Effect of physical activity and/or healthy eating on GDM risk: The DALI Lifestyle Study

David Simmons, Roland Devlieger, André van Assche, Goele Jans, Sander Galjaard, Rosa Corcoy, Juan M Adelantado, Fidelma Dunne, Gernot Desoye, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R Mathiesen, Dorte M Jensen, Lise Lotte Torvin Andersen, Annunziata Lapolla, Maria G Dalfrà, Alessandra Bertolotto, Ewa Wender-Ozegowska, Agnieszka ZawiejskaDavid Hill, Frank J Snoek, Judith Gm Jelsma, Mireille N. M. van Poppel

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Context: Lifestyle approaches for preventing gestational diabetes mellitus (GDM) have produced mixed results. Objective: The aim of the present study was to compare the effectiveness of 3 lifestyle interventions [healthy eating (HE), physical activity (PA), and both HE and PA (HE+PA)] with usual care (UC) in reducing GDM risk. Design: The present study was a multicenter randomized controlled trial conducted from 2012 to 2014 [the DALI (Vitamin D and lifestyle intervention for GDM prevention) lifestyle study]. Setting: The study occurred at antenatal clinics across 11 centers in 9 European countries. Patients: Consecutive pregnant women at ,20 weeks of gestation with a body mass index (BMI) of 29 kg/m2 and without GDM using the International Association of Diabetes and Pregnancy Study Group criteria (n = 436). For the intervention, women were randomized, stratified by site, to UC, HE, PA, or HE+PA. The women received 5 face-to-face and#4 telephone coaching sessions using the principles of motivational interviewing. A gestational weight gain (GWG) ,5 kg was targeted. The coaches received standardized training and an intervention toolkit tailored to their culture and language. Main Outcome Measures: The endpoints were the GWG at 35 to 37 weeks and the fasting glucose and insulin sensitivity [homeostasis model assessment insulin resistance (HOMA-IR)] at 24 to 28 weeks. Results: We randomized 108 women to HE+PA, 113 to HE, 110 to PA, and 105 to UC. In the HE+PA group, but not HE or PA alone, women achieved substantially lessGWGthan did the controls (UC) by 35 to 37 weeks (22.02; 95% confidence interval, 23.58 to 20.46 kg). Despite this reduction, no improvements were seen in fasting or postload glucose levels, insulin concentrations, or HOMA-IR. The birthweights and large and small for gestational age rates were similar. Conclusions: The combined HE+PA intervention was able to limit GWG but did not reduce fasting glycemia. Thus, lifestyle changes alone are unlikely to prevent GDM among women with a BMI of 29 kg/m2.

OriginalsprogEngelsk
TidsskriftJournal of Clinical Endocrinology and Metabolism
Vol/bind102
Udgave nummer3
Sider (fra-til)903-913
ISSN0021-972X
DOI
StatusUdgivet - 2017

Fingeraftryk

Gestational Diabetes
Medical problems
Exercise
Insulin
Weight Gain
Insulin Resistance
Fasting
Glucose
Telephone
Body Mass Index
Vitamin D
Homeostasis
Healthy Diet
Motivational Interviewing
Gestational Age
Pregnant Women
Language
Randomized Controlled Trials
Outcome Assessment (Health Care)
Confidence Intervals

Citer dette

Simmons, D., Devlieger, R., van Assche, A., Jans, G., Galjaard, S., Corcoy, R., ... van Poppel, M. N. M. (2017). Effect of physical activity and/or healthy eating on GDM risk: The DALI Lifestyle Study. Journal of Clinical Endocrinology and Metabolism, 102(3), 903-913. https://doi.org/10.1210/jc.2016-3455
Simmons, David ; Devlieger, Roland ; van Assche, André ; Jans, Goele ; Galjaard, Sander ; Corcoy, Rosa ; Adelantado, Juan M ; Dunne, Fidelma ; Desoye, Gernot ; Harreiter, Jürgen ; Kautzky-Willer, Alexandra ; Damm, Peter ; Mathiesen, Elisabeth R ; Jensen, Dorte M ; Andersen, Lise Lotte Torvin ; Lapolla, Annunziata ; Dalfrà, Maria G ; Bertolotto, Alessandra ; Wender-Ozegowska, Ewa ; Zawiejska, Agnieszka ; Hill, David ; Snoek, Frank J ; Jelsma, Judith Gm ; van Poppel, Mireille N. M. / Effect of physical activity and/or healthy eating on GDM risk : The DALI Lifestyle Study. I: Journal of Clinical Endocrinology and Metabolism. 2017 ; Bind 102, Nr. 3. s. 903-913.
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title = "Effect of physical activity and/or healthy eating on GDM risk: The DALI Lifestyle Study",
abstract = "Context: Lifestyle approaches for preventing gestational diabetes mellitus (GDM) have produced mixed results. Objective: The aim of the present study was to compare the effectiveness of 3 lifestyle interventions [healthy eating (HE), physical activity (PA), and both HE and PA (HE+PA)] with usual care (UC) in reducing GDM risk. Design: The present study was a multicenter randomized controlled trial conducted from 2012 to 2014 [the DALI (Vitamin D and lifestyle intervention for GDM prevention) lifestyle study]. Setting: The study occurred at antenatal clinics across 11 centers in 9 European countries. Patients: Consecutive pregnant women at ,20 weeks of gestation with a body mass index (BMI) of 29 kg/m2 and without GDM using the International Association of Diabetes and Pregnancy Study Group criteria (n = 436). For the intervention, women were randomized, stratified by site, to UC, HE, PA, or HE+PA. The women received 5 face-to-face and#4 telephone coaching sessions using the principles of motivational interviewing. A gestational weight gain (GWG) ,5 kg was targeted. The coaches received standardized training and an intervention toolkit tailored to their culture and language. Main Outcome Measures: The endpoints were the GWG at 35 to 37 weeks and the fasting glucose and insulin sensitivity [homeostasis model assessment insulin resistance (HOMA-IR)] at 24 to 28 weeks. Results: We randomized 108 women to HE+PA, 113 to HE, 110 to PA, and 105 to UC. In the HE+PA group, but not HE or PA alone, women achieved substantially lessGWGthan did the controls (UC) by 35 to 37 weeks (22.02; 95{\%} confidence interval, 23.58 to 20.46 kg). Despite this reduction, no improvements were seen in fasting or postload glucose levels, insulin concentrations, or HOMA-IR. The birthweights and large and small for gestational age rates were similar. Conclusions: The combined HE+PA intervention was able to limit GWG but did not reduce fasting glycemia. Thus, lifestyle changes alone are unlikely to prevent GDM among women with a BMI of 29 kg/m2.",
keywords = "Adult, Birth Weight, Blood Glucose/metabolism, Diabetes, Gestational/prevention & control, Diet Therapy/methods, Diet, Healthy, Europe, Exercise, Exercise Therapy/methods, Female, Fetal Macrosomia/epidemiology, Glucose Tolerance Test, Humans, Infant, Newborn, Infant, Small for Gestational Age, Insulin Resistance, Insulin/metabolism, Life Style, Metabolic Equivalent, Motivational Interviewing/methods, Obesity, Odds Ratio, Overweight, Pregnancy, Pregnancy Complications, Prenatal Care, Weight Gain",
author = "David Simmons and Roland Devlieger and {van Assche}, Andr{\'e} and Goele Jans and Sander Galjaard and Rosa Corcoy and Adelantado, {Juan M} and Fidelma Dunne and Gernot Desoye and J{\"u}rgen Harreiter and Alexandra Kautzky-Willer and Peter Damm and Mathiesen, {Elisabeth R} and Jensen, {Dorte M} and Andersen, {Lise Lotte Torvin} and Annunziata Lapolla and Dalfr{\`a}, {Maria G} and Alessandra Bertolotto and Ewa Wender-Ozegowska and Agnieszka Zawiejska and David Hill and Snoek, {Frank J} and Jelsma, {Judith Gm} and {van Poppel}, {Mireille N. M.}",
year = "2017",
doi = "10.1210/jc.2016-3455",
language = "English",
volume = "102",
pages = "903--913",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "Heinemann",
number = "3",

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Simmons, D, Devlieger, R, van Assche, A, Jans, G, Galjaard, S, Corcoy, R, Adelantado, JM, Dunne, F, Desoye, G, Harreiter, J, Kautzky-Willer, A, Damm, P, Mathiesen, ER, Jensen, DM, Andersen, LLT, Lapolla, A, Dalfrà, MG, Bertolotto, A, Wender-Ozegowska, E, Zawiejska, A, Hill, D, Snoek, FJ, Jelsma, JG & van Poppel, MNM 2017, 'Effect of physical activity and/or healthy eating on GDM risk: The DALI Lifestyle Study', Journal of Clinical Endocrinology and Metabolism, bind 102, nr. 3, s. 903-913. https://doi.org/10.1210/jc.2016-3455

Effect of physical activity and/or healthy eating on GDM risk : The DALI Lifestyle Study. / Simmons, David; Devlieger, Roland; van Assche, André; Jans, Goele; Galjaard, Sander; Corcoy, Rosa; Adelantado, Juan M; Dunne, Fidelma; Desoye, Gernot; Harreiter, Jürgen; Kautzky-Willer, Alexandra; Damm, Peter; Mathiesen, Elisabeth R; Jensen, Dorte M; Andersen, Lise Lotte Torvin; Lapolla, Annunziata; Dalfrà, Maria G; Bertolotto, Alessandra; Wender-Ozegowska, Ewa; Zawiejska, Agnieszka; Hill, David; Snoek, Frank J; Jelsma, Judith Gm; van Poppel, Mireille N. M.

I: Journal of Clinical Endocrinology and Metabolism, Bind 102, Nr. 3, 2017, s. 903-913.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Effect of physical activity and/or healthy eating on GDM risk

T2 - The DALI Lifestyle Study

AU - Simmons, David

AU - Devlieger, Roland

AU - van Assche, André

AU - Jans, Goele

AU - Galjaard, Sander

AU - Corcoy, Rosa

AU - Adelantado, Juan M

AU - Dunne, Fidelma

AU - Desoye, Gernot

AU - Harreiter, Jürgen

AU - Kautzky-Willer, Alexandra

AU - Damm, Peter

AU - Mathiesen, Elisabeth R

AU - Jensen, Dorte M

AU - Andersen, Lise Lotte Torvin

AU - Lapolla, Annunziata

AU - Dalfrà, Maria G

AU - Bertolotto, Alessandra

AU - Wender-Ozegowska, Ewa

AU - Zawiejska, Agnieszka

AU - Hill, David

AU - Snoek, Frank J

AU - Jelsma, Judith Gm

AU - van Poppel, Mireille N. M.

PY - 2017

Y1 - 2017

N2 - Context: Lifestyle approaches for preventing gestational diabetes mellitus (GDM) have produced mixed results. Objective: The aim of the present study was to compare the effectiveness of 3 lifestyle interventions [healthy eating (HE), physical activity (PA), and both HE and PA (HE+PA)] with usual care (UC) in reducing GDM risk. Design: The present study was a multicenter randomized controlled trial conducted from 2012 to 2014 [the DALI (Vitamin D and lifestyle intervention for GDM prevention) lifestyle study]. Setting: The study occurred at antenatal clinics across 11 centers in 9 European countries. Patients: Consecutive pregnant women at ,20 weeks of gestation with a body mass index (BMI) of 29 kg/m2 and without GDM using the International Association of Diabetes and Pregnancy Study Group criteria (n = 436). For the intervention, women were randomized, stratified by site, to UC, HE, PA, or HE+PA. The women received 5 face-to-face and#4 telephone coaching sessions using the principles of motivational interviewing. A gestational weight gain (GWG) ,5 kg was targeted. The coaches received standardized training and an intervention toolkit tailored to their culture and language. Main Outcome Measures: The endpoints were the GWG at 35 to 37 weeks and the fasting glucose and insulin sensitivity [homeostasis model assessment insulin resistance (HOMA-IR)] at 24 to 28 weeks. Results: We randomized 108 women to HE+PA, 113 to HE, 110 to PA, and 105 to UC. In the HE+PA group, but not HE or PA alone, women achieved substantially lessGWGthan did the controls (UC) by 35 to 37 weeks (22.02; 95% confidence interval, 23.58 to 20.46 kg). Despite this reduction, no improvements were seen in fasting or postload glucose levels, insulin concentrations, or HOMA-IR. The birthweights and large and small for gestational age rates were similar. Conclusions: The combined HE+PA intervention was able to limit GWG but did not reduce fasting glycemia. Thus, lifestyle changes alone are unlikely to prevent GDM among women with a BMI of 29 kg/m2.

AB - Context: Lifestyle approaches for preventing gestational diabetes mellitus (GDM) have produced mixed results. Objective: The aim of the present study was to compare the effectiveness of 3 lifestyle interventions [healthy eating (HE), physical activity (PA), and both HE and PA (HE+PA)] with usual care (UC) in reducing GDM risk. Design: The present study was a multicenter randomized controlled trial conducted from 2012 to 2014 [the DALI (Vitamin D and lifestyle intervention for GDM prevention) lifestyle study]. Setting: The study occurred at antenatal clinics across 11 centers in 9 European countries. Patients: Consecutive pregnant women at ,20 weeks of gestation with a body mass index (BMI) of 29 kg/m2 and without GDM using the International Association of Diabetes and Pregnancy Study Group criteria (n = 436). For the intervention, women were randomized, stratified by site, to UC, HE, PA, or HE+PA. The women received 5 face-to-face and#4 telephone coaching sessions using the principles of motivational interviewing. A gestational weight gain (GWG) ,5 kg was targeted. The coaches received standardized training and an intervention toolkit tailored to their culture and language. Main Outcome Measures: The endpoints were the GWG at 35 to 37 weeks and the fasting glucose and insulin sensitivity [homeostasis model assessment insulin resistance (HOMA-IR)] at 24 to 28 weeks. Results: We randomized 108 women to HE+PA, 113 to HE, 110 to PA, and 105 to UC. In the HE+PA group, but not HE or PA alone, women achieved substantially lessGWGthan did the controls (UC) by 35 to 37 weeks (22.02; 95% confidence interval, 23.58 to 20.46 kg). Despite this reduction, no improvements were seen in fasting or postload glucose levels, insulin concentrations, or HOMA-IR. The birthweights and large and small for gestational age rates were similar. Conclusions: The combined HE+PA intervention was able to limit GWG but did not reduce fasting glycemia. Thus, lifestyle changes alone are unlikely to prevent GDM among women with a BMI of 29 kg/m2.

KW - Adult

KW - Birth Weight

KW - Blood Glucose/metabolism

KW - Diabetes, Gestational/prevention & control

KW - Diet Therapy/methods

KW - Diet, Healthy

KW - Europe

KW - Exercise

KW - Exercise Therapy/methods

KW - Female

KW - Fetal Macrosomia/epidemiology

KW - Glucose Tolerance Test

KW - Humans

KW - Infant, Newborn

KW - Infant, Small for Gestational Age

KW - Insulin Resistance

KW - Insulin/metabolism

KW - Life Style

KW - Metabolic Equivalent

KW - Motivational Interviewing/methods

KW - Obesity

KW - Odds Ratio

KW - Overweight

KW - Pregnancy

KW - Pregnancy Complications

KW - Prenatal Care

KW - Weight Gain

U2 - 10.1210/jc.2016-3455

DO - 10.1210/jc.2016-3455

M3 - Journal article

C2 - 27935767

VL - 102

SP - 903

EP - 913

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 3

ER -