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Clinical Trial
. 2019 May 28;11(6):1210.
doi: 10.3390/nu11061210.

Effectiveness of Following Mediterranean Diet Recommendations in the Real World in the Incidence of Gestational Diabetes Mellitus (GDM) and Adverse Maternal-Foetal Outcomes: A Prospective, Universal, Interventional Study with a Single Group. The St Carlos Study

Nuria García de la Torre  1   2 , Carla Assaf-Balut  3   4 , Inés Jiménez Varas  5 , Laura Del Valle  6 , Alejandra Durán  7   8 , Manuel Fuentes  9 , Náyade Del Prado  10 , Elena Bordiú  11   12 , Johanna Josefina Valerio  13   14 , Miguel A Herraiz  15   16 , Nuria Izquierdo  17   18 , Maria José Torrejón  19 , Maria Angeles Cuadrado  20   21 , Paz de Miguel  22   23 , Cristina Familiar  24 , Isabelle Runkle  25   26 , Ana Barabash  27   28 , Miguel A Rubio  29   30 , Alfonso L Calle-Pascual  31   32   33
Affiliations
Clinical Trial

Effectiveness of Following Mediterranean Diet Recommendations in the Real World in the Incidence of Gestational Diabetes Mellitus (GDM) and Adverse Maternal-Foetal Outcomes: A Prospective, Universal, Interventional Study with a Single Group. The St Carlos Study

Nuria García de la Torre et al. Nutrients. .

Abstract

We reported that a Mediterranean Diet (MedDiet), supplemented with extra-virgin olive oil (EVOO) and pistachios, reduces GDM incidence and several other adverse outcomes. In order to assess its translational effects in the real world we evaluated the effect of MedDiet from 1st gestational visit in GDM rate compared with control (CG) and intervention (IG) groups from the previously referred trial. As secondary objective we also compared adverse perinatal outcomes between normoglycemic and diabetic women. This trial is a prospective, clinic-based, interventional study with a single group. 1066 eligible normoglycaemic women before 12 gestational weeks were assessed. 932 women (32.4 ± 5.2 years old, pre-gestational BMI 22.5 ± 3.5 kg/m2) received a motivational lifestyle interview with emphasis on daily consumption of EVOO and nuts, were followed-up and analysed. Binary regression analyses were used to examine the risk for each pregnancy outcome, pregnancy-induced hypertension, preeclampsia, gestational weight gain (GWG), caesarean-section, perineal trauma, preterm delivery, small (SGA) and large for gestational age (LGA), and Neonatal Intensive Care Unit admissions. GDM was diagnosed in 13.9%. This rate was significantly lower than the CG: RR 0.81 (0.73-0.93), p < 0.001 and no different from the IG: RR 0.96 (0.85-1.07), p = 0.468. GWG was lower in diabetic women (10.88 ± 6.46 vs. 12.30 ± 5.42 Kg; p = 0.013). Excessive weight gain (EWG) was also lower in GDM [RR 0.91 (0.86-0.96); p < 0.001] without a significant increase of insufficient weight gain. LGA were also lower (1 (0.8%) vs. 31 (3.9%); p < 0.05)), and SGA were similar (5 (3.8%) vs. 30 (3.7%)). LGA were associated to EWG (RR 1.61 (1.35-1.91), p < 0.001). Differences in other maternal-foetal outcomes were not found. In conclusions an early MedDiet nutritional intervention reduces GDM incidence and maternal-foetal adverse outcomes and should be universally applied as 1st line therapy. GDM might not be consider as a high risk pregnancy any longer.

Keywords: MedDiet; gestational diabetes mellitus; maternofoetal outcomes; nutrition; pregnancy; real world.

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Conflict of interest statement

The authors declare no conflict of interest.

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Flow chart of the study conduct.
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