Original Article | Published:

Clinical Studies and Practice

Impact of lifestyle intervention for obese women during pregnancy on maternal metabolic and inflammatory markers

International Journal of Obesity volume 41, pages 598605 (2017) | Download Citation

Abstract

Background:

Offspring of obese mothers have increased risk of developing obesity and related short- and long-term disease. The cause is multifactorial and may partly be explained by the unfavorable intrauterine environment. Intervention during pregnancy leading to a healthier lifestyle among obese may alter this.

Objective:

To assess the effect of lifestyle intervention on markers of maternal metabolism and inflammation in ‘the TOP (Treatment of Obese Pregnant Women) study’, a randomized controlled trial.

Methods:

In the TOP-study 425 participants with body mass index 30 kg/m2 were randomized to intervention with dietary advices and physical activity assessed by pedometer (PA+D), physical activity assessed by pedometer (PA) or control (C). Of 389 participants completing the study 376 had available blood samples. Serum was analyzed for insulin, c-peptide, lipid profile, leptin, high-sensitivity CRP (hsCRP) and Soluble urokinase Plasminogen Activator Receptor (suPAR), in week 18–20 and 28–30, and simultaneously a 2-h oral glucose-tolerance-test was performed. Diet was assessed in gestational week 11–14 and 36–37 using a validated 360-item Food Frequency Questionnaire.

Results:

Median levels of hsCRP in gestational week 28–30 were lower in each of the intervention groups (8.3 mg/l in PA+D group, P=0.03; and 8.8 mg/l in PA group, P=0.02) versus the control group (11.5 mg/l). Obtaining 11 000 steps per day as aimed for resulted in a 21% lower hsCRP compared to non-compliant women. Women reporting high carbohydrate intake had around 30% higher hsCRP concentrations in late gestation than women reporting the lowest intake. There were no differences in lipid profile or any of the metabolic markers in gestational week 28–30 when comparing the intervention and control groups.

Conclusions:

Lifestyle intervention in obese women can reduce hsCRP representing a marker of inflammation during pregnancy. The effect may partly be mediated by more physical activity and partly by changes in intake of carbohydrates and the glycaemic load.

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Acknowledgements

‘Sygekassernes Helsefond’, ‘Brødrene Hartmann Fonden’, and the Danish Council for Strategic Research (09-067124, Centre for Fetal Programming) supported this research.

Author information

Affiliations

  1. Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

    • K M Renault
    • , S Hædersdal
    •  & L Nilas
  2. Obstetric Clinic, JMC, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

    • K M Renault
  3. Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

    • E M Carlsen
    •  & D Cortes
  4. Center for Diabetes Research, Copenhagen University Hospital Gentofte, Hellerup, Denmark

    • S Hædersdal
  5. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    • L Nilas
    •  & D Cortes
  6. The Research Unit Women's and Children's Health, the Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

    • N J Secher
  7. Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

    • J Eugen-Olsen
  8. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark

    • S F Olsen
    •  & T I Halldorsson
  9. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    • S F Olsen
  10. Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland

    • T I Halldorsson
  11. Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland

    • T I Halldorsson
  12. Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

    • K Nørgaard

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to K M Renault.

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DOI

https://doi.org/10.1038/ijo.2017.9

Supplementary Information accompanies this paper on International Journal of Obesity website (http://www.nature.com/ijo)

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