Diet and physical activity reduce weight, waist circumference, and systolic blood pressure in GDM patientsDiet and exercise help women with history of gestational diabetes

We systematically analysed the literature to assess whether diet and physical activity interventions delivered in high-income countries (HICs) could affect cardio-metabolic biomarkers among women with gestational diabetes mellitus (GDM) in pregnancy. Ten databases and two trial registries were searched from inception until 16/03/2026. Studies were included if they were randomised controlled trials in HICs that allocated women with GDM to diet and/or physical activity interventions, or a control group, and reported outcomes at 12 ± 3 months after the intervention. The review was preregistered in PROSPERO (CRD42024597324; CRD42024518659). We used random effects meta-analyses to pool data. We included 17 studies with 6,535 participants. There was evidence that interventions led to a significant reduction in weight (-0.89 kg (95% CI -1.74, -0.03); I = 57.7%), waist circumference (difference -0.79 cm (95% CI -1.45, -0.13); I = 0%), and systolic blood pressure (-1.60 mmHg (95% CI -3.16, -0.04), I = 72.1%). However, there was no evidence of a significant effect of these interventions on blood lipids, glycaemic outcomes, diastolic blood pressure, or type 2 diabetes incidence. The review highlights the need for high quality research on reducing the risk of long-term cardiometabolic disease among women with a history of GDM in HICs.