Department of Nutrition and Toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, China.
Department of Nutrition and Toxicology, School of Public Health, Hangzhou Normal University, Hangzhou, China.
Clin Nutr ESPEN. 2023 Oct;57:501-509. doi: 10.1016/j.clnesp.2023.07.091. Epub 2023 Aug 4.
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.
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.
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/m (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.
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.
许多观察性研究表明，低血糖指数（GI）饮食对妊娠期糖尿病（GDM）有益；然而，干预试验的结果仍不一致。本研究旨在评估低 GI 饮食建议干预对 GDM 高危孕妇妊娠结局的影响。
通过 2022 年 3 月检索 PubMed、Web of Science、Embase 和 Cochrane Library 数据库，查找关于增加 GDM 风险的孕妇接受低 GI 饮食建议干预对母婴结局影响的随机临床试验（RCT）。采用随机或固定效应模型计算联合治疗效果。采用贝叶斯（Begg）和伊格（Egger）检验和漏斗图检查评估发表偏倚。
纳入 9 项 RCT 共 3416 名参与者。低 GI 饮食建议并未改变 GDM 的发病风险。与对照组饮食相比，低 GI 饮食建议显著降低了妊娠增重（GWG）（加权均数差，WMD=-0.93kg，95%CI：-1.31，-0.55；p<0.001；n=7）和早产风险（RR=0.55，95%CI：0.35，0.88；p=0.012；n=5）。亚组分析显示，低 GI 饮食干预对早产的影响仅在 BMI 高于 30kg/m2 的女性中显著（RR=0.28，95%CI：0.10，0.77，p=0.014；n=3）；对 GWG 的显著影响不因 BMI 和 GDM 风险因素类型的分层而改变。未发现其他母婴结局有显著变化。
孕期低 GI 饮食建议干预可降低高危 GDM 孕妇的 GWG 和早产风险；然而，这些干预措施并不能显著预防这些孕妇的 GDM 发生。
