A clinical trial of a Mediterranean-style diet during pregnancy shows promise in reducing the risk of excess weight gain and gestational diabetes. Gestational diabetes (GDM) is a form of diabetes that occurs during pregnancy. Affecting between 5 and 10 per cent of all pregnancies in Australia, GDM is high on the health concern radar.

The raised blood sugars from GDM can result in the developing baby growing too large, causing birth complications. Following delivery, the baby can also experience low blood glucose levels caused by being removed from the glucose-rich environment of the mother. The mother also suffers a much higher lifetime risk of developing type 2 diabetes.

Women who enter pregnancy who are already carrying too much weight or have risk factors for metabolic disease such as high blood pressure or elevated blood fats (lipids) are at greater risk of pregnancy complications such as gestational diabetes and pre-eclampsia. This puts both the mum and the baby at a heightened risk of diabetes and cardiovascular disease in the future.

A Mediterranean-style diet has shown favourable benefits in reducing the risk of type 2 diabetes and cardiovascular complications. But as yet, not as much is known how it may fare when followed during pregnancy in women who are at higher risk of metabolic disease.

Considered one of the world’s healthiest dietary patterns, and certainly the most well researched, the Mediterranean diet is linked to a host of positive health benefits. The theme of the Mediterranean diet is one abundant in fruits, vegetables, wholegrains, legumes and olive oil and features fish and poultry more than red meat.

A recent clinical trial tested how following a Mediterranean-style diet could help pregnant women who have significant risk factors for diabetes and heart disease. Called the ESTEEM study, it involved over 1,200 women at five UK maternity units.

Women from various ethnic inner-city backgrounds with metabolic risk factors such as obesity, high blood pressure or high blood triglycerides were randomised to either receive routine antenatal care or to receive ongoing individualised advice on following a Mediterranean-style diet in addition to their antenatal care.

Women allocated to the Mediterranean-style diet gained on average 1.25 kg less weight than those who had routine care. This was a positive since most women were carrying too much weight into their pregnancy to begin with.

The other key finding was a drop in the incidence of GDM by 35 per cent in women following the Mediterranean diet. Other pregnancy complications such as high blood pressure, pre-eclampsia, stillbirth, small for gestational age foetus, or admission to a neonatal care unit were not different between the two groups of women. Women in the Mediterranean-style diet group did though report better overall quality of life than those in the control group.

Adding further support to the key study finding, when the results were combined with a similar type of trial done in Spain involving 874 pregnant women, there was a similar reduction in the risk of GDM by one-third.

Implications

A Mediterranean-style diet could be an effective way for women who enter pregnancy with a high risk of GDM to mitigate this with an eating plan that has a host of health benefits both short-and long-term.

Last Reviewed: 29/07/2020

© Norman Swan Medical Communications.



References

For reference: Al Wattar BH et al. Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM): A pragmatic multicentre randomised trial. PLOS Medicine Epub online 23 July 2019 doi: 10.1371/journal.pmed.1002857.

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