近日，挪威科技大学Trine Moholdt团队研究了妊娠期糖尿病风险增加的女性在怀孕前和怀孕期间进行限时饮食和运动训练对预后的影响。相关论文发表在2025年9月9日出版的《英国医学杂志》上。

为了探讨孕前生活方式干预对妊娠期糖尿病高危人群糖耐量的影响，研究组进行了一项单中心随机对照试验（开始前），在挪威特隆赫姆大学医院招募了167参与者，至少有一项妊娠期糖尿病的危险因素。将参与者随机（1:1）分为生活方式干预组和标准护理对照组。干预包括运动训练和限时饮食，从怀孕前开始一直持续到整个怀孕期间。使用将心率转化为分数（个人活动智力，PAI）的体力活动指标来设定运动量，目标是≥100周PAI点。限时饮食指的是每周至少5天，每天在≤10小时内消耗所有能量。主要结果测量妊娠第28周口服葡萄糖耐量试验2小时血浆葡萄糖水平。初步分析采用意向治疗原则。

参与者在2020年10月2日至2023年5月12日登记入组：干预组84人，对照组83人，其中111人怀孕（干预组56人，对照组55人）。干预组中一名参与者因孕前糖尿病被排除在分析之外。对照组中一名参与者的妊娠资料因双胎妊娠被排除在分析之外。干预对妊娠第28周口服糖耐量试验2小时血糖水平无显著影响（平均差异为0.48 mmol/L， 95%可信区间为0.05 ~ 1.01，P=0.08）。在怀孕前，31/83参与者:（37%），而24/55参与者:（44%）的干预组孕妇符合这些标准。在怀孕前，平均进食时间为9.9小时/天（标准差1.2），平均每周PAI点数为111点（标准差54），但在怀孕期间，两项干预措施的依从性均有所下降。

研究结果表明，在怀孕前开始并在怀孕期间持续进行限时饮食和运动训练的组合对妊娠后期的血糖控制没有显著影响。

附：英文原文

Title: Time restricted eating and exercise training before and during pregnancy for people with increased risk of gestational diabetes: single centre randomised controlled trial (BEFORE THE BEGINNING)

Author: MA Jafar Sujan, Hanna MS Skarstad, Guro Rosvold, Stine L Fougner, Turid Follestad, Kjell Salvesen, Trine Moholdt

Issue&Volume: 2025/09/09

Abstract:

Objective To determine the effect of a prepregnancy lifestyle intervention on glucose tolerance in people at higher risk of gestational diabetes mellitus.

Design Single centre randomised controlled trial (BEFORE THE BEGINNING).

Setting University hospital in Trondheim, Norway.

Participants 167 participants with at least one risk factor for gestational diabetes mellitus who contemplated pregnancy.

Intervention The participants were randomly allocated (1:1) to a lifestyle intervention or a standard care control group. The intervention consisted of exercise training and time restricted eating, started before pregnancy and continued throughout pregnancy. Exercise volume was set using a physical activity metric that translates heart rate into a score (personal activity intelligence, PAI), with the goal of ≥100 weekly PAI points. Time restricted eating involved consuming all energy within ≤10 hours/day for at least five days a week.

Main outcome measures Two hour plasma glucose level in an oral glucose tolerance test at gestational week 28. The primary analysis used an intention-to-treat principle.

Results 167 participants were enrolled from 2 October 2020 to 12 May 2023: 84 in the intervention group and 83 in the control group, out of whom 111 became pregnant (56 in intervention group and 55 in control group). One participant in the intervention group was excluded from the analysis because of prepregnancy diabetes. Pregnancy data from one participant in the control group were excluded from the analysis because of twin pregnancy. The intervention had no significant effect on two hour plasma glucose level in an oral glucose tolerance test at gestational week 28 (mean difference 0.48 mmol/L, 95% confidence interval 0.05 to 1.01, P=0.08). In the prepregnancy period, 31/83 participants (37%) in the intervention group adhered to prespecified criteria, whereas 24/55 participants (44%) in the intervention group who became pregnant fulfilled these criteria. During the prepregnancy period, the average eating window was 9.9 hours/day (standard deviation 1.2) and the average number of weekly PAI points was 111 (standard deviation 54), but the adherence to both intervention components decreased during pregnancy.

Conclusions A combination of time restricted eating and exercise training started before and continued throughout pregnancy had no significant effect on glycaemic control in late pregnancy.

DOI: 10.1136/bmj-2024-083398

Source: https://www.bmj.com/content/390/bmj-2024-083398