{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:58:49Z","timestamp":1788544729742,"version":"build-2803163510"},"reference-count":27,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T00:00:00Z","timestamp":1590019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Obese women are more likely to have decreased insulin sensitivity and are at increased risk for many adverse pregnancy outcomes. An early lifestyle intervention (LI) may have the potential to reduce the impact of insulin resistance (IR) on perinatal outcomes. We report post hoc analysis of an open-label randomized control trial that includes IR women with body-mass index \u226525 randomly assigned to a LI with a customized low glycemic index diet or to standard care (SC) involving generic counseling about healthy diet and physical activity. Women were evaluated at 16, 20, 28, and 36 weeks of gestation, at which times perinatal outcomes were collected and analyzed. An oral-glucose-tolerance test (OGTT) showed that women in the LI group had lower plasma glucose levels at 120 min at 16\u201318 weeks of gestation, and at 60 and 120 min at 24\u201328 weeks. More importantly, these women had a lower rate of large-for-gestational-age (LGA) infants (p = 0.04). Interestingly, the caloric restriction and low-glycemic index diet did not increase the rate of small-for-gestational-age (SGA) babies in the LI group. A lifestyle intervention started early in pregnancy on overweight and obese women had the potential to restore adequate glucose tolerance and mitigate the detrimental role of IR on neonatal outcomes, especially on fetal growth.<\/jats:p>","DOI":"10.3390\/nu12051496","type":"journal-article","created":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T11:31:18Z","timestamp":1590060678000},"page":"1496","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Impact of an Early Lifestyle Intervention on Pregnancy Outcomes in a Cohort of Insulin-Resistant Overweight and Obese Women"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8531-7124","authenticated-orcid":false,"given":"Daniela","family":"Menichini","sequence":"first","affiliation":[{"name":"International Doctorate School in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy"},{"name":"Unit of Obstetrics and Gynecology, Mother-Infant Department, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8306-8005","authenticated-orcid":false,"given":"Elisabetta","family":"Petrella","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, Mother-Infant Department, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenza","family":"Dipace","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, University Hospital Policlinic of Modena, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Di Monte","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, University Hospital Policlinic of Modena, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Neri","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, Mother-Infant Department, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Facchinetti","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, Mother-Infant Department, University of Modena and Reggio Emilia, 41125 Modena, Italy"},{"name":"Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, University Hospital Policlinic of Modena, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1530\/REP-10-0088","article-title":"Obesity, Insulin Resistance and Pregnancy Outcome","volume":"140","author":"Catalano","year":"2010","journal-title":"Reproduction"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s12933-018-0762-4","article-title":"Association between insulin resistance and the development of cardiovascular disease","volume":"17","author":"Ormazabal","year":"2018","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/0026-0495(88)90136-9","article-title":"The relationship of maternal and fetal glucose concentrations in the human from midgestation until term","volume":"37","author":"Bozzetti","year":"1988","journal-title":"Metabolism"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1111\/j.1471-0528.2006.00989.x","article-title":"The short- and long-term implications of maternal obesity on the mother and her offspring","volume":"113","author":"Catalano","year":"2006","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"The HAPO Study Cooperative Research Group (2009). Hyperglycemia and adverse pregnancy outcome (hapo) study: Associations with neonatal anthropometrics. Diabetes, 58, 453\u2013459.","DOI":"10.2337\/db08-1112"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s40618-016-0607-5","article-title":"Gestational diabetes mellitus: An updated overview","volume":"40","author":"Chiefari","year":"2017","journal-title":"J. Endocrinol. Investig."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.3109\/14767050903551392","article-title":"Diabetes Mellitus and the Risk of Preterm Birth with Regard to the Risk of Spontaneous Preterm Birth","volume":"23","author":"Klein","year":"2010","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.3109\/14767050903550659","article-title":"The fetal and maternal consequences of gestational diabetes mellitus","volume":"23","author":"Reece","year":"2010","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_9","first-page":"CD010443","article-title":"Diet and exercise interventions for preventing gestational diabetes mellitus","volume":"12","author":"Bain","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/mcn.12333","article-title":"Adherence to a lifestyle programme in overweight\/obese pregnant women and effect on gestational diabetes mellitus: A randomized controlled trial","volume":"13","author":"Bruno","year":"2017","journal-title":"Matern. Child Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100030","DOI":"10.1016\/j.ajogmf.2019.100030","article-title":"Food glycemic index changes in overweight\/obese pregnant women enrolled in a lifestyle program: A randomized controlled trial","volume":"1","author":"Facchinetti","year":"2019","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2011). Standards of Medical Care in Diabetes\u20142011. Diabetes Care, 34, S11\u2013S61.","DOI":"10.2337\/dc11-S011"},{"key":"ref_13","unstructured":"National Institute for Clinical Health and Care Excellence (2015). NICE guidance on diabetes in pregnancy: Management of diabetes and its complications from preconception to the postnatal period. Lond. UK NICE Clin. Guidel., 15, NG3."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists (2018). ACOG Practice Bulletin No. 190: Gestational diabetes mellitus. Obstet. Gynecol., 131, e49\u2013e64.","DOI":"10.1097\/AOG.0000000000002501"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"s177","DOI":"10.1038\/sj.ejcn.1600759","article-title":"Report of the IDECG Working Group on lower and upper limits of carbohydrate and fat intake","volume":"53","author":"Bier","year":"1999","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s13340-015-0212-4","article-title":"Glucose area under the curve during oral glucose tolerance test as an index of glucose intolerance","volume":"7","author":"Sakaguchi","year":"2016","journal-title":"Diabetol. Int."},{"key":"ref_17","first-page":"1","article-title":"Hypertensive Disorders of Pregnancy","volume":"3","author":"Mammaro","year":"2009","journal-title":"J. Prenat. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/GCO.0b013e328332d24e","article-title":"New guidelines for weight gain during pregnancy: What obstetrician\/gynecologists should know","volume":"21","author":"Rasmussen","year":"2009","journal-title":"Curr. Opin. Obstet. Gynecol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.tem.2018.09.004","article-title":"Gestational Diabetes Mellitus: Mechanisms, Treatment, and Complications","volume":"29","author":"Johns","year":"2018","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1111\/1471-0528.15386","article-title":"Care of Women with Obesity in Pregnancy. Green-top Guideline No. 72. BJOG 2018","volume":"126","author":"Denison","year":"2019","journal-title":"BJOG"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.2337\/diacare.26.8.2261","article-title":"Low-glycemic index diets in the management of diabetes: A meta-analysis of randomized controlled trials","volume":"26","author":"Hayne","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1093\/ajcn\/84.4.807","article-title":"Effect of a low-glycemic-index diet during pregnancy on obstetric outcomes","volume":"84","author":"Moses","year":"2006","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/S0002-9378(99)70662-9","article-title":"Longitudinal changes in glucose metabolism during pregnancy in obese women with normal glucose tolerance and gestational diabetes mellitus","volume":"180","author":"Catalano","year":"1999","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1507\/endocrj.EJ14-0163","article-title":"The Association between Maternal Insulin Resistance in Mid-Pregnancy and Neonatal Birthweight in Uncomplicated Pregnancies","volume":"61","author":"Yamashita","year":"2014","journal-title":"Endocr. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"517","DOI":"10.3945\/ajcn.113.074138","article-title":"Pregnancy and glycemic index outcomes study: Effects of low glycemic index compared with conventional dietary advice on selected pregnancy outcomes","volume":"99","author":"Moses","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1017\/S0007114510000425","article-title":"The influence of maternal glycaemia and dietary glycaemic index on pregnancy outcome in healthy mothers","volume":"104","author":"McGowan","year":"2010","journal-title":"Br. J. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mitanchez, D., Ciangura, C., and Jacqueminet, S. (2020). How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses. Nutrients, 12.","DOI":"10.3390\/nu12020353"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/5\/1496\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:31:00Z","timestamp":1760175060000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/5\/1496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,21]]},"references-count":27,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["nu12051496"],"URL":"https:\/\/doi.org\/10.3390\/nu12051496","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,21]]}}}