Effect of low-glycemic index diet advice on pregnant outcomes in women with elevated risk of gestational diabetes mellitus: A meta-analysis of randomized controlled trails

Yuanyuan Deng; Jingjing Yu; Ahui Tao; Jun Liu; Qianqian Wang; Yifei Cao; Shufen Han; Xianrong Xu; Xiao Yan; Xuexian Fang; Fuzhi Lian

doi:10.1016/j.clnesp.2023.07.091

Effect of low-glycemic index diet advice on pregnant outcomes in women with elevated risk of gestational diabetes mellitus: A meta-analysis of randomized controlled trails

Clin Nutr ESPEN. 2023 Oct:57:501-509. doi: 10.1016/j.clnesp.2023.07.091. Epub 2023 Aug 4.

Authors

Yuanyuan Deng¹, Jingjing Yu¹, Ahui Tao¹, Jun Liu¹, Qianqian Wang¹, Yifei Cao¹, Shufen Han¹, Xianrong Xu¹, Xiao Yan¹, Xuexian Fang¹, Fuzhi Lian²

Affiliations

¹ Department of Nutrition and Toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, China.
² Department of Nutrition and Toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, China. Electronic address: fuzhi.lian@hznu.edu.cn.

PMID: 37739699
DOI: 10.1016/j.clnesp.2023.07.091

Abstract

Background and aims: The beneficial effect of low-glycemic index (GI) diet on gestational diabetes mellitus (GDM) has been suggested in many observational studies; however, results from intervention trials remain inconsistent. This study aims to estimate the effect of interventions with low-GI dietary advice on pregnant outcomes in women with elevated risk of GDM.

Design: PubMed, Web of Science, Embase, and Cochrane Library databases were searched for randomized clinical trials (RCTs) through March 2022. Studies reporting the effect of low-GI diet advice intervention on maternal and fetal outcomes in pregnant women with increased risks of GDM were included. Random or fixed effects model was used to calculate combined treatment effects. Publication bias was assessed via Begg's and Egger's tests and funnel plot inspection.

Results: Nine RCTs recruiting 3416 participants were included. Low-GI diet advice did not modulate the risk of GDM. Compared with control diets, low-GI diet advice significantly reduced gestational weight gain (GWG) (weighted mean differences, WMD = -0.93 kg, 95% CI: -1.31, -0.55; p < 0.001; n = 7) and the risk of premature birth (RR = 0.55, 95% CI: 0.35, 0.88; p = 0.012; n = 5). In subgroup analyses, the effect of low-GI diet interventions on premature birth was significant only in women with BMI higher than 30 kg/m² (RR = 0.28, 95% CI: 0.10, 0.77, p = 0.014; n = 3); the significant effect on GWG was not altered by stratification of BMI and the type of GDM risk factors. No significant changes in other maternal and newborn outcomes were found.

Conclusions: Low-GI diet advice interventions during pregnancy decreased GWG and the risk of premature birth in women with elevated GDM risk; however, the interventions did not significantly prevent GDM development in these women.

Keywords: Gestational diabetes mellitus; Low glycemic index; Meta-analysis; Pregnancy outcomes; Randomized controlled trials.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Combined Modality Therapy
Databases, Factual
Diabetes, Gestational*
Female
Glycemic Index
Humans
Infant, Newborn
Pregnancy
Premature Birth*
Randomized Controlled Trials as Topic