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Article

TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus

1
Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece
2
Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, GR-57400 Thessaloniki, Greece
3
Department of Midwifery, Faculty of Health Sciences, Alexander Campus, International Hellenic University, GR-57400 Thessaloniki, Greece
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School of Physical Education and Sports Science, Democritus University of Thrace, GR-69100 Komotini, Greece
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2nd Department of Obstetrics and Gynecology, Hippokratio General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Str, GR-54642 Thessaloniki, Greece
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Clinical Research and Evidence-Based Medicine Unit, Hippokration Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Str, GR-54642 Thessaloniki, Greece
7
Harris Manchester College, University of Oxford, Oxford OX1 3TD, UK
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
These authors contributed equally to this work.
Academic Editors: David Simmons and Clive J. Petry
Nutrients 2021, 13(7), 2457; https://doi.org/10.3390/nu13072457
Received: 1 June 2021 / Revised: 6 July 2021 / Accepted: 14 July 2021 / Published: 18 July 2021
(This article belongs to the Special Issue Advances in the Nutrition of Diabetes and Gestational Diabetes)
Medical nutrition therapy is an integral part of gestational diabetes mellitus (GDM) management; however, the prescription of optimal energy intake is often a difficult task due to the limited available evidence. The present pilot, feasibility, parallel, open-label and non-randomized study aimed to evaluate the effect of a very low energy diet (VLED, 1600 kcal/day), or a low energy diet (LED, 1800 kcal/day), with or without personalized exercise sessions, among women with GDM in singleton pregnancies. A total of 43 women were allocated to one of four interventions at GDM diagnosis: (1) VLED (n = 15), (2) VLED + exercise (n = 4), (3) LED (n = 16) or (4) LED + exercise (n = 8). Primary outcomes were gestational weight gain (GWG), infant birth weight, complications at delivery and a composite outcomes score. Secondary outcomes included type of delivery, prematurity, small- for-gestational-age (SGA) or large-for-gestational-age (LGA) infants, macrosomia, Apgar score, insulin use, depression, respiratory quotient (RQ), resting metabolic rate (RMR) and middle-upper arm circumference (MUAC). GWG differed between intervention groups (LED median: 12.0 kg; VLED: 5.9 kg). No differences were noted in the type of delivery, infant birth weight, composite score, prevalence of prematurity, depression, RQ, Apgar score, MUAC, or insulin use among the four groups. Regarding components of the composite score, most infants (88.4%) were appropriate-for-gestational age (AGA) and born at a gestational age of 37–42 weeks (95.3%). With respect to the mothers, 9.3% experienced complications at delivery, with the majority being allocated at the VLED + exercise arm (p < 0.03). The composite score was low (range 0–2.5) for all mother-infant pairs, indicating a “risk-free” pregnancy outcome. The results indicate that adherence to a LED or VLED induces similar maternal, infant and obstetrics outcomes. View Full-Text
Keywords: pregnancy; physical activity; lifestyle; diet; caloric intake; low-calorie diet; diabetes mellitus; gestational weight gain; depression; obstetrical outcome pregnancy; physical activity; lifestyle; diet; caloric intake; low-calorie diet; diabetes mellitus; gestational weight gain; depression; obstetrical outcome
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MDPI and ACS Style

Tsirou, E.; Grammatikopoulou, M.G.; Nigdelis, M.P.; Taousani, E.; Savvaki, D.; Assimakopoulos, E.; Tsapas, A.; Goulis, D.G. TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus. Nutrients 2021, 13, 2457. https://doi.org/10.3390/nu13072457

AMA Style

Tsirou E, Grammatikopoulou MG, Nigdelis MP, Taousani E, Savvaki D, Assimakopoulos E, Tsapas A, Goulis DG. TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus. Nutrients. 2021; 13(7):2457. https://doi.org/10.3390/nu13072457

Chicago/Turabian Style

Tsirou, Efrosini, Maria G. Grammatikopoulou, Meletios P. Nigdelis, Eleftheria Taousani, Dimitra Savvaki, Efstratios Assimakopoulos, Apostolos Tsapas, and Dimitrios G. Goulis. 2021. "TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus" Nutrients 13, no. 7: 2457. https://doi.org/10.3390/nu13072457

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