International Journal of Preventive Medicine (Int J Prev Med)2008-7802112017102518421842ENSocial Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, YazdDepartment of Health Education and Promotion, Social determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, YazdDepartment of Health, Azad University of Firoozabad Branch, FarsNutrition and Food Security Research Center, ShahidSadoughi University of Medical Sciences, YazdDepartment of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Statistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, IsfahanDepartment of Midwifery, Nursing and Midwifery School, Isfahan University of Medical Sciences, Isfahan20171025<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">Chronic insulin resistance (IR) is a basic part of the pathophysiology of gestational diabetes mellitus. Nutrition signifcantly impacts IR and weight loss reduces insulin levels, whereas weight gain increases the concentrations. Therefore, we surveyed the effect of nutrition intervention on IR in pregnant women and whether this effect is irrespective of weight gaining in accordance with Institute of Medicine limits. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">This prospective, randomized clinical trial was carried out among 150 primiparous pregnant mothers in ffteen health centers, fve hospitals, and 15 private obstetrical offces in Isfahan. The nutrition intervention included education of healthy diet with emphasize on 50%&ndash;55% of total energy intake from carbohydrate (especially complex carbohydrates), 25%&ndash;30% from fat (to increase mono unsaturated fatty acids and decrease saturated and trans‑fatty acids), and 15%&ndash;20% from protein during pregnancy for experimental group. The controls received the usual prenatal care by their health‑care providers. </span></p><p><strong></strong><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">This trial decreased pregnancy‑induced insulin increases (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.01) and IR marginally (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.05). ANCOVA demonstrated that control of gestational weight gaining was more effective to decrease IR (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.02)<br />while insulin values decreased by nutrition intervention and irrespective of weight control (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.06). Fasting plasma glucose (FPG) concentrations did not decrease by intervention (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.56) or weight management (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.15). </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">The current intervention was effective to decrease pregnancy‑induced insulin increases and IR. Considering study results on FPG levels and incidence of GDM, we suggest repeat of study design in a larger sample.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Diet modifcation, insulin resistance, intervention studies, Iran, pregnancy</span> <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" /></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1842http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1842/2130