Women with gestational diabetes mellitus randomized to a higher–complex carbohydrate/low-fat diet manifest lower adipose tissue insulin resistance, inflammation …
TL Hernandez, RE Van Pelt, MA Anderson… - Diabetes …, 2016 - Am Diabetes Assoc
TL Hernandez, RE Van Pelt, MA Anderson, MS Reece, RM Reynolds, BA de la Houssaye…
Diabetes care, 2016•Am Diabetes AssocOBJECTIVE 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 …
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 …
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.
Am Diabetes Assoc