Maternal Diet and Pregnancy Outcomes

MATERNAL DIET AND PREGNANCY OUTCOMES
There is ample evidence showing that maternal obesity increases the risk of
metabolic complications (i.e., gestational diabetes, pregnancy-induced hypertension,
and preeclampsia) and alters fetal growth and risk for disease postnatally.
But little attention has been paid to how to prevent these problems. Maternal diet,
as a key component of the maternal environment, likely contributes to the risk as
well as the prevention of these metabolic complications. Although the studies of
maternal diet and pregnancy complications have been done primarily in nonobese
women, the findings persist after adjusting for body weight or BMI, suggesting
that the results are applicable to obese as well as to nonobese women.
In the past, much of the nutritional therapy for GDM patients focused on energy
restriction because lower calorie intakes controlled glycemia and reduced
macrosomia (53, 67). However, given concern about the effect of maternal ketosis
induced by energy restriction on fetal neurophysiological and cognitive development,
the focus shifted from reducing energy intakes to adjusting carbohydrate
and fat intakes for women with gestational glucose intolerance. Currently, the
American Diabetes Association limits energy intake for overweight compared to
normal-weight women. For example, 36–40 kcal/kg are recommended for women
with body weights <90% of standard, whereas 24 kcal/kg are recommended for
women weighing between 121% and 150% of standard. Only 12–18 kcal/kg are
recommended when ideal body weight exceeds 150% of standard. These energy
recommendations are less than that recommended by the Institute of Medicine for
pregnancy (59), but are higher than the energy levels fed in early studies of GDM
(53, 58). The American Diabetes Association also recommends that carbohydrate
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284 KING
and fat intake each be 40% of total energy, with the remaining 20% from protein
(32). This was updated in 2004 to suggest a range in carbohydrate intake from 45%
to 65% of the total calories to be consistent with the new Dietary Reference Intakes
(82). No specific recommendation was made regarding the type of carbohydrate,
however.
Dietary Carbohydrate
Given that maximal maternal-fetal glucose transfer occurs postprandially (32),
reducing glucose concentrations at this time has a greater impact on limiting accelerated
fetal growth than on lowering fasting glucose levels. Thus, studies have
begun to investigate how to reduce postprandial glycemia and thereby lessen fetal
glucose exposure. Low-glycemic-load diets have been shown in several small
studies of pregnant women to reduce the glycemic response to meals and to improve
insulin sensitivity in mid and late pregnancy, thereby reducing placental
and birth weights and neonatal fat mass (27, 28). Since a low dietary glycemic
load reduces fetal glucose levels, this diet is also associated with approximately a
twofold increased risk of an SGA birth (79). Obviously, if total carbohydrate intake
is limited along with a shift toward low-glycemic foods, the postprandial glycemic
spikes will be reduced and fetal glucose supply may be inadequate to support fetal
growth. Research is needed to determine optimal levels of glycemic load for obese
pregnant women to prevent excessive fetal growth without inducing SGA.
Although GDM women are advised to limit the amount of carbohydrate intake
to 40% of total energy to maintain good glycemic control (32, 47, 58), a shift toward
more complex carbohydrates should permit higher total carbohydrate intakes with
a comparable glycemic response. When low-glycemic sources are the basis of the
diet, up to 60% of the energy can be given as carbohydrate to pregnant diabetic
women without any detrimental effect on glucose tolerance (32). It has also been
shown that diabetic, pregnant women fed diets providing 65% of the energy as
carbohydrate and 60–70 g fiber required less exogenous insulin than did women
consuming 40% carbohydrate diets with 20 g fiber (65). Epidemiological studies
have also shown that 100-kcal increases in carbohydrate to the diet were associated
with a 12% decrease in risk of impaired glucose tolerance and a 9%decrease in the
risk of GDM (77). In other words, substituting carbohydrate for fat significantly
decreased the risk of poor glycemic control. Thus, limiting dietary carbohydrate
among pregnant women to avoid excessive postprandial glucose spikes seems to
be unnecessary if low-glycemic, complex carbohydrates form the basis of the diet.
Dietary Fat
Lowering the level of carbohydrate in a diet implies increased levels of fats. Evidence
is now accumulating that a high fat intake is linked to insulin resistance
and a higher risk of gestational diabetes. The type and the amount of dietary fat
both seem to play a role. For example, the recurrence of GDM is significantly
higher among women consuming diets providing about 40% of the energy as fat
compared with that of women consuming lower-fat (about 33%) diets (63). This
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MATERNAL OBESITY 285
relationship could reflect a lower intake of fiber and complex carbohydrates since
these dietary factors are usually inversely related to fat intake. Conversely, high
intakes of polyunsaturated fats are associated with better pregnancy outcomes,
and they may even be protective of impaired glucose tolerance (IGT) or GDM
(10, 91). These relationships persist after controlling for body weight or BMI. A
high saturated fat intake also is related to the risk for IGT orGDM(10). All women
consuming more than 30% of their total energy as saturated fat (about three times
recommended intakes) had IGT or GDM; no similar cutoff was evident for high
polyunsaturated fatty acid intakes. Furthermore, a high intake of saturated fat was
the only factor linked to the development of IGT orGDMin young, normal-weight
women lacking other risk factors for this disease, which suggests that modifying
fat intakes prior to and during pregnancy could be an effective way to prevent
gestational glucose intolerance.
Diet Recommendations
As mentioned above, the current recommendations by the American Diabetes Association
specify amounts of carbohydrate and fat intake for preventing or treating
gestational glucose intolerance. Maintaining carbohydrate and fat intakes within
the acceptable macronutrient distribution ranges recommended by the Institute of
Medicine (46a) would allow more flexibility in dietary planning without appreciably
altering risk of IGT. At the same time, it seems prudent to also consider
types of carbohydrate and fat when managing the diets of pregnant women at risk
for IGT. Emerging evidence suggests an emphasis on high-complex, high-fiber,
low-glycemic sources of carbohydrate while increasing the intake of polyunsaturated
fat acids and limiting saturated fat intake. The 2005 Dietary Guidelines for
Americans provide guidance consistent with this dietary pattern for nonpregnant
women. The following adaptations from the 2005 Dietary Guidelines may serve
as the basis of a sound dietary pattern for pregnant women (80).
Keep total fat intake between 20% and 35% of the calories and total carbohydrate
intake between 45% and 65% of the calories.
Choose fiber-rich fruits, vegetables, and whole grains often. In general, consume
at least 2 cups of fruit, 21/2 cups of vegetables, and 3 ounces of wholegrain
products daily.
Choose most fats from good sources of polyunsaturated fatty acids, such as
fish, nuts, and vegetable oils, and limit the intake of saturated fatty acids to
less than 10% of the calories each day.
PERSPECTIVES
There is substantial evidence that maternal obesity alters the course of pregnancy.
In early pregnancy, placental and embryonic development is affected. In late pregnancy,
maternal metabolic complications and alterations in fetal size and body
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286 KING
fat occur. The in utero environment of obese women appears to force the fetus
to metabolic adjustments that influence immediate and long-term development.
These adjustments may not be consistent with good health in the postnatal environment.
Ways to prevent or reduce metabolic aberrations in obese pregnant
women have not been identified. Maternal diet seems to play a substantial role, but
the effects of preconceptional and gestational diet need further study. In preparation
for pregnancy, obese women are often advised to lose weight. However, exposure
to undernutrition during the periconceptional period may also be inconsistent with
good pregnancy outcomes. It is prudent, therefore, to proceed with caution when
advising obese women about diet prior to and during gestation.
ACKNOWLEDGMENTS
I would like to acknowledge Amy Lightner for her help in reviewing and summarizing
the literature for this article and Janet Wu for her assistance with drawing
the figures.
The Annual Review of Nutrition is online at http://nutr.annualreviews.org
LITERATURE CITED
1. Bajoria R, Sooranna SR,Ward B, Chatterjee
R. 2002. Prospective function of placental
leptin at maternal-fetal interface.
Placenta 23:103–15
2. Barker D. 1995. Fetal origins of coronary
heart disease. Br. Med. J. 311:171–74
3. Barker D, Bull A, Osmond D, Simmonds
S. 1990. Fetal and placental size and risk
of hypertension in adult life. Br. Med. J.
301:259–62
4. Barker DJ. 2001. A new model for the origins
of chronic disease. Med. Health Care
Philos. 4:31–35
5. Barker DJ. 2003. Coronary heart disease:
a disorder of growth. Horm. Res.
59(Suppl. 1):35–41
6. Barker DJ. 2004. The developmental origins
of chronic adult disease. Acta Paediatr.
Suppl. 93:26–33
7. Barker DJ. 2004. The developmental origins
of well-being. Philos. Trans. R. Soc.
Lond. B Biol. Sci. 359:1359–66
8. Bethune M, Bell R. 2003. Evaluation of
the measurement of the fetal fat layer, interventricular
septum and abdominal circumference
percentile in the prediction
of macrosomia in pregnancies affected by
gestational diabetes. Ultrasound Obstet.
Gynecol. 22:586–90
9. Bo S, Menato G, Gallo ML, Bardelli C,
Lezo A, et al. 2004. Mild gestational hyperglycemia,
the metabolic syndrome and
adverse neonatal outcomes. Acta Obstet.
Gynecol. Scand. 83:335–40
10. Bo S, Menato G, Lezo A, Signorile A,
Bardelli C, et al. 2001. Dietary fat and
gestational hyperglycaemia. Diabetologia
44:972–78
11. Boney C, Verma A, Tucker R, Vohr B.
2005. Metabolic syndrome in childhood:
association with birth weight, maternal
obesity, and gestational diabetes mellitus.
Pediatrics 115:e290–96
12. Bronstein MN, Mak RP, King JC. 1996.
Unexpected relationship between fat mass
and basal metabolic rate in pregnant
women. Br. J. Nutr. 75:659–68
13. Burton G, Hempstock J, Jauniaux E.
2001. Nutrition of the human fetus during
the first trimester—a review. Placenta
22:S70–76
14. Butte NF. 2000. Carbohydrate and lipid
Annu. Rev. Nutr. 2006.26:271-291. Downloaded from www.annualreviews.org
Access provided by Texas A&M University – College Station on 02/06/21. For personal use only.
MATERNAL OBESITY 287
metabolism in pregnancy: normal compared
with gestational diabetes mellitus.
Am. J. Clin. Nutr. 71:1256–61S
15. Butte NF, Ellis KJ, Wong WW, Hopkinson
JM, Smith EO. 2003. Composition of
gestational weight gain impacts maternal
fat retention and infant birth weight. Am.
J. Obstet. Gynecol. 189:1423–32
16. Butte NF, Hopkinson JM, Nicolson MA.
1997. Leptin in human reproduction:
serum leptin levels in pregnant and lactating
women. J. Clin. Endocrinol. Metab.
82:585–89
17. Butte NF, Wong WW, Treuth MS, Ellis
KJ, Smith EO. 2004. Energy requirements
during pregnancy based on total energy
expenditure and energy deposition. Am.
J. Clin. Nutr. 79:1078–87
18. Castro LC, Avina RL. 2002. Maternal
obesity and pregnancy outcomes. Curr.
Opin. Obstet. Gynecol. 14:601–6
19. Catalano P, Nizielski S, Shao J, Preston
L, Qiao L, Friedman JE. 2002. Downregulated
IRS-1 and PPARgamma in obese
women with gestational diabetes: relationship
to FFA during pregnancy. Am.
J. Physiol. Endocrinol. Metab. 282:E522–
33
20. Catalano PM. 1999. Pregnancy and lactation
in relation to range of acceptable
carbohydrate and fat intake. Eur. J. Clin.
Nutr. 53:S131–35
21. Catalano PM. 2003. Editorial: obesity
and pregnancy—the propagation of a vicious
cycle? J. Clin. Endocrinol. Metab.
88:3505–6
22. Catalano PM, Huston L, Amini SB,
Kalhan SC. 1999. Longitudinal changes
in glucose metabolism during pregnancy
in obese women with normal glucose
tolerance and gestational diabetes mellitus.
Am. J. Obstet. Gynecol. 180:903–
16
23. Catalano PM, Kirwan JP, Haugel-de
Mouzon S, King J. 2003. Gestational diabetes
and insulin resistance: role in shortand
long-term implications for mother and
fetus. J. Nutr. 133:1674–83S
24. Catalano PM, Thomas A, Huston-Presley
L, Amini SB. 2003. Increased fetal adiposity:
a very early marker of abnormal
in utero development. Am. J. Obstet. Gynecol.
189:1698–704
25. Catalano PM, Tyzbir ED, Wolfe RR,
Calles J, Roman NM, et al. 1993. Carbohydrate
metabolism during pregnancy in
control subjects and women with gestational
diabetes. Am. J. Physiol. 264:E60–
67
26. Chevalier S, Marliss EB, Morais JA,
Lamarche M, Gougeon R. 2005. Wholebody
protein anabolic response is resistance
to the action of insulin in obese
women. Am. J. Clin. Nutr. 82:355–65
27. Clapp JF. 1998. Effect of dietary carbohydrate
on the glucose and insulin response
to mixed caloric intake and exercise in
both nonpregnant and pregnant women.
Diabetes Care 21:B107–12
28. Clapp JF. 2002. Maternal carbohydrate intake
and pregnancy outcome. Proc. Nutr.
Soc. 61:45–50
29. Cnattingius S, Bergstrom R, Lipworth L,
Kramer MS. 1998. Prepregnancy weight
and the risk of adverse pregnancy outcomes.
New Engl. J. Med. 338:147–52
30. Collinson A, Moore S, O’Connell M,
Charalambos C, Prentice A. 2005. Developmental
changes in leptin as a measure
of energy status in human infants in a natural
ecologic setting. Am. J. Clin. Nutr.
81:488–94
31. Dabelea D, Pettitt DJ. 2001. Intrauterine
diabetic environment confers risks for
type 2 diabetes mellitus and obesity in
the offspring, in addition to genetic susceptibility.
J. Pediatr. Endocrinol. Metab.
14:1085–91
32. Dornhorst A, Frost G. 2002. The principles
of dietary management of gestational
diabetes: reflection on current evidence. J.
Hum. Nutr. Dietet. 15:145–56
33. Duggleby SL, Jackson AA. 2001. Relationship
of maternal protein turnover and
lean body mass during pregnancy and
birth length. Clin. Sci. 101:65–72
Annu. Rev. Nutr. 2006.26:271-291. Downloaded from www.annualreviews.org
Access provided by Texas A&M University – College Station on 02/06/21. For personal use only.
288 KING
34. Duggleby SL, Jackson AA. 2002. Protein,
amino acid and nitrogen metabolism
during pregnancy: How might the mother
meet the needs of her fetus? Curr. Opin.
Clin. Nutr. Metab. Care 5:503–9
35. Ehrenberg H, Huston-Presley M, Catalano
PM. 2003. The influence of obesity
and gestational diabetes mellitus on accretion
and the distribution of adipose tissue
in pregnancy. Am. J. Obstet. Gynecol.
189:944–48
36. Friedman JE, Ishizuka T, Shao J, Huston
LP, Highman T, et al. 1999. Impaired
glucose transport and insulin receptor tyrosine
phosphorylation in skeletal muscle
from obese women with gestational diabetes.
Diabetes 48:1807–14
37. Galtier-Dereure F, Boegner C, Bringer J.
2000. Obesity and pregnancy: complications
and cost. Am. J. Clin. Nutr. 71:1242–
48S
38. Gluckman P, Hanson M. 2005. The Fetal
Matrix: Evolution, Development and
Disease. London: Cambridge Univ. Press
39. Godfrey KM, Barker DJ. 2001. Fetal programming
and adult health. Public Health
Nutr. 4:611–24
39a. Greenberg AS, Obin MS. 2006. Obesity
and the role of adipose tissue in inflammation
and metabolism. Am. J. Clin. Nutr.
83:461–65S
40. Grundy S. 2004. Obesity, metabolic
syndrome, and cardiovascular disease.
J. Clin. Endocrinol. Metab. 89:2595–
600
41. Hales CN, Barker DJ. 2001. The thrifty
phenotype hypothesis. Br. Med. Bull.
60:5–20
42. Havel PJ. 2004. Update on adipocyte hormones.
Regulation of energy balance and
carbohydrate/lipid metabolism. Diabetes
53:S143–51
43. Herrera E. 2000. Metabolic adaptations in
pregnancy and their implications for the
availability of substrates to the fetus. Eur.
J. Clin. Nutr. 54(Suppl. 1):S47–51
44. Herrera E. 2002. Lipid metabolism in
pregnancy and its consequences in the fetus
and newborn. Endocrinology 19:43–
55
45. Highman RJ, Friedman JE, Huston LP,
Wong WW, Catalan PM. 1998. Longitudinal
changes in maternal serum leptin
concentrations, body composition, and
resting metabolic rate in pregnancy. Am.
J. Obstet. Gynecol. 178:1010–15
46. Hytten FE. 1980. Nutrition. In Clinical
Physiology in Obstetrics, ed. F Hytten, G
Chamberlain, pp. 163–92. Oxford: Blackwell
Sci.
46a. Institute of Medicine. 2002. Dietary Reference
Intakes for Energy, Carbohydrate,
Fiber, Fat, Fatty Acids, Cholesterol, Protein,
and Amino Acids. Part I. Washington,
DC: Natl. Acad. Press
47. Jovanovic L. 1998. American Diabetes
Association’s Fourth International
Workshop-Conference on Gestational Diabetes
Mellitus: summary and discussion.
Therapeutic interventions. Diabetes Care
21:131–37
48. Kac G, BenicioMH,Velasquez-Melendez
G, Valente JG, Struchiner CJ. 2004. Gestational
weight gain and prepregnancy
weight influence postpartum weight retention
in a cohort of Brazilian women.
J. Nutr. 134:661–66
49. Kalhan SC. 2000. Protein metabolism in
pregnancy. Am. J. Clin. Nutr. 71:1249–
55S
50. Kalhan SC, Rossi KQ, Gruca LL, Super
DM, Savin SM. 1998. Relation between
transamination of branched-chain
amino acids and urea synthesis: evidence
from human pregnancy. Am. J. Physiol.
275:E423–31
51. King JC. 2000. Physiology of pregnancy
and nutrient metabolism. Am. J. Clin.
Nutr. 71:1218–25S
52. Kitzmiller JL. 1980. The endocrine
pancreas and maternal metabolism. In
Maternal-Fetal Endocrinology, ed. D
Tulchinsky, KJ Ryan, pp. 58–83. Philadelphia,
PA: Saunders
53. Knopp RH, Magee MS, Raisys V,
Benedetti T. 1991. Metabolic effects
Annu. Rev. Nutr. 2006.26:271-291. Downloaded from www.annualreviews.org
Access provided by Texas A&M University – College Station on 02/06/21. For personal use only.
MATERNAL OBESITY 289
of hypocaloric diets in management of

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