Future implications of obesity, gestational hypertensive disorders and diabetes to health and longevity - the significance of lifestyle intervention
Main Article Content
Abstract
The association of obesity, gestational diabetes mellitus and hypertensive disorders of pregnancy are early warning to future compromise of women's health and longevity in the form of later life hypertension and overt diabetes mellitus and their complications, as was shown in some large population-based studies. The association of these two pathologies with maternal obesity is significant. The most efficient approach to preempt future consequences is a modification of lifestyle, leaning mostly on two pillars, dietary approach and physical activity, a comprehensive form of intervention that copes with all three, i.e. obesity, gestational hypertension and gestational diabetes mellitus. These interventions are discussed in this review as well as the most efficient ways of implementing them. All sources point to a major role for personalized approaches and some form of group support.
Abbreviations: HT – hypertension, GDM – Gestational diabetes mellitus, GHTN – Gestational hypertension
Keywords:
Gestational hypertension, Gestational diabetes mellitus, Obesity, Lifestyle modifying intervention, Group support
Article Details
How to Cite
SHLOMO, Izhar Ben; KAMISA, Dikla.
Future implications of obesity, gestational hypertensive disorders and diabetes to health and longevity - the significance of lifestyle intervention.
Medical Research Archives, [S.l.], v. 13, n. 3, mar. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6368>. Date accessed: 09 apr. 2025.
doi: https://doi.org/10.18103/mra.v13i3.6368.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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21. Li R, Zhang S, Li Q, et al. Transportation physical activity and new-onset hypertension: A nationwide cohort study in China. Hypertens Res. 2022;45(9):1430-1440. doi:10.1038/s41440-022-00973-6
22. Shariful Islam M, Fardousi A, Sizear MI, Rabbani MG, Islam R, Saif-Ur-Rahman KM. Effect of leisure-time physical activity on blood pressure in people with hypertension: a systematic review and meta-analysis. Sci Rep. 2023;13(1):10639. doi:10.1038/s41598-023-37149-2
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24. Edwards JJ, Deenmamode AHP, Griffiths M, et al. Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials. Br J Sports Med. 2023 October;57(20):1317-1326. doi:10.1136/bjsports-2022-106503
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27. Wahid A, Manek N, Nichols M, et al. Quantifying the Association Between Physical Activity and Cardiovascular Disease and Diabetes: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2016;5(9):e002495. doi:10.1161/JAH A.115.002495
28. Matos M, Mendes R, Silva AB, Sousa N. Physical activity and exercise on diabetic foot related outcomes: A systematic review. Diabetes Res Clin Pract. 2018; 139:81-90. doi:10.1016/j.diab res.2018.02.020
29. Zhang Y, Yang Y, Huang Q, Zhang Q, Li M, Wu Y. The effectiveness of lifestyle interventions for diabetes remission on patients with type 2 diabetes mellitus: A systematic review and meta-analysis. Worldviews Evid Based Nurs. 2023;20(1):64-78. doi:10.1111/wvn.12608
30. Valenzuela PL, Carrera-Bastos P, Gálvez BG, et al. Lifestyle interventions for the prevention and treatment of hypertension. Nat Rev Cardiol. 2021;18(4):251-275. doi:10.1038/s41569-020-00437-9
31. Samson SL, Vellanki P, Blonde L, et al. American Association of Clinical Endocrinology Consensus Statement: Comprehensive Type 2 Diabetes Management Algorithm - 2023 Update Endocr Pract. Endocr Pract. 2023;29(5):305-340. doi:10.1016/j.eprac.2023.02.001
32. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343-1350. doi:10.1056/NEJM200105033441801
33. Roberts S, Barry E, Craig D, Airoldi M, Bevan G, Greenhalgh T. Preventing type 2 diabetes: systematic review of studies of cost-effectiveness of lifestyle programmes and metformin, with and without screening, for pre-diabetes. BMJ Open. 2017;7(11):e017184. doi:10.1136/bmjopen-2017-017184
34. Rosales CB, Denman CA, Bell ML, et al. Meta Salud Diabetes for cardiovascular disease prevention in Mexico: a cluster-randomized behavioural clinical trial. Int J Epidemiol. 2021;50(4):1272-1282.
doi:10.1093/ije/dyab072
35. Quansah DY, Gilbert L, Arhab A, et al. Effect of a prepartum and postpartum, complex interdisciplinary lifestyle and psychosocial intervention on metabolic and mental health outcomes in women with gestational diabetes mellitus (the MySweetheart trial): randomised, single centred, blinded, controlled trial. BMJ Med. 2024;3(1):e000588. doi:10.1136/bmj med-2023-000588
36. van Dam HA, van der Horst FG, Knoops L, Ryckman RM, Crebolder HF, van den Borne BH. Social support in diabetes: a systematic review of controlled intervention studies. Patient Educ Couns. 2005;59(1):1-12. doi:10.1016/j.pec.2004.11.001
37. Rejeski WJ, Ip EH, Bertoni AG, et al. Lifestyle change and mobility in obese adults with type 2 diabetes. N Engl J Med. 2012;366(13):1209-1217. doi:10.1056/NEJMoa1110294
38. Chen YC, Li IC. Effectiveness of interventions using empowerment concept for patients with chronic disease: a systematic review. JBI Libr Syst Rev. 2009;7(27):1179-1233. doi:10.11124/01938924-200907270-00001
39. Chang MW, Tan A, Ling J, Wegener DT, Robbins LB. Mediators of intervention effects on dietary fat intake in low-income overweight or obese women with young children. Appetite. 2020;151: 104700. doi:10.1016/j.appet.2020.104700
2. Wicklow B, Retnakaran R. Gestational Diabetes Mellitus and Its Implications across the Life Span. Diabetes Metab J. 2023;47(3):333-344. doi:10.4093/dmj.2022.0348
3. Crump C, Sundquist J, Sundquist K. Adverse Pregnancy Outcomes and Long-Term Mortality in Women. JAMA Intern Med. 2024;184(6):631-640. doi:10.1001/jamainternmed.2024.0276
4. Crump C, Sundquist J, McLaughlin MA, et al. Adverse pregnancy outcomes and long term risk of ischemic heart disease in mothers: national cohort and co-sibling study. BMJ. 2023;380:e072112. doi:10.1136/bmj-2022-072112
5. Crump C, Sundquist J, Sundquist K. Adverse pregnancy outcomes and long-term risk of chronic kidney disease in women: national cohort and co-sibling study. Am J Obstet Gynecol. 2024; 230 (5):563.e1-563.e20. doi:10.1016/j.ajog.2023.10.008
6. Wang YX, Mitsunami M, Manson JE, et al. Association of Gestational Diabetes with Subsequent Long-Term Risk of Mortality. JAMA Intern Med. 2023;183(11):1204-1213. doi:10.1001/jamainternm ed.2023.4401
7. Yang J, Song Y, Gaskins AJ, et al. Mediterranean diet and female reproductive health over lifespan: a systematic review and meta-analysis. Am J Obstet Gynecol. 2023;229(6):617-631. doi: 10.1016/j.ajog.2023.05.030
8. Song X, Wang C, Wang T, Zhang S, Qin J. Obesity and risk of gestational diabetes mellitus: A two-sample Mendelian randomization study. Diabetes Res Clin Pract. 2023; 197:110561. doi: 10.1016/j.dia bres.2023.110561
9. Li J, Wang M, Ma S, Jin Z, Yin H, Yang S. Association of gastrointestinal microbiome and obesity with gestational diabetes mellitus-an updated globally based review of the high-quality literatures. Nutr Diabetes. 2024;14(1):31.doi:10.1038/s41387-024-00291-5
10. Song Z, Cheng Y, Li T, Fan Y, Zhang Q, Cheng H. Prediction of gestational diabetes mellitus by different obesity indices. BMC Pregnancy Childbirth. 2022;22(1):288. doi:10.1186/s12884-022-04615-0
11. Sun Y, Shen Z, Zhan Y, et al. Effects of pre-pregnancy body mass index and gestational weight gain on maternal and infant complications. BMC Pregnancy Childbirth. 2020;20(1):390.
doi:10.1186/s12884-020-03071-y
12. Lewandowska M, Więckowska B, Sajdak S. Pre-Pregnancy Obesity, Excessive Gestational Weight Gain, and the Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus. J Clin Med. 2020;9(6):1980. doi:10.3390/jcm9061980
13. Sunder A, Varghese B, Darwish B, et al. Maternal Obesity: An Obstetric Risk. Cureus. 2022; 14(9):e29345. doi:10.7759/cureus.29345
14. Yang Y, Le Ray I, Zhu J, Zhang J, Hua J, Reilly M. Preeclampsia Prevalence, Risk Factors, and Pregnancy Outcomes in Sweden and China. JAMA Netw Open. 2021;4(5):e218401.
doi:10.1001/jamanetworkopen.2021.8401
15. Soltsman S, Ben Shlomo I. Harefuah. 2025; 164(2):119-123. https://acrobat.adobe.com/id/urn:aaid:sc:AP:9d4412e4-4167-4940-8206-756b25a7a783
16. Green CL, Lamming DW, Fontana L. Molecular mechanisms of dietary restriction promoting health and longevity. Nat Rev Mol Cell Biol. 2022;23(1):56-73. doi:10.1038/s41580-021-00411-4
17. Theodoridis X, Chourdakis M, Chrysoula L, et al. Adherence to the DASH Diet and Risk of Hypertension: A Systematic Review and Meta-Analysis. Nutrients. 2023;15(14):3261. doi:10.3390/n u15143261
18. Morze J, Danielewicz A, Hoffmann G, Schwingshackl L. Diet Quality as Assessed by the Healthy Eating Index, Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension Score, and Health Outcomes: A Second Update of a Systematic Review and Meta-Analysis of Cohort Studies. J Acad Nutr Diet. 2020;120(12):1998-2031.e15. doi:10.1016/j.jand.2020.08.076
19. Toi PL, Anothaisintawee T, Chaikledkaew U, Briones JR, Reutrakul S, Thakkinstian A. Preventive Role of Diet Interventions and Dietary Factors in Type 2 Diabetes Mellitus: An Umbrella Review. Nutrients. 2020;12(9):2722. doi:10.3390/nu12092722
20. Nagata JM, Vittinghoff E, Pettee Gabriel K, et al. Physical Activity and Hypertension From Young Adulthood to Middle Age. Am J Prev Med. 2021;60(6):757-765. doi: 10.1016/j.amepre.2020.1 2.018
21. Li R, Zhang S, Li Q, et al. Transportation physical activity and new-onset hypertension: A nationwide cohort study in China. Hypertens Res. 2022;45(9):1430-1440. doi:10.1038/s41440-022-00973-6
22. Shariful Islam M, Fardousi A, Sizear MI, Rabbani MG, Islam R, Saif-Ur-Rahman KM. Effect of leisure-time physical activity on blood pressure in people with hypertension: a systematic review and meta-analysis. Sci Rep. 2023;13(1):10639. doi:10.1038/s41598-023-37149-2
23. Lee LL, Mulvaney CA, Wong YKY, Chan ES, Watson MC, Lin HH. Walking for hypertension. Cochrane Database Syst Rev. 2021;2(2):CD008823. doi:10.1002/14651858.CD008823.pub2
24. Edwards JJ, Deenmamode AHP, Griffiths M, et al. Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials. Br J Sports Med. 2023 October;57(20):1317-1326. doi:10.1136/bjsports-2022-106503
25. Saco-Ledo G, Valenzuela PL, Ruiz-Hurtado G, Ruilope LM, Lucia A. Exercise Reduces Ambulatory Blood Pressure in Patients With Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2020;9(24): e018487. doi:10.1161/JAHA.120.018487
26. Correia RR, Veras ASC, Tebar WR, Rufino JC, Batista VRG, Teixeira GR. Strength training for arterial hypertension treatment: a systematic review and meta-analysis of randomized clinical trials. Sci Rep. 2023;13(1):201. doi:10.1038/s41598-022-26583-3
27. Wahid A, Manek N, Nichols M, et al. Quantifying the Association Between Physical Activity and Cardiovascular Disease and Diabetes: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2016;5(9):e002495. doi:10.1161/JAH A.115.002495
28. Matos M, Mendes R, Silva AB, Sousa N. Physical activity and exercise on diabetic foot related outcomes: A systematic review. Diabetes Res Clin Pract. 2018; 139:81-90. doi:10.1016/j.diab res.2018.02.020
29. Zhang Y, Yang Y, Huang Q, Zhang Q, Li M, Wu Y. The effectiveness of lifestyle interventions for diabetes remission on patients with type 2 diabetes mellitus: A systematic review and meta-analysis. Worldviews Evid Based Nurs. 2023;20(1):64-78. doi:10.1111/wvn.12608
30. Valenzuela PL, Carrera-Bastos P, Gálvez BG, et al. Lifestyle interventions for the prevention and treatment of hypertension. Nat Rev Cardiol. 2021;18(4):251-275. doi:10.1038/s41569-020-00437-9
31. Samson SL, Vellanki P, Blonde L, et al. American Association of Clinical Endocrinology Consensus Statement: Comprehensive Type 2 Diabetes Management Algorithm - 2023 Update Endocr Pract. Endocr Pract. 2023;29(5):305-340. doi:10.1016/j.eprac.2023.02.001
32. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343-1350. doi:10.1056/NEJM200105033441801
33. Roberts S, Barry E, Craig D, Airoldi M, Bevan G, Greenhalgh T. Preventing type 2 diabetes: systematic review of studies of cost-effectiveness of lifestyle programmes and metformin, with and without screening, for pre-diabetes. BMJ Open. 2017;7(11):e017184. doi:10.1136/bmjopen-2017-017184
34. Rosales CB, Denman CA, Bell ML, et al. Meta Salud Diabetes for cardiovascular disease prevention in Mexico: a cluster-randomized behavioural clinical trial. Int J Epidemiol. 2021;50(4):1272-1282.
doi:10.1093/ije/dyab072
35. Quansah DY, Gilbert L, Arhab A, et al. Effect of a prepartum and postpartum, complex interdisciplinary lifestyle and psychosocial intervention on metabolic and mental health outcomes in women with gestational diabetes mellitus (the MySweetheart trial): randomised, single centred, blinded, controlled trial. BMJ Med. 2024;3(1):e000588. doi:10.1136/bmj med-2023-000588
36. van Dam HA, van der Horst FG, Knoops L, Ryckman RM, Crebolder HF, van den Borne BH. Social support in diabetes: a systematic review of controlled intervention studies. Patient Educ Couns. 2005;59(1):1-12. doi:10.1016/j.pec.2004.11.001
37. Rejeski WJ, Ip EH, Bertoni AG, et al. Lifestyle change and mobility in obese adults with type 2 diabetes. N Engl J Med. 2012;366(13):1209-1217. doi:10.1056/NEJMoa1110294
38. Chen YC, Li IC. Effectiveness of interventions using empowerment concept for patients with chronic disease: a systematic review. JBI Libr Syst Rev. 2009;7(27):1179-1233. doi:10.11124/01938924-200907270-00001
39. Chang MW, Tan A, Ling J, Wegener DT, Robbins LB. Mediators of intervention effects on dietary fat intake in low-income overweight or obese women with young children. Appetite. 2020;151: 104700. doi:10.1016/j.appet.2020.104700