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Article

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

1
Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
2
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28040 Madrid, Spain
3
Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
4
Preventive Medicine Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
5
Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
6
Clinical Laboratory Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
*
Author to whom correspondence should be addressed.
These two authors contributed equally to this work.
Nutrients 2019, 11(6), 1210; https://doi.org/10.3390/nu11061210
Received: 26 March 2019 / Revised: 18 May 2019 / Accepted: 24 May 2019 / Published: 28 May 2019
(This article belongs to the Special Issue Impact of adherence to the Mediterranean diet on health)
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. View Full-Text
Keywords: pregnancy; nutrition; MedDiet; real world; gestational diabetes mellitus; maternofoetal outcomes pregnancy; nutrition; MedDiet; real world; gestational diabetes mellitus; maternofoetal outcomes
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MDPI and ACS Style

García de la Torre, N.; Assaf-Balut, C.; Jiménez Varas, I.; del Valle, L.; Durán, A.; Fuentes, M.; del Prado, N.; Bordiú, E.; Valerio, J.J.; Herraiz, M.A.; Izquierdo, N.; Torrejón, M.J.; Cuadrado, M.A.; de Miguel, P.; Familiar, C.; Runkle, I.; Barabash, A.; Rubio, M.A.; Calle-Pascual, A.L. 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. Nutrients 2019, 11, 1210. https://doi.org/10.3390/nu11061210

AMA Style

García de la Torre N, Assaf-Balut C, Jiménez Varas I, del Valle L, Durán A, Fuentes M, del Prado N, Bordiú E, Valerio JJ, Herraiz MA, Izquierdo N, Torrejón MJ, Cuadrado MA, de Miguel P, Familiar C, Runkle I, Barabash A, Rubio MA, Calle-Pascual AL. 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. Nutrients. 2019; 11(6):1210. https://doi.org/10.3390/nu11061210

Chicago/Turabian Style

García de la Torre, Nuria, Carla Assaf-Balut, Inés Jiménez Varas, Laura del Valle, Alejandra Durán, Manuel Fuentes, Náyade del Prado, Elena Bordiú, Johanna Josefina Valerio, Miguel A. Herraiz, Nuria Izquierdo, Maria José Torrejón, Maria Angeles Cuadrado, Paz de Miguel, Cristina Familiar, Isabelle Runkle, Ana Barabash, Miguel A. Rubio, and Alfonso L. Calle-Pascual. 2019. "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" Nutrients 11, no. 6: 1210. https://doi.org/10.3390/nu11061210

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