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- Publisher Website: 10.1093/ajcn/nqaa137
- Scopus: eid_2-s2.0-85089125453
- PMID: 32537643
- WOS: WOS:000561751100009
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Article: Effects of a modestly lower carbohydrate diet in gestational diabetes: a randomized controlled trial
Title | Effects of a modestly lower carbohydrate diet in gestational diabetes: a randomized controlled trial |
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Authors | |
Keywords | lower carbohydrate gestational diabetes ketones diet MAMI study |
Issue Date | 2020 |
Publisher | Oxford University Press (OUP): ASN. The Journal's web site is located at http://www.ajcn.org/ |
Citation | The American Journal of Clinical Nutrition, 2020, v. 112 n. 2, p. 284-292 How to Cite? |
Abstract | Background:
Lower carbohydrate diets have the potential to improve glycemia but may increase ketonemia in women with gestational diabetes (GDM). We hypothesized that modestly lower carbohydrate intake would not increase ketonemia.
Objective:
To compare blood ketone concentration, risk of ketonemia, and pregnancy outcomes in women with GDM randomly assigned to a lower carbohydrate diet or routine care.
Methods:
Forty-six women aged (mean ± SEM) 33.3 ± 0.6 y and prepregnancy BMI 26.8 ± 0.9 kg/m2 were randomly assigned at 28.5 ± 0.4 wk to a modestly lower carbohydrate diet (MLC, ∼135 g/d carbohydrate) or routine care (RC, ∼200 g/d) for 6 wk. Blood ketones were ascertained by finger prick test strips and 3-d food diaries were collected at baseline and end of the intervention.
Results:
There were no detectable differences in blood ketones between completers in the MLC group compared with the RC group (0.1 ± 0.0 compared with 0.1 ± 0.0 mmol/L, n = 33, P = 0.31, respectively), even though carbohydrate and total energy intake were significantly lower in the intervention group (carbohydrate 165 ± 7 compared with 190 ± 9 g, P = 0.04; energy 7040 ± 240 compared with 8230 ± 320 kJ, P <0.01, respectively). Only 20% of participants in the MLC group met the target intake compared with 65% in the RC group (P <0.01). There were no differences in birth weight, rate of large-for-gestational-age infants, percent fat mass, or fat-free mass between groups.
Conclusions:
An intervention to reduce carbohydrate intake in GDM did not raise ketones to clinical significance, possibly because the target of 135 g/d was difficult to achieve in pregnancy. Feeding studies with food provision may be needed to assess the benefits and risks of low-carbohydrate diets. This trial was registered at www.anzctr.org.au as ACTRN12616000018415. |
Persistent Identifier | http://hdl.handle.net/10722/287825 |
ISSN | 2023 Impact Factor: 6.5 2023 SCImago Journal Rankings: 1.883 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Mijatovic, J | - |
dc.contributor.author | Louie, JCY | - |
dc.contributor.author | Buso, MEC | - |
dc.contributor.author | Atkinson, FS | - |
dc.contributor.author | Ross, GP | - |
dc.contributor.author | Markovic, TP | - |
dc.contributor.author | Brand-Miller, JC | - |
dc.date.accessioned | 2020-10-05T12:03:50Z | - |
dc.date.available | 2020-10-05T12:03:50Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | The American Journal of Clinical Nutrition, 2020, v. 112 n. 2, p. 284-292 | - |
dc.identifier.issn | 0002-9165 | - |
dc.identifier.uri | http://hdl.handle.net/10722/287825 | - |
dc.description.abstract | Background: Lower carbohydrate diets have the potential to improve glycemia but may increase ketonemia in women with gestational diabetes (GDM). We hypothesized that modestly lower carbohydrate intake would not increase ketonemia. Objective: To compare blood ketone concentration, risk of ketonemia, and pregnancy outcomes in women with GDM randomly assigned to a lower carbohydrate diet or routine care. Methods: Forty-six women aged (mean ± SEM) 33.3 ± 0.6 y and prepregnancy BMI 26.8 ± 0.9 kg/m2 were randomly assigned at 28.5 ± 0.4 wk to a modestly lower carbohydrate diet (MLC, ∼135 g/d carbohydrate) or routine care (RC, ∼200 g/d) for 6 wk. Blood ketones were ascertained by finger prick test strips and 3-d food diaries were collected at baseline and end of the intervention. Results: There were no detectable differences in blood ketones between completers in the MLC group compared with the RC group (0.1 ± 0.0 compared with 0.1 ± 0.0 mmol/L, n = 33, P = 0.31, respectively), even though carbohydrate and total energy intake were significantly lower in the intervention group (carbohydrate 165 ± 7 compared with 190 ± 9 g, P = 0.04; energy 7040 ± 240 compared with 8230 ± 320 kJ, P <0.01, respectively). Only 20% of participants in the MLC group met the target intake compared with 65% in the RC group (P <0.01). There were no differences in birth weight, rate of large-for-gestational-age infants, percent fat mass, or fat-free mass between groups. Conclusions: An intervention to reduce carbohydrate intake in GDM did not raise ketones to clinical significance, possibly because the target of 135 g/d was difficult to achieve in pregnancy. Feeding studies with food provision may be needed to assess the benefits and risks of low-carbohydrate diets. This trial was registered at www.anzctr.org.au as ACTRN12616000018415. | - |
dc.language | eng | - |
dc.publisher | Oxford University Press (OUP): ASN. The Journal's web site is located at http://www.ajcn.org/ | - |
dc.relation.ispartof | The American Journal of Clinical Nutrition | - |
dc.subject | lower carbohydrate | - |
dc.subject | gestational diabetes | - |
dc.subject | ketones | - |
dc.subject | diet | - |
dc.subject | MAMI study | - |
dc.title | Effects of a modestly lower carbohydrate diet in gestational diabetes: a randomized controlled trial | - |
dc.type | Article | - |
dc.identifier.email | Louie, JCY: jimmyl@hku.hk | - |
dc.identifier.authority | Louie, JCY=rp02118 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1093/ajcn/nqaa137 | - |
dc.identifier.pmid | 32537643 | - |
dc.identifier.scopus | eid_2-s2.0-85089125453 | - |
dc.identifier.hkuros | 314712 | - |
dc.identifier.volume | 112 | - |
dc.identifier.issue | 2 | - |
dc.identifier.spage | 284 | - |
dc.identifier.epage | 292 | - |
dc.identifier.isi | WOS:000561751100009 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0002-9165 | - |