The Association of Maternal Night-Eating Pattern With Glucose Tolerance During Pregnancy

• ClinicalTrials.gov Identifier: NCT03803345
• Recruitment Status: Recruiting
• First Posted: January 14, 2019
• Last Update Posted: April 26, 2021
• Sponsor: KK Women's and Children's Hospital
• Collaborators: National University, Singapore; National University Hospital, Singapore; Duke-NUS Medical School (Singapore)
• Information provided by (Responsible Party): KK Women's and Children's Hospital

Study Description

Brief Summary:

This study aims to assess the associations of maternal food timing with glucose levels during pregnancy.

Condition or disease
Metabolic Disease

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.

Study Design

• Study Type: Observational
• Estimated Enrollment: 400 participants
• Observational Model: Other
• Time Perspective: Prospective
• Official Title: The Association of Maternal Night-Eating Pattern With Glucose Tolerance During Pregnancy
• Actual Study Start Date: March 28, 2019
• Estimated Primary Completion Date: February 28, 2022
• Estimated Study Completion Date: August 31, 2022

Groups and Cohorts

Outcome Measures

Primary Outcome Measures :

1. Maternal glucose tolerance [ Time Frame: 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.
2. Maternal night-eating pattern [ Time Frame: Up to 4 days, during second trimester of pregnancy ]
   Maternal night-eating pattern as assessed by the food diary and food record app.
3. Maternal meal and snack distribution [ Time Frame: 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 Outcome Measures :

1. Maternal insulin profile [ Time Frame: Up to 4 weeks, during second trimester of pregnancy ]
   Maternal insulin profile as assessed by the fasting insulin level.
2. Maternal gestational diabetes status [ Time Frame: up to 4 weeks, during second trimester of pregnancy ]
   Maternal gestational diabetes status as assessed by the Oral Glucose Tolerance Test.
3. Maternal glycemic variability [ Time Frame: 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).
4. Maternal diet quality [ Time Frame: up to 1 month, during second trimester of pregnancy ]
   Maternal diet quality as assessed by the Food Frequency Questionnaire.
5. Maternal type of food intake [ Time Frame: 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.
6. Maternal nutritional intake [ Time Frame: Up to 4 days, during second trimester of pregnancy ]
   Maternal nutritional intake as assessed by the food diary and food record app.
7. Maternal eating frequency [ Time Frame: Up to 4 days, during second trimester of pregnancy ]
   Maternal eating frequency as assessed by the food diary and food record app.
8. Maternal meal and snack regularity [ Time Frame: 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.
9. Maternal physical activity [ Time Frame: Up to 10 days, during second trimester of pregnancy ]
   Maternal physical activity as measured by the Actigraph accelerometer.
10. Maternal physical activity [ Time Frame: Up to 1 week, during second trimester of pregnancy ]
    Maternal physical activity as assessed using the modified International Physical Activity Questionnaire (IPAQ).
11. Maternal sedentary behavior [ Time Frame: Up to 10 days, during second trimester of pregnancy ]
    Maternal sedentary behavior as measured by the Actigraph accelerometer.
12. Maternal sedentary behavior [ Time Frame: Up to 1 week, during second trimester of pregnancy ]
    Maternal sedentary behavior as assessed using the structured questionnaires based on frequency and duration of time spent in sedentary behaviour.
13. Maternal sleep related behavior [ Time Frame: Up to 10 days, during second trimester of pregnancy ]
    Maternal sleep related behaviour as measured by the Actigraph accelerometer.
14. Maternal sleep related behavior [ Time Frame: Up to 1 month, during second trimester of pregnancy ]
    Maternal sleep related behavior as assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire.
15. Maternal light exposure [ Time Frame: Up to 10 days, during second trimester of pregnancy ]
    Maternal light exposure as measured by the Actigraph accelerometer.
16. Maternal light exposure [ Time Frame: Up to 1 week, during second trimester of pregnancy ]
    Maternal light exposure as assessed by the Harvard Light Exposure Assessment (H-LEA) questionnaire.
17. Maternal electronic media use before bedtime [ Time Frame: 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.
18. Maternal mood [ Time Frame: Up to 1 week, during second trimester of pregnancy ]
    Maternal mood as assessed by the Depression Anxiety Stress Scale (DASS21) questionnaire.
19. Maternal gestational weight gain [ Time Frame: Up to 42 weeks, throughout pregnancy ]
    Maternal weight measured by calibrated weighing scale as recorded in medical notes
20. Dietary data from food record app. [ Time Frame: 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.

Other Outcome Measures:

1. Maternal hypertension status [ Time Frame: Up to 42 weeks, during pregnancy ]
   Maternal hypertension status obtained from medical notes.
2. Maternal delivery outcomes [ Time Frame: Up to 72 hours, after delivery ]
   Maternal delivery outcomes obtained from medical notes.
3. Birth weight [ Time Frame: Up to 72 hours, after delivery ]
   Offspring birth weight in gram obtained from medical notes.
4. Birth length [ Time Frame: Up to 72 hours, after delivery ]
   Offspring birth length in cm obtained from medical notes.
5. Birth head circumference [ Time Frame: Up to 72 hours, after delivery ]
   Offspring birth head circumference in cm obtained from medical notes.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 45 Years (Adult)
• Sexes Eligible for Study: Female
• Gender Based Eligibility: Yes
• Gender Eligibility Description: Pregnant women.
• Accepts Healthy Volunteers: Yes
• Sampling Method: Non-Probability Sample

Study Population

Healthy pregnant women aged 18-45 years old and at 18-21 weeks of gestation upon recruitment.

Criteria

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

Contacts and Locations

Contacts

Contact: Dora Xin Ping Gan; 65 6394 7254; dora.gan.xin.p@kkh.com.sg

Locations

Singapore

KK Women's and Children's Hospital; Recruiting

Singapore, Singapore, 229899

Principal Investigator: See Ling Loy, PhD

Sponsors and Collaborators

KK Women's and Children's Hospital

National University, Singapore

National University Hospital, Singapore

Duke-NUS Medical School (Singapore)

Investigators

• Principal Investigator: See Ling Loy, PhD; KK Women's and Children's Hospital

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Loy SL, Cheung YB, Chong M, Müller-Riemenschneider F, Lek N, Lee YS, Tan KH, Chern B, Yap F, Chan J. Maternal night-eating pattern and glucose tolerance during pregnancy: study protocol for a longitudinal study. BMJ Open. 2019 Oct 10;9(10):e030036. doi: 10.1136/bmjopen-2019-030036.

• Responsible Party: KK Women's and Children's Hospital
• ClinicalTrials.gov Identifier: NCT03803345
• Other Study ID Numbers: CIRB 2018/2529
• First Posted: January 14, 2019
• Last Update Posted: April 26, 2021
• Last Verified: April 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by KK Women's and Children's Hospital:

Food timing; Gestational diabetes mellitus; Glucose tolerance; Night-eating; Pregnancy outcomes; Snacking

Additional relevant MeSH terms:

Metabolic Diseases