Original Article

International Journal of Obesity (2008) 32, 495–501; doi:10.1038/sj.ijo.0803710; published online 29 January 2008

A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women

S Wolff1, J Legarth2, K Vangsgaard2, S Toubro1 and A Astrup1

  1. 1Department of Human Nutrition, Faculty of Life Science, Copenhagen University, Copenhagen, Denmark
  2. 2Department of Obstetrics and Gynecology, Herlev Hospital, Copenhagen University, Copenhagen, Denmark

Correspondence: Dr S Wolff, Department of Human Nutrition, Faculty of Life Science, Copenhagen University, Rolighedsvej 30, Copenhagen DK-1958, Denmark. E-mail: swo@sst.dk

Received 16 December 2005; Revised 23 June 2007; Accepted 24 June 2007; Published online 29 January 2008.

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Abstract

Objective:

 

Can gestational weight gain in obese women be restricted by 10-h dietary consultations and does this restriction impact the pregnancy-induced changes in glucose metabolism?

Design:

 

A randomized controlled trial with or without restriction of gestational weight gain to 6–7 kg by ten 1-h dietary consultations.

Subjects:

 

Fifty nondiabetic nonsmoking Caucasian obese pregnant women were randomized into intervention group (n=23, 28plusminus4 years, prepregnant body mass index (BMI) 35plusminus4 kg m-2) or control group (n=27, 30plusminus5 years, prepregnant BMI 35plusminus3 kg m-2).

Measurements:

 

The weight development was measured at inclusion (15 weeks), at 27 weeks, and 36 weeks of gestation. The dietary intakes were reported in the respective weeks by three 7-day weighed food records and blood samples for analyses of fasting s-insulin, s-leptin, b-glucose, and 2-h b-glucose after an oral glucose tolerance test were collected.

Results:

 

The women in the intervention group successfully limited their energy intake, and restricted the gestational weight gain to 6.6 kg vs a gain of 13.3 kg in the control group (P=0.002, 95% confidence interval (CI): 2.6–10.8 kg). Both s-insulin and s-leptin were reduced by 20% in the intervention group compared to the control group at week 27, mean difference: -16 pmol l-1 (P=0.04, 95% CI: -32 to -1) for insulin and -23 ng ml-1 (P=0.004, 95% CI: -39 to -8) for leptin. At 36 weeks of gestation, the s-insulin was further reduced by 23%, -25 pmol l-1 (-47 to -4, P=0.022) and the fasting b-glucose were reduced by 8% compared with the control group (-0.3 mmol l-1, -0.6 to -0.0, P=0.03).

Conclusions:

 

Restriction of gestational weight gain in obese women is achievable and reduces the deterioration in the glucose metabolism.

Keywords:

pregnancy, diet, weight gain, insulin, leptin, glucose

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