Sugar May Add To Excessive Gestational Weight Gain

Ekaterina Maslova PhD Doctor of Science in Nutrition and Epidemiology Center for Fetal Programming Copenhagen, Interview with:
Ekaterina Maslova PhD

Doctor of Science in Nutrition and Epidemiology
Center for Fetal Programming
Copenhagen, Denmark

Medical Research: What is the background for this study? What are the main findings?

Response: From prior studies we know that excessive gestational weight gain (GWG) in pregnancy is associated with complications for both the mother and the child, including gestational diabetes, hypertension, and high birth weight. Understanding the factors that determine gestational weight gain would allow for interventions early on to improve pregnancy outcomes. Dietary intake has been found to influence gestational weight gain in other studies, but evidence is conflicting and still quite limited. In non-pregnant populations a high-protein diet was shown to decrease weight and improve weight maintenance. We therefore hypothesized that a similar relation may exist for gestational weight gain in pregnant women.

In this study we had data on dietary intake of more than 45,000 Danish women who were pregnant between 1996 and 2002. We examined the relation between their intake of protein and carbohydrates and the rate of gestational weight gain (in grams per week). We found that women who consumed a high protein-to-carbohydrate (PC) ratio gained less gestational weight gain compared to women with a lower PC ratio in their diet. The results was stronger in women who started their pregnancy already overweight compared to normal weight women.

Since a high PC ratio may result from either a high protein intake or low carbohydrate intake, we decided to focus on a component of carbohydrates that may increase gestational weight gain: added sugar. We found that pregnant women with higher intake of sugar gained more weight in pregnancy compared to those who consumed less added sugar. This averaged out to about 1.4 kg (or 7%) higher weight gain across the entire pregnancy.

Medical Research: What should clinicians and patients take away from your report?

Response: Dietary interventions in pregnant women many have clinically relevant effects on gestational weight gain, especially in overweight women. Any recommendations on protein and carbohydrate intake need to consider not only the quantity of intake but also the quality of the dietary sources (e.g. animal, vegetable) as well as address substitution foods. For example, a decrease in added sugar may lead to an increase in artificial sweeteners, which may carry their own risks. These findings need also to be regarded in the context of other research findings, nutrient requirements in pregnancy, and the patient’s own situation and needs.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: It will, first of all, be important to have these findings replicated in other large cohorts and such studies need to include overweight and obese women in addition to normal weight women. Evaluating the diet-gestational weight gain relation separately in these groups of pregnant women would tell us whether they may benefit more (or less) from a change in their macronutrient intake. If more conclusive evidence is needed these dietary changes could be evaluated in a randomized clinical trial.


Maslova E,

Halldorsson TI, Astrup A, Etal Dietary protein-to-carbohydrate ratio and added
sugar as determinants ofexcessive gestational weight gain: a prospective cohort study.

BMJOpen 2015;: e005839. doi:10.1136/


[wysija_form id=”1″] Interview with: Ekaterina Maslova PhD (2015). Sugar May Add To Excessive Gestational Weight Gain