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The effect of pre‐pregnancy lifestyle counselling on food intakes and association between food intakes and gestational diabetes in high‐risk women: results from a randomised controlled trial
Abstract
Background: Healthy diets before and during pregnancy have been suggested to reduce the risk of gestational diabetes (GDM). Several lifestyle intervention studies for pregnant women have reported dietary improvements after counselling. However, evidence concerning the effect of counselling initiated before pregnancy on diets is limited. Methods: This randomised controlled study explored whether pre‐pregnancy lifestyle counselling influenced food intakes, as well as whether changes in food intakes were associated with GDM. The participants comprised 75 women with prior GDM and/or a body mass index ≥ 30 kg m–2. Women were randomised into a control or an intervention group, and their food intakes were followed from pre‐pregnancy to early pregnancy using a food frequency questionnaire. The control and intervention groups were combined to assess the association between changes in food intakes and GDM. The diagnosis of GDM was based on a 75‐g oral glucose tolerance test conducted in the first and second trimester of pregnancy. Results: Pre‐pregnancy lifestyle counselling showed no major overall effect on food intakes. The intake of low‐fat cheese increased significantly in women who did not develop GDM compared to women who did after adjusting for potential confounders (P = 0.028). This association was not observed for regular‐fat cheese. Conclusions: The findings obtained in the present study suggest that an increased intake of low‐fat but not regular‐fat cheese between pre‐pregnancy and early pregnancy is associated with a lower risk of GDM in high‐risk women.
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Pre-pregnancy diet and/or physical activity interventions were not associated with a statistically significant difference in rates of gestational diabetes mellitus compared with control or standard care (2 studies; n = 214; RR 1.19, 95% CI 0.81, 1.75).
“Pre‐pregnancy diet and/or physical activity interventions were not associated with a significant difference in rates of GDM (2 studies; n = 214; RR 1.19, 95% CI 0.81, 1.75).”
From Pre‐Pregnancy Diet and/or Physical Activity Interventions for the Prevention of Gestational Diabetes Mellitus: A Systematic Review and Meta‐Analysis (2025) · cites this paper as [34]
Five randomised trials assessing pre-pregnancy diet and/or physical activity interventions (n = 1924 women) were included in the meta-analysis.
“Five randomised trials assessing pre‐pregnancy diet and/or physical activity interventions (n = 1924 women) were included.”
From Pre‐Pregnancy Diet and/or Physical Activity Interventions for the Prevention of Gestational Diabetes Mellitus: A Systematic Review and Meta‐Analysis (2025) · cites this paper as [34]
The conclusions are limited by the small number of studies included; only two studies provided data for the primary outcome of gestational diabetes mellitus.
“Our conclusions are limited by the small number of studies included. Only two studies provided data for our primary outcome of GDM [34, 37].”
From Pre‐Pregnancy Diet and/or Physical Activity Interventions for the Prevention of Gestational Diabetes Mellitus: A Systematic Review and Meta‐Analysis (2025) · cites this paper as [34]
All but one study assessed a combined diet and physical activity intervention.
“All but one study assessed a combined diet and physical activity intervention [33, 34, 36, 37].”
From Pre‐Pregnancy Diet and/or Physical Activity Interventions for the Prevention of Gestational Diabetes Mellitus: A Systematic Review and Meta‐Analysis (2025) · cites this paper as [34]
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Cited by
Sorted by citations
Sampathkumar, S., Parkhi, D., Ghebremichael-Weldeselassie, Y., Sukumar, N., & Saravanan, P. (2023) · Nutrition & Diabetes · doi:10.1038/s41387-023-00251-5 · Cited by 23
“To our knowledge, our systematic review and meta-analysis is the fi rst to show the evidence for pre-pregnancy lifestyle interventions and the risk of GDM. Data from RCTs were limited and showed that pre-pregnancy lifestyle interventions may reduce the risk of developing GDM by about 24%.”
MethodPoprzeczny, A. J., Mitchell, M., Deussen, A. R., Habibi, N., Cheung, T. O., & Grieger, J. A. (2025) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/ajo.70032 · Cited by 3
Metadata
- Authors
- Valkama, A. J., Meinilä, J., Koivusalo, S., Lindström, J., Rönö, K., Stach‐Lempinen, B., Kautiainen, H., & Eriksson, J. G.
- Affiliations
- University of Helsinki (FI)
- Finnish Institute for Health and Welfare (FI)
- South Karelia Central Hospital (FI)
- Corresponding author
- Valkama, A. J.
- Venue
- Journal of Human Nutrition and Dietetics
- Publisher
- Wiley
- Published
- 2018-02-22
- Volume
- 31
- Issue
- 3
- Pages
- 301-305
- ISSN
- 0952-3871 (ISSN-L)
- 1365-277X
- OpenAlex
- W2790781988
- Cited by
- 12
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 3 · 2022: 2 · 2020: 1 · 2019: 1 · 2018: 2
- FWCI
- 1.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Human Nutrition and Dietetics (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- WOS
- Funders
- Jalmari ja Rauha Ahokkaan Säätiö
- Foundation for Cardiovascular Research
- Helsingin ja Uudenmaan Sairaanhoitopiiri
- Seventh Framework Programme (278603)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Keywords
- gestational diabetes mellitus, dietary intake, high-risk pregnancy, obesity, low-fat cheese, dietary fat, dietary intervention, early pregnancy
- MeSH terms
- Adult, Counseling, Diet, Diet Surveys, Eating, Female, Humans, Life Style, Pregnancy, Health Behavior, Body Mass Index, Diabetes, Gestational, Preconception Care, Treatment Outcome
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