Researchers in China studied 348 pregnant women to see if keeping a simple journal about eating, exercise, and sleep could prevent gestational diabetes—a type of diabetes that develops during pregnancy. Women who tracked their daily habits from weeks 14-28 of pregnancy had only a 9.5% chance of developing the condition, compared to 20.5% in women who didn’t track. This suggests that paying attention to lifestyle choices during pregnancy, with the help of a journal, can significantly reduce the risk of this common pregnancy complication.

The Quick Take

  • What they studied: Whether keeping a personal pregnancy journal to track eating, exercise, sleep, and weight gain could help prevent gestational diabetes (a blood sugar problem that happens during pregnancy).
  • Who participated: 348 pregnant women in Beijing, China who were screened early for gestational diabetes. They were randomly split into two groups: one that kept detailed journals and one that didn’t.
  • Key finding: Women who kept pregnancy journals had about half the rate of gestational diabetes (9.5%) compared to women who didn’t keep journals (20.5%). This difference was statistically significant, meaning it’s unlikely to be due to chance.
  • What it means for you: If you’re pregnant or planning to become pregnant, tracking your daily habits—especially diet, exercise, sleep, and weight—may help reduce your risk of developing gestational diabetes. However, this study was done in one hospital in China, so results may vary in different populations.

The Research Details

This was a case-control study, which means researchers compared two similar groups of pregnant women—one that received an intervention (keeping journals) and one that didn’t. All 348 women received standard pregnancy education about gestational diabetes. The study group kept individualized journals from weeks 14-28 of pregnancy, tracking their daily eating habits, physical activity, sleep patterns, and weight changes. Both groups then took the same glucose tolerance test (a blood sugar test) between weeks 24-28 to see who developed gestational diabetes.

The researchers used a random number table to fairly assign women to either the journal-keeping group or the control group, which helps reduce bias. Both groups received routine pregnancy guidance, so the main difference was whether they kept detailed personal records.

This type of study design is useful for understanding whether a specific action (keeping a journal) can prevent a health problem. However, case-control studies can’t prove cause-and-effect as definitively as some other study types.

This research approach matters because it tests a simple, low-cost intervention that pregnant women can do themselves. Rather than relying only on medical treatments, this study explores whether self-awareness and lifestyle management can prevent gestational diabetes before it develops. The results suggest that behavioral changes—which are often easier and safer than medications—may be effective.

Strengths of this study include the random assignment of participants, a reasonable sample size of 348 women, and the use of a standardized blood sugar test for all participants. The study was conducted at a single hospital in Beijing, which means the results may not apply equally to all populations worldwide. The study doesn’t provide detailed information about how well women actually followed their journals or what specific journal entries were most helpful. Additionally, we don’t know if other factors (like genetics or socioeconomic status) might have influenced the results.

What the Results Show

The main finding was a significant difference in gestational diabetes rates between the two groups. In the journal-keeping group, only 9.5% of women (15 out of 158) developed gestational diabetes, while in the control group, 20.5% of women (34 out of 166) developed it. This means the journal-keeping group had roughly half the rate of gestational diabetes.

The researchers also identified several lifestyle factors that were associated with gestational diabetes risk: poor dietary habits, low physical activity, inadequate sleep, exposure to secondhand smoke, and excessive weight gain during pregnancy. These findings suggest that multiple lifestyle factors work together to influence diabetes risk.

The study was conducted between April and November 2022 at a hospital in Beijing, with all participants screened early in pregnancy and followed through the second trimester. The glucose tolerance test used to diagnose gestational diabetes is a standard medical test where pregnant women drink a sugary solution and have their blood sugar measured.

While the abstract doesn’t provide detailed breakdowns of secondary findings, the research identified that maternal lifestyle was a critical factor in determining whether gestational diabetes would develop. This suggests that multiple lifestyle changes working together—rather than focusing on just one factor—may be most effective. The study also implies that the timing of intervention (starting at week 14 of pregnancy) may be important for prevention.

Previous research has shown that gestational diabetes affects 2-10% of pregnancies worldwide and increases health risks for both mother and baby. This study adds to existing evidence that lifestyle interventions can help prevent gestational diabetes. The finding that journal-keeping reduces risk aligns with other research showing that self-monitoring and awareness can improve health outcomes. However, most previous studies have focused on diet and exercise alone, while this study examined multiple lifestyle factors together.

This study has several important limitations. First, it was conducted at only one hospital in Beijing, China, so the results may not apply to pregnant women in other countries or regions with different healthcare systems and populations. Second, the study doesn’t explain exactly how women used their journals or whether some women followed the process better than others. Third, we don’t know if women in the journal group received more attention or encouragement from healthcare providers, which could have influenced results independently of the journal itself. Finally, the study doesn’t provide information about long-term outcomes after pregnancy or whether preventing gestational diabetes led to other health benefits.

The Bottom Line

If you are pregnant or planning to become pregnant, consider keeping a simple journal to track your eating habits, physical activity, sleep, and weight gain. This appears to be a safe, low-cost way to reduce your risk of gestational diabetes. However, this should complement—not replace—regular prenatal care and screening. Talk with your healthcare provider about what specific information would be most helpful to track. Confidence level: Moderate. While this study shows promise, more research in different populations would strengthen these findings.

This research is most relevant for pregnant women, especially those with risk factors for gestational diabetes (such as family history, overweight status, or previous gestational diabetes). Healthcare providers caring for pregnant women should also pay attention to these findings. Women who are not pregnant but planning pregnancy may benefit from establishing healthy lifestyle habits now. This research is less relevant for non-pregnant individuals, though the lifestyle factors identified (diet, exercise, sleep, avoiding secondhand smoke) are beneficial for everyone.

The study tracked women from weeks 14-28 of pregnancy, so benefits appeared within about 3-4 months of starting the journal. Most women would know if they developed gestational diabetes by week 28 when the glucose tolerance test is typically performed. However, establishing healthy habits takes time, so starting the journal as early as possible in pregnancy—ideally by week 14—appears most beneficial.

Want to Apply This Research?

  • Create a daily pregnancy wellness log that tracks: (1) meals and snacks eaten, (2) minutes of physical activity, (3) hours of sleep, (4) weight (weekly), and (5) exposure to secondhand smoke. Users could rate each category on a simple scale and receive weekly summaries showing patterns.
  • Users could set specific, achievable goals such as: ‘Walk for 20 minutes 3 times this week,’ ‘Eat vegetables with 2 meals daily,’ ‘Get 7-8 hours of sleep,’ and ‘Avoid secondhand smoke.’ The app could send gentle reminders and celebrate completed goals to maintain motivation.
  • Implement a long-term tracking dashboard that shows trends over weeks 14-28 of pregnancy. Users could see their progress on each lifestyle factor and receive personalized feedback. The app could flag concerning patterns (like rapid weight gain or consistently poor sleep) and suggest discussing them with their healthcare provider at the next appointment.

This research suggests that keeping a pregnancy journal and managing lifestyle factors may help reduce gestational diabetes risk, but it is not a substitute for medical care. All pregnant women should receive regular prenatal screening and care from qualified healthcare providers. If you are pregnant or planning to become pregnant, discuss these findings with your doctor or midwife before making changes to your routine. Gestational diabetes requires professional medical diagnosis and management. This summary is for educational purposes and should not be used to diagnose or treat any medical condition.