Metabolic Disease
Conditions
Keywords
Food timing, Gestational diabetes mellitus, Glucose tolerance, Night-eating, Pregnancy outcomes, Snacking
Brief summary
This study aims to assess the associations of maternal food timing with glucose levels during pregnancy.
Detailed description
A novel line of research has emerged, suggesting that synchronizing the timing of food intake with body's circadian rhythms or day-night cycle has metabolic implications. Eating at the inappropriate time can disrupt circadian system which might induce metabolic perturbations, including glucose abnormalities. Recent evidence showed that circadian timing of eating was associated with glucose regulation in pregnant women. However, little is known about night-eating pattern during pregnancy, particularly the influence of nocturnal snacking on glycaemic control. This cross-sectional study aims to recruit 400 pregnant women at 18-21 weeks' gestation. The investigators will assess maternal dietary intake, monitor 24-hour activity-rest pattern and light-dark exposure, and measure glucose and insulin profiles during the second trimester of pregnancy. Maternal socio-demographic status, lifestyle characteristics, health conditions and pregnancy outcomes will be asked through interview or retrieved from medical notes. This study allows understanding the importance of circadian eating pattern, which is a modifiable behavior, in glycaemic control during pregnancy, and help to provide evidence for developing nutritional guidelines which can ameliorate metabolic health for mothers.
Interventions
None listed
Sponsors
KK Women's and Children's Hospital
National University of Singapore
National University Hospital, Singapore
Duke-NUS Graduate Medical School
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
1. 18-21 week's gestation 2. Singapore citizens or Singapore Permanent Residents 3. Age 18-45 years 4. Plan to follow-up for antenatal care in KK Women's and Children's Hospital 5. Intend to deliver in KK Women's and Children's Hospital 6. Provide written informed consent
Exclusion criteria
1. Type 1 or 2 diabetes 2. Diabetes in pregnancy as confirmed by oral glucose tolerance test 3. Use of medications such as anticonvulsant medications or oral steroids in the past 1 month 4. Multiple pregnancy 5. On routine night-shift work for at least 3x/week over the past 1 month 6. Known or suspected allergy to medical grade adhesives 7. Chronic kidney diseases 8. Preeclampsia 9. Eventual miscarriage or undergo termination event
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maternal glucose tolerance | Up to 4 weeks, during second trimester of pregnancy | Maternal glucose tolerance based on plasma glucose levels as assessed by the Oral Glucose Tolerance Test. |
| Maternal night-eating pattern | Up to 4 days, during second trimester of pregnancy | Maternal night-eating pattern as assessed by the food diary and food record app. |
| Maternal meal and snack distribution | Up to 4 days, during second trimester of pregnancy | Maternal meal and snack distribution as assessed by the food diary and food record app. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maternal insulin profile | Up to 4 weeks, during second trimester of pregnancy | Maternal insulin profile as assessed by the fasting insulin level. |
| Maternal gestational diabetes status | up to 4 weeks, during second trimester of pregnancy | Maternal gestational diabetes status as assessed by the Oral Glucose Tolerance Test. |
| Maternal glycemic variability | Up to 10 days, during second trimester of pregnancy | Maternal glycemic variability based on continuous glucose monitoring profile as assessed by the continuous glucose monitoring system (Freestyle Libre Pro, Abbott). |
| Maternal diet quality | up to 1 month, during second trimester of pregnancy | Maternal diet quality as assessed by the Food Frequency Questionnaire. |
| Maternal type of food intake | up to 10 weeks, during second trimester of pregnancy | Maternal type of food intake as assessed by the food diary, food record app and Food Frequency Questionnaire. |
| Maternal nutritional intake | Up to 4 days, during second trimester of pregnancy | Maternal nutritional intake as assessed by the food diary and food record app. |
| Maternal eating frequency | Up to 4 days, during second trimester of pregnancy | Maternal eating frequency as assessed by the food diary and food record app. |
| Maternal meal and snack regularity | Up to 1 month, during second trimester of pregnancy | Maternal meal and snack regularity as assessed by the questionnaire based on frequency of meal/ snack delay and skipping. |
| Maternal physical activity | Up to 10 days, during second trimester of pregnancy | Maternal physical activity as measured by the Actigraph accelerometer. |
| Maternal sedentary behavior | Up to 10 days, during second trimester of pregnancy | Maternal sedentary behavior as measured by the Actigraph accelerometer. |
| Maternal sleep related behavior | Up to 10 days, during second trimester of pregnancy | Maternal sleep related behaviour as measured by the Actigraph accelerometer. |
| Maternal light exposure | Up to 10 days, during second trimester of pregnancy | Maternal light exposure as measured by the Actigraph accelerometer. |
| Maternal electronic media use before bedtime | up to 1 week, during second trimester of pregnancy | Maternal electronic media use before bedtime as assessed by the structured questionnaire based on frequency, duration and location of electronic device use. |
| Maternal mood | Up to 1 week, during second trimester of pregnancy | Maternal mood as assessed by the Depression Anxiety Stress Scale (DASS21) questionnaire. |
| Maternal gestational weight gain | Up to 42 weeks, throughout pregnancy | Maternal weight measured by calibrated weighing scale as recorded in medical notes |
| Dietary data from food record app. | up to 4 days, during second trimester of pregnancy | Feasibility and validity of using food record mobile app to capture maternal dietary intake, compared with paper-based food diary. |
Countries
Singapore
Contacts
PRINCIPAL_INVESTIGATORSee Ling Loy, PhD
KK Women's and Children's Hospital
Outcome results
None listed