title: Impact of lifestyle intervention for obese women during pregnancy on maternal metabolic and inflammatory markers.
abstract: Offspring of obese mothers have increased risk of developing obesity and related short- and long-term disease. The cause is multifactorial and may partly be explained by the unfavorable intrauterine environment. Intervention during pregnancy leading to a healthier lifestyle among obese may alter this.
  
  
  
  To assess the effect of lifestyle intervention on markers of maternal metabolism and inflammation in 'the TOP (Treatment of Obese Pregnant Women) study', a randomized controlled trial.
  
  
  
  In the TOP-study 425 participants with body mass index ⩾30 kg/m2were randomized to intervention with dietary advices and physical activity assessed by pedometer (PA+D), physical activity assessed by pedometer (PA) or control (C). Of 389 participants completing the study 376 had available blood samples. Serum was analyzed for insulin, c-peptide, lipid profile, leptin, high-sensitivity CRP (hsCRP) and Soluble urokinase Plasminogen Activator Receptor (suPAR), in week 18-20 and 28-30, and simultaneously a 2-h oral glucose-tolerance-test was performed. Diet was assessed in gestational week 11-14 and 36-37 using a validated 360-item Food Frequency Questionnaire.
  
  
  
  Median levels of hsCRP in gestational week 28-30 were lower in each of the intervention groups (8.3 mg/l in PA+D group, P=0.03; and 8.8 mg/l in PA group, P=0.02) versus the control group (11.5 mg/l). Obtaining 11 000 steps per day as aimed for resulted in a 21% lower hsCRP compared to non-compliant women. Women reporting high carbohydrate intake had around 30% higher hsCRP concentrations in late gestation than women reporting the lowest intake. There were no differences in lipid profile or any of the metabolic markers in gestational week 28-30 when comparing the intervention and control groups.
  
  
  
  Lifestyle intervention in obese women can reduce hsCRP representing a marker of inflammation during pregnancy. The effect may partly be mediated by more physical activity and partly by changes in intake of carbohydrates and the glycaemic load.
authors.affiliation: Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.|Obstetric Clinic, JMC, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: K M
authors.initials: KM
authors.lastname: Renault
authors.affiliation: Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: E M
authors.initials: EM
authors.lastname: Carlsen
authors.affiliation: Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.|Center for Diabetes Research, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Hædersdal
authors.affiliation: Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Nilas
authors.affiliation: The Research Unit Women's and Children's Health, the Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: N J
authors.initials: NJ
authors.lastname: Secher
authors.affiliation: Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Eugen-Olsen
authors.affiliation: Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: D
authors.initials: D
authors.lastname: Cortes
authors.affiliation: Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.|Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
authors.forename: S F
authors.initials: SF
authors.lastname: Olsen
authors.affiliation: Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.|Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.|Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland.
authors.forename: T I
authors.initials: TI
authors.lastname: Halldorsson
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Nørgaard
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood* / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002149:Energy Intake / Q000502:physiology; D015444:Exercise; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007328:Insulin / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D009426:Netherlands; D009765:Obesity / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology / Q000517:prevention & control*; D040242:Risk Reduction Behavior; D015430:Weight Gain
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D015850:Interleukin-6; D020738:Leptin; D002097:C-Reactive Protein