A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity : the DALI randomised controlled trial
van Poppel, M. N. M. (Institute of Sport Science. University of Graz)
Simmons, David (Institute of Metabolic Science. Addenbrooke's Hospital)
Devlieger, Roland (University Hospitals Leuven (Bèlgica))
van Assche, F. A. (University Hospitals Leuven (Bèlgica))
Jans, G. (University Hospitals Leuven (Bèlgica))
Galjaard, Sander (Division of Obstetrics and Prenatal Medicine. Department of Obstetrics and Gynaecology. Erasmus University Medical Center)
Corcoy i Pla, Rosa (Institut d'Investigació Biomèdica Sant Pau)
Adelantado, Juan M.. (Institut d'Investigació Biomèdica Sant Pau)
Dunne, Fidelma (College of Medicine. Nursing and Health Sciences. National University of Ireland)
Harreiter, Jürgen (Medical University of Vienna)
Kautzky-Willer, A. (Gender Medicine Unit. Endocrinology and Metabolism. Department of Internal Medicine III. Medical University of Vienna)
Damm, Peter (University of Copenhagen)
Mathiesen, Elisabeth Reinhardt (University of Copenhagen)
Jensen, Dorte M (Department of Clinical Research. Faculty of Health Sciences. University of Southern Denmark)
Andersen, Lise-Lotte (Department of Clinical Research. Faculty of Health Sciences. University of Southern Denmark)
Tanvig, Mette
Lapolla, Annunziata (Dipartimento di Medicina. Università Degli Studi di Padova)
Dalfra, Maria Grazia (Università Degli Studi di Padova)
Bertolotto, Alessandra (Azienda Ospedaliero Universitaria Pisana Dipartimento di Medicina.)
Wender-Ozegowska, E. (Poznań University of Medical Sciences)
Zawiejska, Agnieszka (Poznań University of Medical Sciences)
Hill, David J. (Lawson Health Research Institute)
Snoek, F. J. (Amsterdam University Medical Center (UMC))
Jelsma, Judith G. M. (Department of Public and Occupational Health. Amsterdam Public Health Research Institute. Amsterdam UMC. Vrije Universiteit Amsterdam)
Desoye, Gernot (Medical University of Graz. Department of Obstetrics and Gynaecology)
Universitat Autònoma de Barcelona

Data:	2019
Resum:	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 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.
Nota:	Altres ajuts: Funding The project described has received funding from the European Community's 7th Framework Programme (FP7/2007-2013) under grant agreement no. 242187. In the Netherlands, additional funding was provided by the Netherlands Organisation for Health Research and Development (ZonMw) (grant no. 200310013). In Poland, additional funding was obtained from the Polish Ministry of Science (grant no. 2203/7, PR/2011/2). In Denmark, additional funding was provided by Odense University Free Research Fund. In the UK, the DALI team acknowledges the support received from the National Institute for Health Research Clinical Research Network Eastern, especially the local diabetes clinical and research teams based in Cambridge. In Spain, additional funding was provided by CAIBER (Consorcio de Apoyo a la Investigación Biomédica en Red; 1527-B-226). The funders had no role in any aspect of the study beyond funding.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Lifestyle intervention ; Mediation ; Neonatal adiposity ; Randomised controlled trial
Publicat a:	Diabetologia, Vol. 62 Núm. 6 (january 2019) , p. 915-925, ISSN 1432-0428

DOI: 10.1007/s00125-019-4842-0
PMID: 30840112

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