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The role of maternal diet on offspring hyperinsulinaemia and adiposity after birth: a systematic review of randomised controlled trials

Published online by Cambridge University Press:  02 November 2021

Sylvia North Open the ORCID record for Sylvia North [Opens in a new window] ,
Catherine Crofts Open the ORCID record for Catherine Crofts [Opens in a new window] ,
Christian Thoma Open the ORCID record for Christian Thoma [Opens in a new window]  and
Caryn Zinn Open the ORCID record for Caryn Zinn [Opens in a new window]
Sylvia North*
Affiliation:
Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
Catherine Crofts
Affiliation:
Human Potential Centre, Auckland University of Technology, Auckland, New Zealand Department of Interdisciplinary Studies, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, Auckland, New Zealand AUT BioDesign Lab, School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
Christian Thoma
Affiliation:
Department of Interdisciplinary Studies, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, Auckland, New Zealand AUT BioDesign Lab, School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
Caryn Zinn
Affiliation:
Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
*
Address for correspondence: Sylvia North, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand. Email: [email protected]
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Abstract

In utero diet may be directly related to the risk of fetal hyperinsulinaemia and offspring metabolic health. This review examines the relationship between maternal dietary exposures and sub-clinical fetal hyperinsulinaemia and neonatal adiposity. Articles were identified in MEDLINE, Web of Science, Cochrane Controlled Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, SCOPUS, and SPORTDiscus (September 2019–March 2021) using the preferred reporting items for systematic reviews and meta-analyses guidelines. PROSPERO registration ID CRD42020146453. Studies were selected by two independent reviewers. Randomised controlled trials (RCT) involving a dietary intervention with pregnant women (healthy pregnancy, gestational diabetes mellitus and obesity) and reporting fetal cord-blood insulin, c-peptide, glucose or adiposity estimates were included. One author extracted all information on main study characteristics and outcomes. Risk of bias was assessed using the Cochrane Collaboration’s bias risk assessment tool. A total of 733 articles were identified. Fourteen articles from 11 RCTs (3614 participants) were included. Studies reviewed showed no specific effect of maternal diet on neonatal cord blood insulin, c-peptide or glucose levels. Infants born to mothers who followed a low glycaemic load (GL) had lower skin fold thickness compared to controls. Interventions that provided individualised nutrition counselling to women with obesity or previous infant born > 4 kg were also associated with lower adiposity. The studies reviewed suggest that lifestyle-based dietary interventions to improve glycaemia (low GL) have a protective effect against excess adiposity. Future studies should incorporate multi-modal interventions with dietary counselling to support lifestyle changes throughout gestation and include assessments of maternal insulin resistance at recruitment.

Keywords

Maternal nutritionprenataloffspring body sizefetal hyperinsulinaemia
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 13 , Issue 5 , October 2022 , pp. 527 - 540
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Copyright
© The Author(s), 2021. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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References

Hernandez, TL, Friedman, JE, Barbour, LA. Insulin resistance in pregnancy: implications for mother and offspring. In Insulin Resistance Childhood Precursors of Adulthood Disease (eds. Zeitler, PS, Nadeau, KJ), 2020; pp. 67–94. Springer Nature, Switzerland, AG: Humana Press.CrossRefGoogle Scholar
Catalano, PM, Shankar, K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ. 2017; 356, j1.CrossRefGoogle ScholarPubMed
Butte, NF. Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr. 2000; 71(5), 1256S–1261S.CrossRefGoogle ScholarPubMed
Tinius, RA, Blankenship, MM, Furgal, KE, et al. Metabolic flexibility is impaired in women who are pregnant and overweight/obese and related to insulin resistance and inflammation. Metabolis. 2020; 104(51–52), 154142.CrossRefGoogle ScholarPubMed
Yogev, Y, Catalano, PM. Pregnancy and obesity. Obstet Gynecol Clin North Am. 2009; 36(2), 285–300.CrossRefGoogle ScholarPubMed
Daly, B, Toulis, KA, Thomas, N, et al. Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: a population-based cohort study. Plos Med. 2018; 15(1), e1002488.CrossRefGoogle ScholarPubMed
Juonala, M, Magnussen, CG, Berenson, GS, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med. 2011; 365(20), 1876–1885.CrossRefGoogle ScholarPubMed
Sobrevia, L, Salsoso, R, Fuenzalida, B, et al. Insulin is a key modulator of fetoplacental endothelium metabolic disturbances in gestational diabetes mellitus. Front Physiol. 2016; 7, 119.CrossRefGoogle ScholarPubMed
Zhu, Y, Mendola, P, Albert, PS, et al. Insulin-like growth factor axis and gestational diabetes mellitus: a longitudinal study in a multiracial cohort. Diabetes. 2016; 65(11), 3495–3504.CrossRefGoogle Scholar
Retnakaran, R. The insulin-like growth factor axis: a new player in gestational diabetes mellitus? Diabetes. 2016; 65(11), 3246–3248.CrossRefGoogle ScholarPubMed
Gęca, T, Kwaśniewska, A. The influence of gestational diabetes mellitus upon the selected parameters of the maternal and fetal system of insulin-like growth factors (igf-1, igf-2, igfbp1-3): a review and a clinical study. J Clin Med. 2020; 9(10), 3256.CrossRefGoogle ScholarPubMed
American Diabetes Association. Management of diabetes in pregnancy: standards of medical care in diabetes—2020. Diabetes Care. 2020; 43(Supplement 1), S183–S192.CrossRefGoogle Scholar
Metzger, BE, Lowe, LP, Dyer, AR, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358(19), 1991–2002.Google ScholarPubMed
Metzger, BE, Persson, B, Lowe, LP, et al. Hyperglycemia and adverse pregnancy outcome study: neonatal glycemia. Pediatrics. 2010; 126(6), e1545–e1552.CrossRefGoogle ScholarPubMed
Lee, IL, Barr, ELM, Longmore, D, et al. Cord blood metabolic markers are strong mediators of the effect of maternal adiposity on fetal growth in pregnancies across the glucose tolerance spectrum: the PANDORA study. Diabetologia. 2020; 63(3), 497–507.CrossRefGoogle ScholarPubMed
Josefson, JL, Scholtens, DM, Kuang, A, et al. Newborn adiposity and cord blood c-peptide as mediators of the maternal metabolic environment and childhood adiposity. Diabetes Care. 2021; 44(5), 1194–1202.CrossRefGoogle ScholarPubMed
Muhlhausler, BS, Gugusheff, JR, Ong, ZY, Vithayathil, MA. Nutritional approaches to breaking the intergenerational cycle of obesity. Can J Physiol Pharmacol. 2013; 91(6), 421–428.CrossRefGoogle ScholarPubMed
Han, S, Middleton, P, Shepherd, E, Van Ryswyk, E, Crowther, CA. Different types of dietary advice for women with gestational diabetes mellitus. Cochrane Db Syst Rev. 2017; 2, Cd009275.Google ScholarPubMed
Yamamoto, JM, Kellett, JE, Balsells, M, et al. Gestational diabetes mellitus and diet: a systematic review and meta-analysis of randomized controlled trials examining the impact of modified dietary interventions on maternal glucose control and neonatal birth weight. Diabetes Care. 2018; 41(7), 1346–1361.CrossRefGoogle ScholarPubMed
Lamminpää, R, Vehviläinen-Julkunen, K, Schwab, U. A systematic review of dietary interventions for gestational weight gain and gestational diabetes in overweight and obese pregnant women. Eur J Nutr. 2018; 57(5), 1721–1736.CrossRefGoogle ScholarPubMed
Castillo, H, Santos, IS, Matijasevich, A. Relationship between maternal pre-pregnancy body mass index, gestational weight gain and childhood fatness at 6-7 years by air displacement plethysmography. Matern Child Nutr. 2015; 11(4), 606–617.CrossRefGoogle ScholarPubMed
Catalano, PM, Thomas, A, Huston-Presley, L, Amini, SB. Increased fetal adiposity: a very sensitive marker of abnormal in utero development. Am J Obstet Gynecol. 2003; 189(6), 1698–1704.CrossRefGoogle ScholarPubMed
Stanley, KP, Fraser, RB, Milner, M, Bruce, C. Cord insulin and c-peptide distribution in an unselected population. Br J Obstet Gynaecol. 1992; 99(6), 512–515.CrossRefGoogle Scholar
Kadakia, R, Scholtens, DM, Rouleau, GW, et al. Cord blood metabolites associated with newborn adiposity and hyperinsulinemia. J Pediatr. 2018; 203(6 Pt 2), 144–149.e1.CrossRefGoogle ScholarPubMed
Liberati, A, Altman, DG, Tetzlaff, J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 339, b2700.CrossRefGoogle ScholarPubMed
Altman, DG. Practical Statistics for Medical Research, 1991. Chapman and Hall, London.Google Scholar
Higgins, JPT, Altman, DG, Gøtzsche, PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011; 343, d5928.CrossRefGoogle ScholarPubMed
Ferrara, A, Hedderson, MM, Brown, SD, et al. A telehealth lifestyle intervention to reduce excess gestational weight gain in pregnant women with overweight or obesity (GLOW): a randomised, parallel-group, controlled trial. Lancet Diabetes Endocrinol. 2020; 8(6), 490–500.CrossRefGoogle ScholarPubMed
Garmendia, ML, Casanello, P, Flores, M, Kusanovic, JP, Uauy, R. The effects of a combined intervention (docosahexaenoic acid supplementation and home-based dietary counseling) on metabolic control in obese and overweight pregnant women: the MIGHT study. Am J Obstet Gynecol. 2021; 224(5), 526.e1–526.e25.CrossRefGoogle ScholarPubMed
Zhang, Y, Wang, L, Yang, W, et al. Effectiveness of low glycemic index diet consultations through a diet glycemic assessment app tool on maternal and neonatal insulin resistance: a randomized controlled trial. JMIR mHealth uHealth. 2019; 7(4), e12081.CrossRefGoogle ScholarPubMed
Van Horn, L, Peaceman, A, Kwasny, M, et al. Dietary approaches to stop hypertension diet and activity to limit gestational weight: maternal offspring metabolics family intervention trial, a technology enhanced randomized trial. Am J Prev Med. 2018; 55(5), 603–614.CrossRefGoogle ScholarPubMed
Rhodes, ET, Pawlak, DB, Takoudes, TC, et al. Effects of a low-glycemic load diet in overweight and obese pregnant women: a pilot randomized controlled trial. Am J Clin Nutr. 2010; 92(6), 1306–1315.CrossRefGoogle ScholarPubMed
Harreiter, J, Simmons, D, Desoye, G, et al. Nutritional lifestyle intervention in obese pregnant women, including lower carbohydrate intake, is associated with increased maternal free fatty acids, 3-β-hydroxybutyrate, and fasting glucose concentrations: a secondary factorial analysis of the European multicenter, randomized controlled DALI lifestyle intervention trial. Diabetes Care. 2019; 42(8), 1380–1389.CrossRefGoogle ScholarPubMed
Patel, N, Hellmuth, C, Uhl, O, et al. Cord metabolic profiles in obese pregnant women: insights into offspring growth and body composition. J Clin Endocrinol Metab. 2018; 103(1), 346–355.CrossRefGoogle ScholarPubMed
Patel, N, Godfrey, KM, Pasupathy, D, et al. Infant adiposity following a randomised controlled trial of a behavioural intervention in obese pregnancy. Int J Obes. 2017; 41(7), 1018–1026.CrossRefGoogle ScholarPubMed
Walsh, JM, Mahony, RM, Culliton, M, Foley, ME, McAuliffe, FM. Impact of a low glycemic index diet in pregnancy on markers of maternal and fetal metabolism and inflammation. Reprod Sci. 2014; 21(11), 1378–1381.CrossRefGoogle ScholarPubMed
Donnelly, JM, Walsh, JM, Byrne, J, Molloy, EJ, McAuliffe, FM. Impact of maternal diet on neonatal anthropometry: a randomized controlled trial. Pediatr Obes. 2015; 10(1), 52–56.CrossRefGoogle ScholarPubMed
Horan, MK, McGowan, CA, Gibney, ER, Byrne, J, Donnelly, JM, McAuliffe, FM. Maternal nutrition and glycaemic index during pregnancy impacts on offspring adiposity at 6 months of age-analysis from the ROLO randomised controlled trial. Nutrients. 2016; 8(1), 15.Google ScholarPubMed
Kizirian, NV, Kong, Y, Muirhead, R, et al. Effects of a low-glycemic index diet during pregnancy on offspring growth, body composition, and vascular health: a pilot randomized controlled trial. Am J Clin Nutr. 2016; 103(4), 1073–1082.CrossRefGoogle ScholarPubMed
Rae, A, Bond, D, Evans, S, North, F, Roberman, B, Walters, B. A randomised controlled trial of dietary energy restriction in the management of obese women with gestational diabetes. Aust N Z J Obstet Gynaecol. 2000; 40(4), 416–422.CrossRefGoogle ScholarPubMed
Mijatovic, J, Louie, JCY, Buso, MEC, et al. Effects of a modestly lower carbohydrate diet in gestational diabetes: a randomized controlled trial. Am J Clin Nutr. 2020; 112(2), 284–292.CrossRefGoogle ScholarPubMed
Harreiter, J, Desoye, G, van Poppel, MNM, et al. The effects of lifestyle and/or Vitamin D supplementation interventions on pregnancy outcomes: what have we learned from the DALI studies? Curr Diab Rep, 2019, 19(12):162.CrossRefGoogle Scholar
Donnelly, JM, Lindsay, KL, Walsh, JM, Horan, M, Molloy, EJ, McAuliffe, FM. Fetal metabolic influences of neonatal anthropometry and adiposity. BMC Pediatr. 2015; 15(1), 175.CrossRefGoogle ScholarPubMed
Xu, J, Ye, S. Influence of low-glycemic index diet for gestational diabetes: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med. 2020; 33(4), 687–692.CrossRefGoogle ScholarPubMed
Zhang, R, Han, S, Chen, G-C, et al. Effects of low-glycemic-index diets in pregnancy on maternal and newborn outcomes in pregnant women: a meta-analysis of randomized controlled trials. Eur J Nutr. 2018; 57(1), 167–177.CrossRefGoogle ScholarPubMed
Li, S, Gan, Y, Chen, M, et al. Effects of the dietary approaches to stop hypertension (DASH) on pregnancy/neonatal outcomes and maternal glycemic control: a systematic review and meta-analysis of randomized clinical trials. Complement Ther Med. 2020; 54(7), 102551.CrossRefGoogle ScholarPubMed
Ornoy, A. Prenatal origin of obesity and their complications: gestational diabetes, maternal overweight and the paradoxical effects of fetal growth restriction and macrosomia. Reprod Toxicol. 2011; 32(2), 205–212.CrossRefGoogle ScholarPubMed
Procter, SB, Campbell, CG. Position of the academy of nutrition and dietetics: nutrition and lifestyle for a healthy pregnancy outcome. J Acad Nutr Diet. 2014; 114(7), 1099–1103.CrossRefGoogle Scholar
Wang, N, Eerdun, G, Dong, Y, Hao, L, Li, T. Correlation of serum resistin level and other metabolic hormones and immune function in neonatal umbilical cord blood. Medicine. 2021; 100(11), e25195.CrossRefGoogle ScholarPubMed
O’Rahilly, S, Burnett, MA, Smith, RF, Darley, JH, Turner, RC. Haemolysis affects insulin but not c-peptide immunoassay. Diabetologia. 1987; 30(6), 394–396.CrossRefGoogle Scholar
Lowe, LP, Metzger, BE, Lowe, WL Jr., Dyer, AR, McDade, TW, McIntyre, HD. Inflammatory mediators and glucose in pregnancy: results from a subset of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. J Clin Endocrinol Metab. 2010; 95(12), 5427–5434.CrossRefGoogle ScholarPubMed
Telschow, A, Ferrari, N, Deibert, C, et al. High maternal and low cord blood leptin are associated with BMI-SDS gain in the first year of life. Obes Facts. 2019; 12(5), 575–585.CrossRefGoogle ScholarPubMed
Gaillard, R, Wright, J, Jaddoe, VWV. Lifestyle intervention strategies in early life to improve pregnancy outcomes and long-term health of offspring: a narrative review. J Dev Orig Health Dis. 2019; 10(3), 314–321.CrossRefGoogle ScholarPubMed
North, S, Zinn, C, Crofts, C. Hyperinsulinemia during pregnancy across varying degrees of glucose tolerance: an examination of the Kraft database. J Obstet Gynaecol Res. 2021; 47(5), 1719–1726.CrossRefGoogle ScholarPubMed
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