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The Effects of Lifestyle and/or Vitamin D Supplementation Interventions on Pregnancy Outcomes: What Have We Learned from the DALI Studies?

  • Diabetes and Pregnancy (M-F Hivert and CE Powe, Section Editors)
  • Published:
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A Correction to this article was published on 22 June 2020

This article has been updated

Abstract

Purpose of Review

The DALI (vitamin D and lifestyle intervention in the prevention of gestational diabetes mellitus (GDM)) study aimed to prevent GDM with lifestyle interventions or Vitamin D supplementation (1600 IU/day). This review summarizes the learnings from the DALI studies among pregnant women with a BMI ≥ 29 kg/m2.

Recent Findings

Women diagnosed with GDM earlier in pregnancy had a worse metabolic profile than those diagnosed later. A combined physical activity (PA) and healthy eating (HE) lifestyle intervention improved both behaviours, limited gestational weight gain (GWG) and was cost-effective. Although GDM risk was unchanged, neonatal adiposity was reduced due to less sedentary time. Neither PA nor HE alone limited GWG or GDM risk. Fasting glucose was higher with HE only intervention, and lower with Vitamin D supplementation.

Summary

Our combined intervention did not prevent GDM, but was cost-effective, limited GWG and reduced neonatal adiposity.

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Change history

  • 22 June 2020

    The original version of this review article unfortunately contained a mistake.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Buckley BS, Harreiter J, Damm P, Corcoy R, Chico A, Simmons D, et al. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A review. Diabet Med. 2012;29(7):844–54. Review showing inconsistencies regarding GDM diagnostic criteria as well as other aspects hampering GDM screening and treatment across Europe.

    CAS  PubMed  Google Scholar 

  2. Simmons D. Diabetes and obesity in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2011;25(1):25–36.

    PubMed  Google Scholar 

  3. Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes Care. 2007;30(Suppl 2):S141–6.

    PubMed  Google Scholar 

  4. Lavery JA, Friedman AM, Keyes KM, Wright JD, Ananth CV. Gestational diabetes in the United States: temporal changes in prevalence rates between 1979 and 2010. BJOG. 2017;124(5):804–13.

    CAS  PubMed  Google Scholar 

  5. • Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773–9. Systematic review describing the high risk of T2DM in women with a history of GDM.

    CAS  Google Scholar 

  6. Harreiter J, Dovjak G, Kautzky-Willer A. Gestational diabetes mellitus and cardiovascular risk after pregnancy. Women’s Health (Lond Engl). 2014;10(1):91–108.

    CAS  Google Scholar 

  7. Retnakaran R, Shah BR. Role of type 2 diabetes in determining retinal, renal, and cardiovascular outcomes in women with previous gestational diabetes mellitus. Diabetes Care. 2017;40(1):101–8.

    CAS  PubMed  Google Scholar 

  8. Egan AM, Simmons D. Lessons learned from lifestyle prevention trials in gestational diabetes mellitus. Diabet Med. 2019;36(2):142–50.

    CAS  PubMed  Google Scholar 

  9. •• Aroda VR, Christophi CA, Edelstein SL, Zhang P, Herman WH, Barrett-Connor E, et al. The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the diabetes prevention program outcomes study 10-year follow-up. J Clin Endocrinol Metab. 2015;100(4):1646–53. Follow-up subanalysis of the DPP focussing on women with a history of GDM and describing the effects of lifestyle intervention, metformin versus placebo on diabetes risk after 10 years.

    CAS  Google Scholar 

  10. Alouki K, Delisle H, Bermudez-Tamayo C, Johri M. Lifestyle interventions to prevent type 2 diabetes: a systematic review of economic evaluation studies. J Diabetes Res. 2016;2016:2159890.

    PubMed  PubMed Central  Google Scholar 

  11. Li R, Zhang P, Barker LE, Chowdhury FM, Zhang X. Cost-effectiveness of interventions to prevent and control diabetes mellitus: a systematic review. Diabetes Care. 2010;33(8):1872–94.

    PubMed  PubMed Central  Google Scholar 

  12. Ekmekcioglu C, Haluza D, Kundi M. 25-Hydroxyvitamin D status and risk for colorectal cancer and Type 2 diabetes mellitus: a systematic review and meta-analysis of epidemiological studies. Int J Environ Res Public Health. 2017;14(2):127. https://doi.org/10.3390/ijerph14020127.

    PubMed Central  Google Scholar 

  13. Rafiq S, Jeppesen PB. Is Hypovitaminosis D Related to incidence of Type 2 diabetes and high fasting glucose level in healthy subjects: a systematic review and meta-analysis of observational studies. Nutrients. 2018;10(1):59. https://doi.org/10.3390/nu10010059.

    PubMed Central  Google Scholar 

  14. Lee CJ, Iyer G, Liu Y, Kalyani RR, Bamba N, Ligon CB, et al. The effect of vitamin D supplementation on glucose metabolism in type 2 diabetes mellitus: a systematic review and meta-analysis of intervention studies. J Diabetes Complicat. 2017;31(7):1115–26.

    CAS  Google Scholar 

  15. Pittas AG, Dawson-Hughes B, Sheehan P, Ware JH, Knowler WC, Aroda VR, et al. Vitamin D supplementation and prevention of type 2 diabetes. N Engl J Med. 2019;381(6):520–30.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Zhang Y, Gong Y, Xue H, Xiong J, Cheng G. Vitamin D and gestational diabetes mellitus: a systematic review based on data free of Hawthorne effect. BJOG. 2018;125(7):784–93.

    CAS  PubMed  Google Scholar 

  17. Jelsma JG, van Poppel MN, Galjaard S, Desoye G, Corcoy R, Devlieger R, et al. DALI: vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention: an European multicentre, randomised trial - study protocol. BMC Pregnancy Childbirth. 2013;13:142. https://doi.org/10.1186/1471-2393-13-142.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Vellinga A, Zawiejska A, Harreiter J, Buckley B, Di Cianni G, Lapolla A, et al. Associations of body mass index (maternal BMI) and gestational diabetes mellitus with neonatal and maternal pregnancy outcomes in a multicentre European database (diabetes and pregnancy vitamin D and lifestyle intervention for gestational diabetes mellitus prevention). ISRN Obes. 2012;2012:424010.

    PubMed  PubMed Central  Google Scholar 

  19. •• Simmons D, Devlieger R, van Assche A, Jans G, Galjaard S, Corcoy R, et al. Effect of physical activity and/or healthy eating on GDM risk: the DALI lifestyle study. J Clin Endocrinol Metab. 2017;102(3):903–13. DALI main lifestyle intervention study describing effects of healthy eating, physical activity or a combined group versus usual care on gluco-metabolic outcomes in pregnancy.

  20. Jelsma JGM, Simmons D, Gobat N, Rollnick S, Blumska K, Jans G, et al. Is a motivational interviewing based lifestyle intervention for obese pregnant women across Europe implemented as planned? Process evaluation of the DALI study. BMC Pregnancy Childbirth. 2017;17(1):293.

    PubMed  PubMed Central  Google Scholar 

  21. • Simmons D, Jelsma JG, Galjaard S, Devlieger R, van Assche A, Jans G, et al. Results from a European multicenter randomized trial of physical activity and/or healthy eating to reduce the risk of gestational diabetes mellitus: the DALI lifestyle pilot. Diabetes Care. 2015;38(9):1650–6. Pilot study of the DALI trial testing the lifestyle interventions and study procedures.

    CAS  PubMed  Google Scholar 

  22. • IOM (Institute of Medicine) and NRC (National Research Council). Weight gain during pregnancy: reexamining the guidelines. Washington, DC: The National Academies Press. 2009. Criteria for recommended weight gain in pregnancy according to pre-pregnancy BMI.

  23. Miller WR, Rollnick S. Motivational interviewing, preparing people to change addictive behavior. New York: The Guildford Press; 1991.

    Google Scholar 

  24. Simmons D, Daniels T, Simmons DJ, van Poppel M, Harreiter J. A Mobile electronic record for lifestyle coaches in gestational diabetes prevention. JMTM. 2019;8(1):37–49.

    Google Scholar 

  25. •• Corcoy R, Mendoza LC, Simmons D, Desoye G, Adelantado JM, Chico A, et al. The DALI vitamin D randomized controlled trial for gestational diabetes mellitus prevention: no major benefit shown besides vitamin D sufficiency. Clin Nutr. 2019; (in press). https://doi.org/10.1016/j.clnu.2019.04.006. DALI vitamin D trial describing the effects of Vitamin D3 supplementation on gluco-metabolic outcomes in pregnancy.

  26. • Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D Supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness. J Bone Miner Res. 2011;26(10):2341–57. Vitamin D dosage and safety trial in pregnancy.

    CAS  PubMed  Google Scholar 

  27. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96(1):53–8.

    CAS  PubMed  Google Scholar 

  28. Miller WR, Rollnick S. The effectiveness and ineffectiveness of complex behavioral interventions: impact of treatment fidelity. Contemp Clin Trials. 2014;37(2):234–41.

    PubMed  Google Scholar 

  29. Jelsma JG, van Leeuwen KM, Oostdam N, Bunn C, Simmons D, Desoye G, et al. Beliefs, barriers, and preferences of European overweight women to adopt a healthier lifestyle in pregnancy to minimize risk of developing gestational diabetes mellitus: an explorative study. J Pregnancy. 2016;2016:3435791.

    PubMed  PubMed Central  Google Scholar 

  30. •• Egan AM, Vellinga A, Harreiter J, Simmons D, Desoye G, Corcoy R, et al. Epidemiology of gestational diabetes mellitus according to IADPSG/WHO 2013 criteria among obese pregnant women in Europe. Diabetologia. 2017;60(10):1913–21. DALI epidemiology paper describing GDM prevalence throughout Europe and risk factors.

    PubMed  PubMed Central  Google Scholar 

  31. Mendoza LC, Harreiter J, Simmons D, Desoye G, Adelantado JM, Juarez F, et al. Risk factors for hyperglycemia in pregnancy in the DALI study differ by period of pregnancy and OGTT time point. Eur J Endocrinol. 2018;179(1):39–49.

    CAS  PubMed  Google Scholar 

  32. • Harreiter J, Simmons D, Desoye G, Corcoy R, Adelantado JM, Devlieger R, et al. IADPSG and WHO 2013 gestational diabetes mellitus criteria identify obese women with marked insulin resistance in early pregnancy. Diabetes Care. 2016;39(7):e90–2. Features of the MetSy in obese pregnant women with GDM diagnosis before 20 weeks of gestation.

    CAS  PubMed  Google Scholar 

  33. • Simmons D, Devlieger R, van Assche A, Galjaard S, Corcoy R, Adelantado JM, et al. Association between gestational weight gain, gestational diabetes risk, and obstetric outcomes: a randomized controlled trial post hoc analysis. Nutrients. 2018;10(11):1568. Secondary analysis describing the effects of weight gain on gluco-metabolic as well as birth outcomes.

    PubMed Central  Google Scholar 

  34. •• Harreiter J, Simmons D, Desoye G, Corcoy R, Adelantado JM, Devlieger R, et al. Nutritional lifestyle intervention in obese pregnant women, including lower carbohydrate intake, is associated with increased maternal free fatty acids, 3-beta-hydroxybutyrate, and fasting glucose concentrations: a secondary factorial analysis of the European multicenter, randomized controlled DALI lifestyle intervention trial. Diabetes Care. 2019;42(8):1380–9. Secondary analysis describing the effects of lifestyle intervention on maternal and fetal lipid metabolism, increased lipolysis was observed, which was associated with increased fasting glucose.

    PubMed  Google Scholar 

  35. •• van Poppel MNM, Simmons D, Devlieger R, van Assche FA, Jans G, Galjaard S, et al. A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity: the DALI randomised controlled trial. Diabetologia. 2019;62(6):915–25. Beneficial effects of combined healthy eating and physical activity on neonatal adiposity intervention was observed.

    CAS  PubMed  PubMed Central  Google Scholar 

  36. van Poppel MN, Jelsma JGM, Simmons D, Devlieger R, Jans G, Galjaard S, et al. Mediators of lifestyle behaviour changes in obese pregnant women. Secondary analyses from the DALI lifestyle randomised controlled trial. Nutrients. 2019;11(2):311. https://doi.org/10.3390/nu11020311.

    PubMed Central  Google Scholar 

  37. • de Wit L, Jelsma JG, van Poppel MN, Bogaerts A, Simmons D, Desoye G, et al. Physical activity, depressed mood and pregnancy worries in European obese pregnant women: results from the DALI study. BMC Pregnancy Childbirth. 2015;15:158. Secondary analysis describing the associations of maternal well being and physical activity in pregnancy.

  38. Sattler MC, Jelsma JGM, Bogaerts A, Simmons D, Desoye G, Corcoy R, et al. Correlates of poor mental health in early pregnancy in obese European women. BMC Pregnancy Childbirth. 2017;17(1):404.

    PubMed  PubMed Central  Google Scholar 

  39. Bodnar LM, Catov JM, Roberts JM, Simhan HN. Prepregnancy obesity predicts poor vitamin D status in mothers and their neonates. J Nutr. 2007;137(11):2437–42.

    CAS  PubMed  Google Scholar 

  40. McAree T. Obesity and vitamin D deficiency - current concepts on their impact on pregnancy. Eur Endocrinol. 2013;9(2):125–7.

    PubMed  PubMed Central  Google Scholar 

  41. • Broekhuizen K, Simmons D, Devlieger R, van Assche A, Jans G, Galjaard S, et al. Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus: economic evaluation alongside the DALI study, a European multicenter randomized controlled trial. Int J Behav Nutr Phys Act. 2018;15(1):23. Cost-effectiveness analysis of the DALI interventions.

  42. Simmons D, Hague WM, Teede HJ, Cheung NW, Hibbert EJ, Nolan CJ, et al. Hyperglycaemia in early pregnancy: the treatment of booking gestational diabetes mellitus (TOBOGM) study. A randomised controlled trial. Med J Aust. 2018;209(9):405–6.43.

    PubMed  Google Scholar 

  43. McIntyre HD, sacks DA, Barbour LA, Feig DS, Catalano PM, Damm P, et al. Issues with the diagnosis and classification of hyperglycemia in early pregnancy. Diabetes Care. 2016;39(1):53–4.

    CAS  PubMed  Google Scholar 

  44. •• Simmons D, Nema J, Parton C, Vizza L, Robertson A, Rajagopal R, et al. The treatment of booking gestational diabetes mellitus (TOBOGM) pilot randomised controlled trial. BMC Pregnancy Childbirth. 2018;18(1):151. Pilot study of an ongoing trial testing effects of early GDM treatment versus late GDM treatment and the effects on pregnancy and birth outcomes.

  45. •• Poston L, Bell R, Croker H, Flynn AC, Godfrey KM, Goff L, et al. Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2015;3(10):767–77. Effects of lifestyle intervention in obese women on LGA infants and glucose metabolism in pregnancy.

    Google Scholar 

  46. •• Dodd JM, Turnbull D, McPhee AJ, Deussen AR, Grivell RM, Yelland LN, et al. Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial. BMJ. 2014;348:g1285. Effects of lifestyle intervention in overweight/obese women on LGA infants and glucose metabolism in pregnancy.

    PubMed  PubMed Central  Google Scholar 

  47. •• Koivusalo SB, Rono K, Klemetti MM, Roine RP, Lindstrom J, Erkkola M, et al. Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish gestational diabetes prevention study (RADIEL): a randomized controlled trial. Diabetes Care. 2016;39(1):24–30. Effects of lifestyle intervention in overweight women or women with a history of GDM on glucose metabolism in pregnancy.

    CAS  PubMed  Google Scholar 

  48. Harreiter J, Kautzky-Willer A. Sex and gender differences in prevention of Type 2 diabetes. Front Endocrinol. 2018;9:220. https://doi.org/10.3389/fendo.2018.00220.

  49. Simmons D, van Poppel MN. UPBEAT, RADIEL, and DALI: what’s the difference? Lancet Diabetes Endocrinol. 2015;3(10):761.

    PubMed  Google Scholar 

  50. Shepherd E, Gomersall JC, Tieu J, Han S, Crowther CA, Middleton P. Combined diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Syst Rev. 2017;11:CD010443.

    PubMed  Google Scholar 

  51. Song C, Li J, Leng J, Ma RC, Yang X. Lifestyle intervention can reduce the risk of gestational diabetes: a meta-analysis of randomized controlled trials. Obes Rev. 2016;17(10):960–9.

    CAS  PubMed  Google Scholar 

  52. Powe CE, Allard C, Battista MC, Doyon M, Bouchard L, Ecker JL, et al. Heterogeneous contribution of insulin sensitivity and secretion defects to gestational diabetes mellitus. Diabetes Care. 2016;39:1052–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Santo EC, Forbes PW, Oken E, Belfort MB. Determinants of physical activity frequency and provider advice during pregnancy. BMC Pregnancy Childbirth. 2017;17(1):286.

    PubMed  PubMed Central  Google Scholar 

  54. Barker ED, Kirkham N, Ng J, Jensen SK. Prenatal maternal depression symptoms and nutrition, and child cognitive function. Br J Psychiatry. 2013;203(6):417–21.

    PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria

    Jürgen Harreiter & Alexandra Kautzky-Willer

  2. Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria

    Gernot Desoye

  3. Institute of Sport Science, University of Graz, Graz, Austria

    Mireille N. M. van Poppel

  4. National University of Ireland, Galway, Ireland

    Fidelma Dunne

  5. Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    Rosa Corcoy

  6. CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain

    Rosa Corcoy

  7. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain

    Rosa Corcoy

  8. KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium

    Roland Devlieger

  9. Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England

    David Simmons

  10. School of Medicine, Macarthur Clinical School, Western Sydney University, Locked Bag 1797, Campbelltown, NSW, 2751, Australia

    David Simmons

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  1. Jürgen Harreiter
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Consortia

on behalf of the DALI Consortium

Corresponding author

Correspondence to David Simmons.

Ethics declarations

The trial was registered under the number ISRCTN7059583, was performed according to the declaration of Helsinki and all local ethics committees approved the study.

Conflict of Interest

Jürgen Harreiter, Gernot Desoye, Mireille van Poppel, Alexandra Kautzky-Willer, Fidelma Dunne, Rosa Corcoy, Roland Devlieger and David Simmons declare that they have no conflict of interest.

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This article is part of the Topical Collection on Diabetes and Pregnancy

Appendix The DALI core investigators group

Appendix The DALI core investigators group

G. Desoye1, D. Simmons2, R. Corcoy3,4, J.M. Adelantado3, R. Devlieger5, P. Damm6, E.R. Mathiesen6, D.M. Jensen7, L.L. Andersen7, A. Lapolla8, MG. Dalfrà8, A Bertolotto9, E. Wender-Ozegowska10, A. Zawiejska10, D J. Hill11, M.N.M. van Poppel12, F.J. Snoek13, A. Kautzky-Willer14, FP. Dunne15

Gernot Desoye, PhD 1Department of Obstetrics and Gynaecology, Medizinische Universitaet Graz, Graz, Austria. E: gernot.desoye@medunigraz.at

David Simmons, MD (Cantab) 2Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England and Macarthur Clinical School, Western Sydney University, Sydney, Australia. E: Da.simmons@westernsydney.edu.au

Rosa Corcoy, PhD 3Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain.

4CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragoza, Spain E: RCorcoy@santpau.cat

Juan M Adelantado, PhD 3Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. E: JAdelantado@santpau.cat

Roland Devlieger, PhD 5KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate. Gynaecology and Obstetrics, University Hospitals Leuven, Belgium. E: roland.devlieger@uzleuven.be

Peter Damm, DMsc. 6Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. E: pdamm@dadlnet.dk

Elizabeth Reinhardt Mathiesen, DMsc. 6Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. E: elisabeth.reinhardt.mathiesen@regionh.dk

Dorte Moeller Jensen, PhD 7Department of Endocrinology and Department of Gynaecology and Obstetrics, Odense University Hospital, Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark. E: Dorte.Moeller.Jensen@rsyd.dk

Lise Lotte T. Anderson, MD. 7Department of Endocrinology and Department of Gynaecology and Obstetrics, Odense University Hospital, Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark. E: lise.lotte.andersen@rsyd.dk

Annunziata Lapolla, MD 8Universita Degli Studi di Padova, Padua, Italy. E: annunziata.lapolla@unipd.it

Maria G Dalfrà, MD 8Universita Degli Studi di Padova, Padua, Italy. E: u053734@sanita.padova.it

Alessandra Bertolotto, PhD. 9Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. E: alessandrabertolotto1959@yahoo.it

Ewa Wender-Ozegowska, PhD. 10Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland. E: ewaoz@post.pl

Agnieszka Zawiejska, PhD 10Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland E: agazaw@post.home.pl

David J.Hill, DPhil. 11Recherche en Santé Lawson SA, St. Gallen, Switzerland. E: david.hill@lawsonresearch.com

Mireille N.M. van Poppel, PhD. 12Department of Public and Occupational Health, EMGO+-Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands and Institute of Sport Science, University of Graz, Graz, Austria. E: mireille.van-poppel@uni-graz.at

Frank J Snoek, PhD 13Department of Medical Psychology, EMGO+-Institute for Health and Care Research, VU University Medical Centre and Medical Psychology AMC, Amsterdam, the Netherlands. E: fj.snoek@vumc.nl

Alexandra Kautzky-Willer, MD 14Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria. E: alexandra.kautzky-willer@meduniwien.ac.at

Fidelma Dunne, PhD 15National University of Ireland, Galway, Ireland. E: fidelma.dunne@nuigalway.ie

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Harreiter, J., Desoye, G., van Poppel, M.N.M. et al. The Effects of Lifestyle and/or Vitamin D Supplementation Interventions on Pregnancy Outcomes: What Have We Learned from the DALI Studies?. Curr Diab Rep 19, 162 (2019). https://doi.org/10.1007/s11892-019-1282-7

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