A simple, individualised, Mediterranean-style diet in pregnancy has the potential to reduce gestational weight gain and the risk of gestational diabetes, suggests a new study in PLoS Medicine.
The multicentre trial randomised 1,252 inner-city multi-ethnic pregnant women with metabolic risk factors (obesity, chronic hypertension, or hypertriglyceridaemia) to a Mediterranean-style diet (n=627); versus usual care (n=625). Mediterranean diet participants received complimentary nuts and extra virgin olive oil and specific dietary advice.
Researchers used an intention-to-treat (ITT) analysis with multivariable models and identified the stratification variables and prognostic factors a priori.
The primary endpoints were composite maternal (gestational diabetes or pre-eclampsia) and composite offspring (stillbirth, small for gestational age, or admission to neonatal care unit) outcomes.
There was no significant reduction in the composite maternal (22.8% vs 28.6%; adjusted odds ratio (aOR) 0.76, 95% CI 0.56–1.03: P=0.08) or composite offspring (17.3% vs 20.9%; aOR 0.79, 95% CI 0.58–1.08: P=0.14) outcomes.
There was an apparent reduction in the odds of gestational diabetes by 35 per cent (aOR 0.65, 95% CI 0.47–0.91, P=0.01) but not in other individual components of the composite outcomes.
Mothers gained less gestational weight (mean difference −1.2 Kg, 95% CI −2.2 to −0.2: P=0.03) with intervention versus control.