Intuitive eating is associated with weight and glucose control during pregnancy and in the early postpartum period in women with gestational diabetes mellitus (GDM): A clinical cohort study

Introduction: High pre-pregnancy weight and body mass index (BMI) increase the risk of gestational diabetes mellitus (GDM) and diabetes after pregnancy. To tackle weight and metabolic health problems, there is a need to investigate novel lifestyle approaches. Outside of pregnancy, higher adherence to intuitive eating (IE) is associated with lower BMI and improved glycemic control. This study investigated the association between IE and metabolic health during pregnancy and in the early postpartum period among women with GDM. Methods: Two-hundred and fourteen consecutive women aged >= 18, diagnosed with GDM between 2015 and 2017 and completed the Eating for Physical rather than Emotional Reasons (EPR) and Reliance on Hunger and Satiety cues (RHSC) subscales of the French Intuitive Eating Scale-2 (IES-2) questionnaire at the first GDM clinic visit were included in this study. Results: Participants' mean age was 33.32 +/- 5.20 years. Their weight and BMI before pregnancy were 68.18 +/- 14.83 kg and 25.30 +/- 5.19 kg/m(2) respectively. After adjusting for confounding variables, the cross-sectional analyses showed that the two subscales of IES-2 at the first GDM visit were associated with lower weight and BMI before pregnancy, and lower weight at the first GDM visit (beta = -0.181 to -0.215, all p = 0.008). In addition, the EPR subscale was associated with HbA1c and fasting plasma glucose at the first GDM visit (beta = -0.170 and to -0.196; all p = 0.016). In the longitudinal analyses, both subscales of IES-2 at first GDM visit were associated with lower weight at the end of pregnancy, BMI and fasting plasma glucose at 6-8 weeks postpartum (beta = -0.143 to -0.218, all p = 0.040) after adjusting for confounders. Conclusions: Increase adherence to IE could represent a novel approach to weight and glucose control during and after pregnancy in women with GDM.