title: Lowering dietary glycaemic index through nutrition education among Malaysian women with a history of gestational diabetes mellitus.
abstract: BACKGROUND
  Gestational diabetes mellitus (GDM) increases risks for type 2 diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve cardio-metabolic outcomes in insulin-resistant individuals. We examined the feasibility of lowering GI through GI-based-education among Asian post-GDM women.
  
  
  METHODS
  A 3-month investigation was carried out on 60 Malaysian women with a mean age of 31.0 +/- 4.5 years and a history of GDM. Subjects were randomised into two groups: LGIE and CHDR. The CHDR group received conventional healthy dietary recommendations only. The LGIE group received GI based-education in addition to conventional healthy dietary recommendations. At baseline and after 3-months, dietary intake of energy and macronutrient intakes including GI diet and glycaemic load was assessed using 3-day food records. Diabetes-Diet and GI-concept scores and physical activity levels were assessed using a questionnaire. Adherence to dietary instructions was measured at the end of 3 months.
  
  
  RESULTS
  At the end of 3 months, the LGIE group had significant reductions in energy intake (241.7 +/- 522.4Kcal, P = 0.037, ES=0.463), total carbohydrate (48.7 +/- 83.5g, P = 0.010, ES = 0.583), GI (3.9 +/- 7.1, P = 0.017, ES = 0.549) and GL (39.0 +/- 55.3, P = 0.003, ES = 0.705) and significant increases in protein (3.7 +/- 5.4g, 0.003, ES = 0.685) and diet fibre (4.6 +/- 7.3g, P = 0.06). The CHDR group had a significant reduction in fat only (5.7 +/- 9.4g, P = 0.006, ES = 0.606). There was a 30% increase in GI-concept scores in the LGIE group (p < 0.001). Changes in GI-concept scores correlated significantly to the reduction in dietary GI (r = -0.642, P = 0.045). Dietary adherence was comparable in both groups.
  
  
  CONCLUSIONS
  GI-education improves GI-concept knowledge and helps lower dietary glycaemic index among women with a history of GDM.
authors.lastname: Sangeetha-Shyam
authors.forename: A
authors.initials: A
authors.lastname: Fatimah
authors.forename: A G
authors.initials: AG
authors.lastname: Rohana
authors.forename: A W
authors.initials: AW
authors.lastname: Norasyikin
authors.forename: C
authors.initials: C
authors.lastname: Karuthan
authors.forename: Shanita S
authors.initials: SS
authors.lastname: Nik
authors.forename: Yusof B N
authors.initials: YB
authors.lastname: Mohd
authors.forename: Azmi K
authors.initials: AK
authors.lastname: Nor
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D016640:Diabetes, Gestational; D004032:Diet / Q000379:methods* / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D038321:Glycemic Index / Q000502:physiology*; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008296:Malaysia; D009043:Motor Activity / Q000502:physiology; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult