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Moses R.G.,Illawarra Shoalhaven Local Health District Wollongong | Casey S.A.,Illawarra Shoalhaven Local Health District Wollongong | Quinn E.G.,Illawarra Shoalhaven Local Health District Wollongong | Cleary J.M.,Illawarra Shoalhaven Local Health District Wollongong | And 4 more authors.
American Journal of Clinical Nutrition | Year: 2014

Background: Eating carbohydrate foods with a high glycemic index (GI) has been postulated to result in fetoplacental overgrowth and higher infant body fat. A diet with a low glycemic index (LGI) has been shown to reduce birth percentiles and the ponderal index (PI). Objectives: We investigated whether offering LGI dietary advice at the first antenatal visit would result in a lower fetal birth weight, birth percentile, and PI than providing healthy eating (HE) advice. This advice had to be presented within the resources of routine antenatal care. Design: The Pregnancy and Glycemic Index Outcomes study was a 2-arm, parallel-design, randomized, controlled trial that compared the effects of LGI dietary advice with HE advice on pregnancy outcomes. Eligible volunteers who attended for routine antenatal care at <20 wk of gestation were randomly assigned to either group. Results: A total of 691 women were enrolled, and 576 women had final data considered. In the LGI group, the GI was reduced from a mean (±SEM) of 56 ± 0.3 at enrollment to 52 ± 0.3 (P < 0.001) at the final assessment. There were no significant differences in primary outcomes of fetal birth weight, birth percentile, or PI. In a multivariate regression analysis, the glycemic load was the only significant dietary predictor (P = 0.046) of primary outcomes but explained < 1% of all variation. Conclusion: A low-intensity dietary intervention with an LGI diet compared with an HE diet in pregnancy did not result in any significant differences in birth weight, fetal percentile, or PI. This trial was registered at https://www.anzctr.org.au as ACTRN12610000174088. © 2014 American Society for Nutrition.

Goletzke J.,University of Bonn | Goletzke J.,University of Sydney | Buyken A.E.,University of Bonn | Louie J.C.Y.,University of Sydney | And 2 more authors.
American Journal of Clinical Nutrition | Year: 2015

Background: Despite normal gestational weight gain, dietary studies in pregnant women show intakes below the recommendations for energy and micronutrients. Objective: This study compared changes in dietary intake from the second to third trimester with emphasis on energy intake and carbohydrate quality. Design: These post hoc analyses were based on 566 women participating in the Pregnancy and Glycemic Index Outcomes study, a randomized controlled trial comparing the effect of low-glycemic index (GI) dietary advice with healthy eating advice on selected pregnancy outcomes. With the use of multilevel mixed-regression analysis, changes in total energy intake, starch, sugar, fiber intake, GI, and glycemic load (GL) were correlated with intake of different micronutrients. Results: Energy intake decreased in the third trimester, and most women did not meet the national recommended amounts for iron, folate, and dietary fiber from food sources alone. After adjustment for age, ethnicity, prepregnancy body mass index, and intervention group, change in energy intake was positively related to change in intake of all micronutrients (P , 0.001). GI, GL, and starch intake were inversely related to micronutrient intake (P , 0.001), whereas higher total sugars predicted higher intake (P , 0.001). Associations with dietary fiber were inconsistent. Conclusions: Normal pregnancy can be associated with a decline in energy and micronutrient intake from diet. Low dietary GI and GL were the best predictors of a favorable micronutrient profile. © 2015 American Society for Nutrition.

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