and BMI. The 'one size fits all' approach is not supported.
AIMS: To (i) evaluate the global impact of interventions designed to prevent excessive gestational weight gain (eGWG) on the incidence of gestational diabetes (GDM), and (ii) examine whether the effects differ by pre-conception body mass index (BMI) or ethnicity. METHODS: A systematic search of randomised controlled trials (RCTs) with a primary or secondary aim to reduce eGWG was conducted in seven international and three Chinese databases without date limits. Meta-analysis data are reported as relative risk (RR) for GDM incidence for interventions including: diet, physical activity (PA), and lifestyle (diet and PA). RESULTS: Forty-five studies were included, 37 in the meta-analyses. Diet and PA interventions reduced GDM risk by 44% (RR: 0.56, 95% CI: 0.36-0.87) and 38% (RR: 0.62, 95% CI: 0.50-0.78), respectively. Lifestyle interventions and BMI didn't significantly alter GDM risk. PA interventions from Southern-Europe reduced GDM risk by 37% (RR: 0.63, 95% CI: 0.50-0.80). Whereas, diet and lifestyle interventions conducted in Asia reduced GDM risk by 62% (RR: 0.38, 95% CI: 0.24-0.59) and 32% (RR: 0.68, 95% CI: 0.54-0.86), respectively. CONCLUSION: Diet and PA interventions designed to reduce GWG are more effective than standard care in reducing the incidence of GDM, although the effect varies by region and BMI. The 'one size fits all' approach is not supported.
Authors: Lisa M Bodnar; Katherine P Himes; Barbara Abrams; Timothy L Lash; Sara M Parisi; Cara L Eckhardt; Betty J Braxter; Sarah Minion; Jennifer A Hutcheon Journal: Obstet Gynecol Date: 2019-11 Impact factor: 7.661
Authors: Michelle C Dimitris; Jay S Kaufman; Lisa M Bodnar; Robert W Platt; Katherine P Himes; Jennifer A Hutcheon Journal: Epidemiology Date: 2022-03-01 Impact factor: 4.822