Literature Review: Pregnant and breastfeeding ... - Eat For Health

ReferenceDietary patternsStudy typeLevel of evidenceSettingFundingParticipantsBaseline comparisonsDietary assessmentTimingComparisonOutcomesResultsMoses 2009aLow versus higher glycaemic index (GI) diets (same carbohydrate intake of 175 g/day but varying foods):- Low GI (including pasta, grain breads, unprocessed breakfast cereals with a high fibre content)- High GI (advised to follow a high fibre, low sugar diet with no specific mention of glycaemic index; potatoes, whole wheat bread, specific high fibre,moderate-high GI breakfast cereals were recommended)RCTII (intervention)Illawarra region, NSW, AustraliaIllawarra Diabetes Service and University of Sydney63 women with gestational diabetes mellitus (GDM); aged 18 to 40 years, singleton pregnancy, no previous GDM, non-smoker, seen for first dietary visitbetween 28 to 32 weeks gestation (recruited between October 2007 to September 2008).Exclusions: any condition or medication that could affect glucose levels, unwillingness to follow the prescribed diet.NANADietary changes starting from 28 weeks to 32 weeks gestationLow (31 women) v high GI diet (32 women)Need for insulin (fasting glucose ≥ 5.5 mmol/L and/or 1-hour postprandial glucose was ≥ 8.0 mmol/L); birthweight (adjusted for sex, gestational age,maternal age, parity, height, and prepregnancy weight); ponderal indexNeed for insulin9/31 women in low GI group v 19/32 women in the high GI group (p = 0.023)Need for insulin after the 19 high GI women were switched to a low GI diet9/31 women in low GI group v 10/32 women in the high GI group (pns)Maternal weight gain from baseline to birth; induction of labour, mode of birth, or gestational age at birth were not significantly differentbetween groups (data not reported in paper)Birth centileLow GI: 46.3 [SEM 5.0] v high GI: 54.3 [4.8], p = 0.25Ponderal indexLow GI: 2.7 [SEM 0.05] v high GI: 2.6 [SEM 0.04], p = 0.12LGA (≥ 90 th centile)3 women (over both groups)SGA (≤ 10 th centile)2 women in the low GI groupFollowupTo birthConfoundingNARisk of biasModerate risk of bias: Computer generated random number list, allocation method not reported; study dietitians not blinded, no missing data reported.RelevanceRelevant to Australian womenOther comments Energy intake and GI were similar between groups after interventionPregnancy and Breastfeeding Dietary Patterns47