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Reduced-energy diet in women with gestational diabetes: the dietary intervention in gestational diabetes DiGest randomized clinical trial

Reduced-energy diet in women with gestational diabetes: the dietary intervention in gestational diabetes DiGest randomized clinical trial
Reduced-energy diet in women with gestational diabetes: the dietary intervention in gestational diabetes DiGest randomized clinical trial

Reduced-energy diets promote weight loss and improve long-term outcomes in type 2 diabetes but are untested in gestational diabetes. We aimed to identify if weight loss in pregnancy improves perinatal outcomes in gestational diabetes. We performed a multicentre parallel, randomized, controlled, double-blind trial of energy restriction in women with singleton pregnancies, gestational diabetes and body mass index ≥25 kg m 2. Participants were randomized to receive a standard-energy control diet (2,000 kcal d −1) or reduced-energy intervention diet (1,200 kcal d −1) from enrollment (29 weeks) until delivery, provided as weekly diet boxes (40% carbohydrate, 35% fat, 25% protein). The randomization was performed in a 1:1 ratio, stratified by center and blinded to the participants and study team. Primary outcomes were maternal weight change from enrollment to 36 weeks and offspring birth weight. In total, 425 participants were randomized to the control (n = 211) or intervention (n = 214). Outcome data were available for 388 of 425 (90.1%) participants at 36 weeks and 382 of 425 (89.8%) at delivery. There was no evidence of a difference in maternal weight change to 36 weeks between groups (intervention effect −0.20 (95% confidence interval −1.01, 0.61); P > 0.1) and offspring standardized birth weight (intervention effect 0.005 (−0.19, 0.20); P > 0.1). A reduced-energy diet was safe in pregnancy. ISRCTN registration no. 65152174.

1078-8956
514-523
Kusinski, Laura C.
37ebebf1-b85b-4ed3-9730-5ad2fee840ea
Jones, Danielle
6addd2cb-f460-49a8-92f0-cf7c497bdb32
Atta, Nooria
e870731b-bd2d-4842-95f7-27223e94548b
Turner, Elizabeth
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Smith, Suzanne
57e41bcc-e579-49a5-b163-8735e5067bb1
Griep, Linda M. Oude
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Rennie, Kirsten
68d6775c-d5d0-49bf-a981-46d80c8264eb
Rolfe, Emanuella De Lucia
658cc447-bdfc-429f-8cec-cb233a72f84d
Sharp, Stephen J.
65e1326f-97f8-4654-b75c-15d046f00532
Farewell, Vern
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Murphy, Helen R.
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Taylor, Roy
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Meek, Claire L.
5fee5eba-aa22-4446-bffd-d3622c7b425d
Kusinski, Laura C.
37ebebf1-b85b-4ed3-9730-5ad2fee840ea
Jones, Danielle
6addd2cb-f460-49a8-92f0-cf7c497bdb32
Atta, Nooria
e870731b-bd2d-4842-95f7-27223e94548b
Turner, Elizabeth
e80e00e2-5fc8-4e5a-bd70-262cff308c2e
Smith, Suzanne
57e41bcc-e579-49a5-b163-8735e5067bb1
Griep, Linda M. Oude
8f655158-ec49-4565-aedb-19059abbda67
Rennie, Kirsten
68d6775c-d5d0-49bf-a981-46d80c8264eb
Rolfe, Emanuella De Lucia
658cc447-bdfc-429f-8cec-cb233a72f84d
Sharp, Stephen J.
65e1326f-97f8-4654-b75c-15d046f00532
Farewell, Vern
6dc33c1f-8eb7-4c7d-8450-c6c7337f76d1
Murphy, Helen R.
48358e20-54dc-4e5b-aa0f-9645dcecadf3
Taylor, Roy
728418b3-9b0a-4756-8a52-9bb71745c6c4
Meek, Claire L.
5fee5eba-aa22-4446-bffd-d3622c7b425d

Kusinski, Laura C., Jones, Danielle, Atta, Nooria, Turner, Elizabeth, Smith, Suzanne, Griep, Linda M. Oude, Rennie, Kirsten, Rolfe, Emanuella De Lucia, Sharp, Stephen J., Farewell, Vern, Murphy, Helen R., Taylor, Roy and Meek, Claire L. (2025) Reduced-energy diet in women with gestational diabetes: the dietary intervention in gestational diabetes DiGest randomized clinical trial. Nature Medicine, 31 (2), 514-523, [100246]. (doi:10.1038/s41591-024-03356-1).

Record type: Article

Abstract

Reduced-energy diets promote weight loss and improve long-term outcomes in type 2 diabetes but are untested in gestational diabetes. We aimed to identify if weight loss in pregnancy improves perinatal outcomes in gestational diabetes. We performed a multicentre parallel, randomized, controlled, double-blind trial of energy restriction in women with singleton pregnancies, gestational diabetes and body mass index ≥25 kg m 2. Participants were randomized to receive a standard-energy control diet (2,000 kcal d −1) or reduced-energy intervention diet (1,200 kcal d −1) from enrollment (29 weeks) until delivery, provided as weekly diet boxes (40% carbohydrate, 35% fat, 25% protein). The randomization was performed in a 1:1 ratio, stratified by center and blinded to the participants and study team. Primary outcomes were maternal weight change from enrollment to 36 weeks and offspring birth weight. In total, 425 participants were randomized to the control (n = 211) or intervention (n = 214). Outcome data were available for 388 of 425 (90.1%) participants at 36 weeks and 382 of 425 (89.8%) at delivery. There was no evidence of a difference in maternal weight change to 36 weeks between groups (intervention effect −0.20 (95% confidence interval −1.01, 0.61); P > 0.1) and offspring standardized birth weight (intervention effect 0.005 (−0.19, 0.20); P > 0.1). A reduced-energy diet was safe in pregnancy. ISRCTN registration no. 65152174.

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Accepted/In Press date: 14 October 2024
Published date: 19 February 2025

Identifiers

Local EPrints ID: 505661
URI: http://eprints.soton.ac.uk/id/eprint/505661
ISSN: 1078-8956
PURE UUID: 18af2c47-d7a0-4b88-93f1-980069c75e19
ORCID for Emanuella De Lucia Rolfe: ORCID iD orcid.org/0000-0003-3542-2767

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Date deposited: 15 Oct 2025 16:57
Last modified: 16 Oct 2025 02:17

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Contributors

Author: Laura C. Kusinski
Author: Danielle Jones
Author: Nooria Atta
Author: Elizabeth Turner
Author: Suzanne Smith
Author: Linda M. Oude Griep
Author: Kirsten Rennie
Author: Emanuella De Lucia Rolfe ORCID iD
Author: Stephen J. Sharp
Author: Vern Farewell
Author: Helen R. Murphy
Author: Roy Taylor
Author: Claire L. Meek

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