British Journal of Nutrition

Full Papers

Human and Clinical Nutrition

Probiotics and dietary counselling contribute to glucose regulation during and after pregnancy: a randomised controlled trial

Kirsi Laitinena1a2 c1, Tuija Poussaa3, Erika Isolauria4a5 and the Nutrition, Allergy, Mucosal Immunology and Intestinal Microbiota Group

a1 Department of Biochemistry and Food Chemistry, University of Turku, 20014 Turku, Finland

a2 Functional Foods Forum, University of Turku, 20014 Turku, Finland

a3 Stat-Consulting, 33230 Tampere, Finland

a4 Department of Paediatrics, University of Turku, 20014 Turku, Finland

a5 Department of Paediatrics, Turku University Central Hospital, 20520 Turku, Finland

Abstract

Balanced glucose metabolism ensures optimal fetal growth with long-term health implications conferred on both mother and child. We examined whether supplementation of probiotics with dietary counselling affects glucose metabolism in normoglycaemic pregnant women. At the first trimester of pregnancy 256 women were randomised to receive nutrition counselling to modify dietary intake according to current recommendations or as controls; the dietary intervention group was further randomised to receive probiotics (Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12; diet/probiotics) or placebo (diet/placebo) in a double-blind manner, whilst the control group received placebo (control/placebo). Blood glucose concentrations were lowest in the diet/probiotics group during pregnancy (baseline-adjusted means 4·45, 4·60 and 4·56 mmol/l in diet/probiotics, diet/placebo and control/placebo, respectively; P = 0·025) and over the 12 months' postpartum period (baseline-adjusted means 4·87, 5·01 and 5·02 mmol/l; P = 0·025). Better glucose tolerance in the diet/probiotics group was confirmed by a reduced risk of elevated glucose concentration compared with the control/placebo group (OR 0·31 (95 % CI 0·12, 0·78); P = 0·013) as well as by the lowest insulin concentration (adjusted means 7·55, 9·32 and 9·27 mU/l; P = 0·032) and homeostasis model assessment (adjusted means 1·49, 1·90 and 1·88; P = 0·028) and the highest quantitative insulin sensitivity check index (adjusted means 0·37, 0·35 and 0·35; P = 0·028) during the last trimester of pregnancy. The effects observed extended over the 12-month postpartum period. The present study demonstrated that improved blood glucose control can be achieved by dietary counselling with probiotics even in a normoglycaemic population and thus may provide potential novel means for the prophylactic and therapeutic management of glucose disorders.

(Received May 01 2008)

(Revised August 07 2008)

(Accepted August 21 2008)

(Online publication November 19 2008)

Correspondence:

c1 Corresponding author: Dr Kirsi Laitinen, fax +358 2 333 6862, email kirsi.laitinen@utu.fi

Footnotes

Abbreviations: HOMA, homeostasis model assessment; QUICKI, quantitative insulin sensitivity check index

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