RT Journal Article
SR Electronic
T1 Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 1247
OP 1251
VO 163
IS 10
A1 Gray-Donald, Katherine
A1 Robinson, Elizabeth
A1 Collier, Aileen
A1 David, Kinga
A1 Renaud, Lise
A1 Rodrigues, Shaila
YR 2000
UL http://www.cmaj.ca/content/163/10/1247.abstract
AB Background: A high prevalence of gestational diabetes mellitus and type 2 diabetes has been observed among the Cree of James Bay, Quebec. To address this problem, a diet and activity intervention during pregnancy, which was based on social learning theory, was initiated in 4 Cree communities. Methods: A prospective intervention compared dietary, weight and glycemic indicators for 107 control subjects and for 112 women who received the intervention during the course of their pregnancy. A control period in 4 communities (July 1995–March 1996) was followed by an intervention period (April 1996–January 1997) when subjects were offered regular, individual diet counselling, physical activity sessions and other activities related to nutrition. Results: The intervention and control groups did not differ at baseline regarding their mean age (24.3 years [SD 6.29] v. 23.8 years [SD 5.86]), mean prepregnancy weight (81.0 kg [SD 19.46] v. 78.9 kg [SD 17.54]) and mean gestational age at recruitment (17.1 weeks [SD 7.06] v. 18.5 weeks [SD 6.92]). The intervention did not result in differences in diet measured at 24–30 weeks' gestation, rate of weight gain over the second half of pregnancy (0.53 kg per week [SD 0.32] v. 0.53 kg per week [SD 0.27]) or plasma glucose level (50 g oral glucose screen) between 24 and 30 weeks (7.21 mmol/L [SD 2.09] v. 7.43 mmol/L [SD 2.10]). Mean birth weights were similar (3741 g [SD 523] v. 3686 g [SD 686]), as was maternal weight at 6 weeks post partum (88.1 kg [SD 16.8] v. 86.4 kg [SD 19.0]). The only changes in dietary intake were a reduction in caffeine (pregnancy) and an increase in folate (post partum). Interpretation: This intervention had only a minor impact on diet; finding ways of encouraging appropriate body weight and activity levels remains a challenge.