Abstract:
OBJECTIVE:Diet therapy in gestational diabetes mellitus (GDM) has focused on carbohydrate restriction but is poorly substantiated. In this pilot randomized clinical trial, we challenged the conventional low-carbohydrate/higher-fat (LC/CONV) diet, hypothesizing that a higher-complex carbohydrate/lower-fat (CHOICE) diet would improve maternal insulin resistance (IR), adipose tissue (AT) lipolysis, and infant adiposity. RESEARCH DESIGN AND METHODS:At 31 weeks, 12 diet-controlled overweight/obese women with GDM were randomized to an isocaloric LC/CONV (40% carbohydrate/45% fat/15% protein; n = 6) or CHOICE (60%/25%/15%; n = 6) diet. All meals were provided. AT was biopsied at 37 weeks. RESULTS:After ∼7 weeks, fasting glucose (P = 0.03) and free fatty acids (P = 0.06) decreased on CHOICE, whereas fasting glucose increased on LC/CONV (P = 0.03). Insulin suppression of AT lipolysis was improved on CHOICE versus LC/CONV (56 vs. 31%, P = 0.005), consistent with improved IR. AT expression of multiple proinflammatory genes was lower on CHOICE (P < 0.01). Infant adiposity trended lower with CHOICE (10.1 ± 1.4 vs. 12.6 ± 2%, respectively). CONCLUSIONS:A CHOICE diet may improve maternal IR and infant adiposity, challenging recommendations for a LC/CONV diet.
journal_name
Diabetes Carejournal_title
Diabetes careauthors
Hernandez TL,Van Pelt RE,Anderson MA,Reece MS,Reynolds RM,de la Houssaye BA,Heerwagen M,Donahoo WT,Daniels LJ,Chartier-Logan C,Janssen RC,Friedman JE,Barbour LAdoi
10.2337/dc15-0515subject
Has Abstractpub_date
2016-01-01 00:00:00pages
39-42issue
1eissn
0149-5992issn
1935-5548pii
dc15-0515journal_volume
39pub_type
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