TY - JOUR
T1 - A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity
T2 - the DALI randomised controlled trial
AU - van Poppel, Mireille N.M.
AU - Simmons, David
AU - Devlieger, Roland
AU - van Assche, F. Andre
AU - Jans, Goele
AU - Galjaard, Sander
AU - Corcoy, Rosa
AU - Adelantado, Juan M.
AU - Dunne, Fidelma
AU - Harreiter, Jürgen
AU - Kautzky-Willer, Alexandra
AU - Damm, Peter
AU - Mathiesen, Elisabeth R.
AU - Jensen, Dorte M.
AU - Andersen, Lise Lotte
AU - Tanvig, Mette
AU - Lapolla, Annunziata
AU - Dalfra, Maria G.
AU - Bertolotto, Alessandra
AU - Wender-Ozegowska, Ewa
AU - Zawiejska, Agnieszka
AU - Hill, David
AU - Snoek, Frank J.
AU - Jelsma, Judith G.M.
AU - Desoye, Gernot
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Aims/hypothesis: Offspring of obese women are at increased risk of features of the metabolic syndrome, including obesity and diabetes. Lifestyle intervention in pregnancy might reduce adverse effects of maternal obesity on neonatal adiposity. Methods: In the Vitamin D And Lifestyle Intervention for Gestational Diabetes Mellitus (GDM) Prevention (DALI) lifestyle trial, 436 women with a BMI ≥29 kg/m 2 were randomly assigned to counselling on healthy eating (HE), physical activity (PA) or HE&PA, or to usual care (UC). In secondary analyses of the lifestyle trial, intervention effects on neonatal outcomes (head, abdominal, arm and leg circumferences and skinfold thicknesses, estimated fat mass, fat percentage, fat-free mass and cord blood leptin) were assessed using multilevel regression analyses. Mediation of intervention effects by lifestyle and gestational weight gain was assessed. Results: Outcomes were available from 334 neonates. A reduction in sum of skinfolds (−1.8 mm; 95% CI −3.5, −0.2; p = 0.03), fat mass (−63 g; 95% CI −124, −2; p = 0.04), fat percentage (−1.2%; 95% CI −2.4%, −0.04%; p = 0.04) and leptin (−3.80 μg/l; 95% CI −7.15, −0.45; p = 0.03) was found in the HE&PA group, and reduced leptin in female neonates in the PA group (−5.79 μg/l; 95% CI −11.43, −0.14; p = 0.05) compared with UC. Reduced sedentary time, but not gestational weight gain, mediated intervention effects on leptin in both the HE&PA and PA groups. Conclusions/interpretation: The HE&PA intervention resulted in reduced adiposity in neonates. Reduced sedentary time seemed to drive the intervention effect on cord blood leptin. Implications for future adiposity and diabetes risk of the offspring need to be elucidated. Trial registration: ISRCTN70595832.
AB - Aims/hypothesis: Offspring of obese women are at increased risk of features of the metabolic syndrome, including obesity and diabetes. Lifestyle intervention in pregnancy might reduce adverse effects of maternal obesity on neonatal adiposity. Methods: In the Vitamin D And Lifestyle Intervention for Gestational Diabetes Mellitus (GDM) Prevention (DALI) lifestyle trial, 436 women with a BMI ≥29 kg/m 2 were randomly assigned to counselling on healthy eating (HE), physical activity (PA) or HE&PA, or to usual care (UC). In secondary analyses of the lifestyle trial, intervention effects on neonatal outcomes (head, abdominal, arm and leg circumferences and skinfold thicknesses, estimated fat mass, fat percentage, fat-free mass and cord blood leptin) were assessed using multilevel regression analyses. Mediation of intervention effects by lifestyle and gestational weight gain was assessed. Results: Outcomes were available from 334 neonates. A reduction in sum of skinfolds (−1.8 mm; 95% CI −3.5, −0.2; p = 0.03), fat mass (−63 g; 95% CI −124, −2; p = 0.04), fat percentage (−1.2%; 95% CI −2.4%, −0.04%; p = 0.04) and leptin (−3.80 μg/l; 95% CI −7.15, −0.45; p = 0.03) was found in the HE&PA group, and reduced leptin in female neonates in the PA group (−5.79 μg/l; 95% CI −11.43, −0.14; p = 0.05) compared with UC. Reduced sedentary time, but not gestational weight gain, mediated intervention effects on leptin in both the HE&PA and PA groups. Conclusions/interpretation: The HE&PA intervention resulted in reduced adiposity in neonates. Reduced sedentary time seemed to drive the intervention effect on cord blood leptin. Implications for future adiposity and diabetes risk of the offspring need to be elucidated. Trial registration: ISRCTN70595832.
KW - Lifestyle intervention
KW - Mediation
KW - Neonatal adiposity
KW - Randomised controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85062781450&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00125-019-4842-0
DO - https://doi.org/10.1007/s00125-019-4842-0
M3 - Article
C2 - 30840112
SN - 0012-186X
VL - 62
SP - 915
EP - 925
JO - Diabetologia
JF - Diabetologia
IS - 6
ER -