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Women With Gestational Diabetes Mellitus Randomized to a Higher-Complex Carbohydrate/Low-Fat Diet Manifest Lower Adipose Tissue Insulin Resistance , Inflammation , Glucose , and Free Fatty Acids : A Pilot Study . OBJECTIVE Diet therapy in gestational diabetes mellitus ( GDM ) has focused on carbohydrate restriction but is poorly substantiated . In this pilot randomized clinical trial , we challenged the conventional low-carbohydrate/higher-fat ( LC/CONV ) diet , hypothesizing that a higher-complex carbohydrate/lower-fat ( CHOICE ) diet would improve maternal insulin resistance ( IR ) , adipose tissue ( AT ) lipolysis , and infant adiposity . RESEARCH DESIGN AND METHODS At 31 weeks , 12 diet-controlled overweight/obese women with GDM were randomized to an isocaloric LC/CONV ( 40 % carbohydrate/45 % fat/15 % protein ; n = 6 ) or CHOICE ( 60 % /25 % /15 % ; n = 6 ) diet . All meals were provided . AT was biopsied at 37 weeks . RESULTS After ∼7 weeks , fasting glucose ( P = 0.03 ) and free fatty acids ( P = 0.06 ) decreased on CHOICE , whereas fasting glucose increased on LC/CONV ( P = 0.03 ) . Insulin suppression of AT lipolysis was improved on CHOICE versus LC/CONV ( 56 vs. 31 % , P = 0.005 ) , consistent with improved IR . AT expression of multiple proinflammatory genes was lower on CHOICE ( P < 0.01 ) . Infant adiposity trended lower with CHOICE ( 10.1 ± 1.4 vs. 12.6 ± 2 % , respectively ) . CONCLUSIONS A CHOICE diet may improve maternal IR and infant adiposity , challenging recommendations for a LC/CONV diet .
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Intervention_Physical
conventional low-carbohydrate/higher-fat ( LC/CONV ) diet
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Intervention_Physical
higher-complex carbohydrate/lower-fat ( CHOICE ) diet
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Intervention_Physical
CHOICE
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Intervention_Physical
diet
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Intervention_Physical
meals
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Outcome_Physical
maternal insulin resistance ( IR ) , adipose tissue ( AT ) lipolysis , and infant adiposity .