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A simple Mediterranean diet during pregnancy does not reduce the overall risk of adverse complications to the mother and offspring, but could reduce weight gain during pregnancy and the risk of gestational diabetes, according to a clinical trial conducted by the United States. Queen Mary University of London. and the University of Warwick.
The results, published in the journal PLOS Medicine and funded by Barts Charity, show that a Mediterranean diet (comprising 30 g of mixed nuts a day and extra virgin olive oil) reduces the risk of developing diabetes by 35% during pregnancy and on average 1.25 kg average weight gain during pregnancy, compared with those who received routine antenatal care.
The study suggests that a Mediterranean-type diet could be an effective intervention for pregnant women with pre-existing obesity, chronic hypertension or high lipid levels.
Professor Shakila Thangaratinam from Queen Mary University in London said: "This is the first study to show that pregnant women at high risk of complications can benefit from a Mediterranean diet to reduce their weight gain and risk of gestational diabetes.
"The implementation of this diet appears to be effective and acceptable to women." Current national dietary recommendations do not include key elements of the Mediterranean diet in their recommendations Women at risk of gestational diabetes should be encouraged to take action from the very beginning of pregnancy, by consuming more nuts, olive oil, fruits and unrefined grains, while reducing their consumption of animal fats and sugar. "
Dr. Bbadel Wattar of the University of Warwick and Queen Mary University of London said: "It has been proven that a Mediterranean-type diet reduces the risk of type 2 diabetes and cardiovascular complications in the general population, but we did not know the effects of such a diet in high-risk pregnant women, and whether it could be culturally adapted to an ethnically diverse population.
"We now know that pregnant women from a multi-ethnic, high-risk population and living in the city center are able to adapt their diet to a Mediterranean style, which can bring them to a new age. important benefits, including a reduction in weight gain and a lower risk of developing gestational diabetes ".
One in four mothers enters pregnancy with pre-existing obesity, chronic hypertension, or elevated fat levels. These can lead to complications during pregnancy, including gestational diabetes (when a high blood sugar level occurs during pregnancy) and pre-eclampsia – the onset of pregnancy. high blood pressure during pregnancy, which can sometimes develop into more serious conditions affecting multiple organs. These mothers and their babies are also at risk for long-term diabetes and cardiovascular complications.
A Mediterranean diet, rich in unsaturated fatty acids, reduces the incidence of cardiovascular disease in the non-pregnant population. During pregnancy, such a diet can potentially improve outcomes for the mother and offspring, but has not been widely evaluated so far.
The ESTEEM study involved 1,252 women from five British maternity hospitals (four in London, including NHS Trust hospitals in Barts Health and the NHS Foundation Trust, and one in Birmingham).
Downtown multiethnic pregnant women with metabolic risk factors, including obesity and chronic hypertension, were randomized to receive routine antenatal care or a Mediterranean-type diet, in addition to their antenatal care. The diet included a high consumption of nuts, extra virgin olive oil, fruits, vegetables, unrefined grains and legumes; moderate to high fish consumption, low to moderate consumption of poultry and dairy products; and low consumption of red meat and processed meat; and avoid sugary drinks, fast foods and foods high in animal fat.
Despite improvements in gestational diabetes and weight gain during pregnancy, no other significant complication of pregnancy, such as high blood pressure, pre-eclampsia, stillbirth, small fetus or l? admission to a neonatal care unit was not observed.
Participants in the Mediterranean diet group reported a better overall quality of life than the control group and a bloated feeling during pregnancy, but no other symptoms such as nausea, vomiting or indigestion were observed.
When the study data were combined with published data from a Spanish study of 874 pregnant women undergoing a Mediterranean diet, the team observed an equally significant reduction in gestational diabetes (reduction 33%), but no effect on the other results.
Fiona Miller Smith, Executive Director of Barts Charity, said: "Faced with the growing problems of diabetes and obesity among pregnant women, we are very proud to support this study that aims to prevent these risks. We are pleased that our funding of Barts' strategy The Women's Health Research Center is being used to improve the health of mothers in East London and thus help future generations. "
To promote their consumption during pregnancy, participants in the Mediterranean diet received a complementary blend of walnuts (30 g / day of nuts, hazelnuts and almonds) and extra virgin olive oil (0.5 liters per week), main source of cooking fat. Participants also received personalized dietary advice at 18, 20 and 28 weeks of gestation.
The diet was sensitized to the culture by providing cooking tips in a bespoke cookbook (see Notes to Editors), which incorporates elements of the Mediterranean diet into local cuisine, elaborated with local community teams.
The work was done at the Barth Women's Research Center, based at Queen Mary University in London, funded by Barts Charity.
The study has limitations, including relying on participant feedback to measure adherence to the intervention, without using objective biomarkers to measure nutritional intake. The team also obtained food intake information from only about 40% of participants in both groups, which limits the interpretation of data on this intake.
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