Cited by 157Gestational Diabetes Research and ManagementDiet and metabolism studiesDiet, Metabolism, and Disease

Women With Gestational Diabetes Mellitus Randomized to a Higher–Complex Carbohydrate/Low-Fat Diet Manifest Lower Adipose Tissue Insulin Resistance, Inflammation, Glucose, and Free Fatty Acids: A Pilot Study

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Hernandez, Teri L., Van Pelt, Rachael E., Anderson, Molly A., Reece, Melanie S., Reynolds, Regina M., de la Houssaye, Becky A., Heerwagen, Margaret, Donahoo, William T. +5 more·2016·Diabetes Care

Abstract

OBJECTIVE: Diet therapy in gestational diabetes mellitus (GDM) has focused on carbohydrate restriction but is poorly substantiated. In this pilot randomized clinical trial, we challenged the conventional low-carbohydrate/higher-fat (LC/CONV) diet, hypothesizing that a higher-complex carbohydrate/lower-fat (CHOICE) diet would improve maternal insulin resistance (IR), adipose tissue (AT) lipolysis, and infant adiposity. RESEARCH DESIGN AND METHODS: At 31 weeks, 12 diet-controlled overweight/obese women with GDM were randomized to an isocaloric LC/CONV (40% carbohydrate/45% fat/15% protein; n = 6) or CHOICE (60%/25%/15%; n = 6) diet. All meals were provided. AT was biopsied at 37 weeks. RESULTS: After ∼7 weeks, fasting glucose (P = 0.03) and free fatty acids (P = 0.06) decreased on CHOICE, whereas fasting glucose increased on LC/CONV (P = 0.03). Insulin suppression of AT lipolysis was improved on CHOICE versus LC/CONV (56 vs. 31%, P = 0.005), consistent with improved IR. AT expression of multiple proinflammatory genes was lower on CHOICE (P < 0.01). Infant adiposity trended lower with CHOICE (10.1 ± 1.4 vs. 12.6 ± 2%, respectively). CONCLUSIONS: A CHOICE diet may improve maternal IR and infant adiposity, challenging recommendations for a LC/CONV diet.

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Crossref · 10.2337/dc15-0515

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  • Fasting glucose was paradoxically higher in women randomised to the relatively lower-carbohydrate (40% of total calories) and higher-fat diet than women consuming a relatively higher-carbohydrate diet (60% of total calories).

    “Rather unexpectedly, fasting glucose was reported to be paradoxically higher in women randomised to the relatively lower-carbohydrate (40% of total calories) and higher-fat diet than women consuming a relatively higher-carbohydrate diet (60% of total calories) [77].”

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Authors
Hernandez, T. L., Van Pelt, R. E., Anderson, M. A., Reece, M. S., Reynolds, R. M., de la Houssaye, B. A., Heerwagen, M., Donahoo, W. T., Daniels, L. J., Chartier-Logan, C., Janssen, R. C., Friedman, J. E., & Barbour, L. A.
Affiliations
  • University of Colorado Anschutz (US)
  • Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
  • Division of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
  • Kaiser Permanente (US)
Corresponding author
Hernandez, Teri L.
Venue
Diabetes Care
Published
2015-07-30
Volume
39
Issue
1
Pages
39-42
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
OpenAlex
W935688119
Cited by
157
References
14
Citations by year
2026: 8 · 2025: 11 · 2024: 15 · 2023: 11 · 2022: 6 · 2021: 13 · 2020: 23 · 2019: 15 · 2018: 21 · 2017: 18 · 2016: 14 · 2015: 2
FWCI
20.86
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institutes of Health (R21 DK 088324)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords
gestational diabetes mellitus, low-fat diet, carbohydrate restriction, insulin resistance, adipose tissue lipolysis, adipose tissue inflammation, free fatty acids, fasting blood glucose, infant adiposity, maternal obesity, dietary intervention
MeSH terms
Adipose Tissue, Adult, Blood Glucose, Diet, Diabetic, Fasting, Fatty Acids, Nonesterified, Female, Humans, Inflammation, Insulin, Insulin Resistance, Obesity, Pilot Projects, Pregnancy, Diabetes, Gestational, Diet, Fat-Restricted, Glycemic Index, Overweight, Young Adult

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