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A new study led by researchers from the University of Leicester and the University of Cambridge has found that low-calorie diets do not significantly alter key outcomes in pregnant women with gestational diabetes. Despite modest improvements in glycemic control and a reduced need for long-acting insulin therapy, the study revealed no significant difference in maternal weight change or offspring birth weight between women who followed a reduced-energy diet and those who adhered to a standard diet.
Gestational diabetes, a condition affecting between 6% and 15% of pregnancies worldwide, is known to increase the risk of adverse maternal and neonatal outcomes. Current medical nutritional therapy guidelines do not specify an optimal energy intake for managing the condition, and the effects of energy restriction have remained largely unexplored.
The study, titled “Dietary Intervention in Gestational Diabetes (DiGest),” was published in Nature Medicine. Researchers examined the impact of a 1,200 kcal-per-day diet versus a standard 2,000 kcal-per-day diet in pregnant women with a body mass index (BMI) of 25 kg/m² or higher. A total of 425 participants were randomly assigned to either a standard-energy control diet (n = 211) or a reduced-energy intervention diet (n = 214). The diets, provided through weekly meal boxes, consisted of 40% carbohydrates, 35% fat, and 25% protein.
Analysis of 388 participants at 36 weeks of gestation and 382 at delivery found no significant differences in maternal weight change or neonatal birth weight. Additionally, neonatal outcomes such as large-for-gestational-age rates, neonatal intensive care unit admissions, gestational age at birth, and cord blood C-peptide concentrations were unaffected by the dietary intervention.
However, secondary analyses indicated that the reduced-energy diet lowered the need for long-acting insulin therapy at 36 weeks, though it had no impact on metformin use, short-acting insulin requirements, blood pressure, or glucose monitoring results. Postnatal hemoglobin A1c (HbA1c) levels were slightly lower in the intervention group, indicating a modest but statistically significant improvement.
Further exploratory analyses classified participants based on weight loss or gain. Women who experienced weight loss (39.6% of participants) had a higher baseline BMI (37.05 kg/m² vs. 34.58 kg/m²) and were more likely to be on metformin at 36 weeks. Weight loss was associated with improved glycemic control, including increased time in range for continuous glucose monitoring (80.4% vs. 71.1%), lower mean glucose levels (5.63 mmol/L vs. 5.94 mmol/L), and reduced systolic blood pressure (116.6 mmHg vs. 119.3 mmHg). Additionally, while weight loss was linked to lower rates of large-for-gestational-age infants, this association lost statistical significance after adjusting for maternal glycemia at 36 weeks. Postnatally, women who lost weight maintained their weight loss and had lower HbA1c levels at three months postpartum.
The study’s findings suggest that modest weight loss in late pregnancy, rather than calorie restriction alone, may contribute to improved outcomes for women with gestational diabetes. Researchers emphasize the need for further studies to evaluate the long-term metabolic effects and sustainability of weight loss in this population.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Pregnant individuals with gestational diabetes should consult their healthcare provider before making any dietary or lifestyle changes.
