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Prenatal adherence to Mediterranean diet may confer cardiometabolic benefit in offspring
Pregnant women with a greater adherence to the Mediterranean diet are more likely to have children with lower BMI, blood pressure and leptin levels, according to an analysis of mother–child cohorts in the United States and Greece.
“Several epidemiological studies and clinical trials support the role of the Mediterranean diet in preventing obesity, type 2 diabetes mellitus and metabolic syndrome in adults, while some recent studies suggest a protective role against obesity development in children,” Leda Chatzi, MD, PhD, assistant professor of nutritional epidemiology at the University of Crete in Heraklion, Greece, and colleagues wrote. “In pregnancy, a higher adherence to the Mediterranean diet has been associated with lower risk of preterm birth, higher birth weight and lower offspring waist circumference at preschool age.”
Chatzi and colleagues analyzed data from 997 mother–child pairs from Project Viva in Massachusetts and 569 pairs from the Rhea study in Crete, Greece. All women completed validated food frequency questionnaires during pregnancy. Researchers estimated adherence to the Mediterranean diet using a modified Mediterranean diet score for nine foods and nutrients; the cohort was stratified by Mediterranean diet score adherence (low, 0-3; moderate, 4-6; or high adherence, 7-9). Weight, height, waist circumference, skinfold thicknesses, BP, lipid levels, C-reactive protein and adipokines were measured in mid-childhood (median age, 7.7 years) in Viva and in early childhood (median age, 4.2 years) in Rhea. Researchers used random-effects models to calculate cohort-specific effects and pooled effects estimates.
After adjustment for maternal age, prepregnancy BMI, race, education level, parity and smoking status, each 3-point increment in the Mediterranean diet score was associated with a mean 0.13-unit lower BMI z score (95% CI, –0.24 to –0.02) for children in the Viva cohort, and a mean 0.15 lower BMI z score in the Rhea cohort (95% CI, –0.29 to 0). In the pooled analysis, each 3-point increase in Mediterranean diet score was associated with a mean 0.14-unit lower BMI z score (95% CI, –0.15 to –0.13), a mean 0.39-cm reduction in waist circumference (95% CI, –0.64 to –0.14) and a mean 0.63-mm reduction in combined subscapular and triceps skinfold thickness (95% CI, –0.98 to –0.28).
Higher adherence to the Mediterranean diet also was associated with improved cardiometabolic markers in children, according to researchers. In pooled analysis, each 3-point increase in Mediterranean diet score was associated with a mean 1.03-mm Hg reduction in systolic BP (95% CI, –1.65 to –0.42); a mean 0.57-mm Hg reduction in diastolic BP (95% CI, –0.98 to –0.16) and a mean 6% reduction in log serum leptin levels (95% CI, –8.5 to –3.5).
“Further adjustment for birth characteristics and infant feeding did not substantively alter any of adjusted models for childhood outcomes,” the researchers wrote. “Results were also similar when we additionally adjusted for child TV watching, fast food intake and child anthropometry at age of the outcome assessment, though with wider [CIs].”
Results persisted after additional adjustments for gestational weight gain, energy intake and gestational diabetes status, according to the researchers. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.