Determinants of gestational diabetes in overweight and obese women: body composition and intervention with fish oil and probiotics
Abstract
Every fifth pregnant woman is diagnosed with gestational diabetes in Finland. It predisposes both the mother and the child to several adverse short- and long-term consequences. The presence of obesity is one of the strongest risk factors for gestational diabetes. Nutritional factors mainly account for the obesity, and the ability to influence these factors could help to prevent gestational diabetes.
Previous studies suggest that fish oil and probiotic supplements could improve insulin sensitivity of the body by decreasing low-grade inflammation and thereby prevent gestational diabetes. The aim of this study was to determine whether these food supplements could improve glucose levels and reduce the risk of gestational diabetes in overweight and obese women. Further, the associations of diet, physical activity, and gestational diabetes with maternal body composition were evaluated.
In the trial, 439 overweight and obese pregnant women were randomized to consume probiotics and/or fish oil daily from 15 gestational weeks onwards. Weight, body composition, glucose and insulin concentrations were determined in early and in late pregnancy. Gestational diabetes was diagnosed with an oral glucose tolerance test. Information on diet and physical activity were collected.
As compared to placebo, intervention with fish oil and probiotics did not reduce the risk for gestational diabetes or affect weight or body composition. Three out of four women gained weight in excess of recommendations, which was related to increased fat mass accrual as compared to women with an ideal weight gain. Protein intake and the good quality of diet were positively correlated with fat free mass. Body composition in early pregnancy did not differ between healthy women and women developing gestational diabetes. Women with gestational diabetes gained weight and fat mass less than healthy women.
In conclusion, according to this study, supplementation with fish oil and/or probiotics does not prevent gestational diabetes or affect body fat mass in overweight and obese pregnant women. Body adiposity is reduced in women with gestational diabetes as compared with healthy overweight or obese women; adiposity increased in women with an excess weight gain in comparison with women with an ideal gestational weight gain.
