Mediterranean diet during pregnancy reduces risk of childhood obesity

A new study suggests that following a Mediterranean diet during pregnancy may prevent childhood obesity, while genetic influences may play a role in long-term health outcomes.

To work: Effect of Mediterranean diet during pregnancy on the onset of overweight or obesity in offspring: A randomized trial. Image Credit: Alex Maryna / Shutterstock.com

In a recently published study International Journal of ObesityResearchers are investigating the effects of nutritional counseling promoting the Mediterranean diet (ADD) during pregnancy on the likelihood that children born to these mothers will be obese or overweight by the time they are two years old.

The effect of maternal nutrition on childhood obesity

The rise in childhood obesity has become a major public health problem worldwide, necessitating the implementation of strategies to prevent health problems later in life. Early life, including pregnancy, is an important time to prevent obesity because a mother’s diet can affect the future health of her child.

Rich in fiber, antioxidants, and healthy fats, MD is known for its benefits in preventing excess weight in adulthood. During pregnancy, MD may protect children from developing obesity through its potential effects on the regulation of certain genes.

However, there remains a lack of evidence as to whether monitoring MD during pregnancy can prevent overweight and obesity in early childhood. Although some observational studies have been conducted, experimental research is needed to understand these relationships.

About the work

The Pregnancy MD (PREMEDI) trial was designed to examine whether women who followed MD while pregnant could prevent their children from becoming obese or overweight up to age two. A total of 104 pregnant women were randomly assigned to receive standard care alone or standard care in addition to personalized MD counseling.

Women assigned to the MD group attended three dietary counseling sessions during pregnancy. The MD’s recommendations included eating more vegetables, fruits, whole grains, fish and legumes, using olive oil and avoiding processed foods.

The primary study outcome was the percentage of children who were obese or overweight at age 2. Secondary outcomes included maternal compliance with MD and weight gain during pregnancy.

The researchers also measured changes in gene expression, focusing on the leptin gene, which is linked to weight regulation. Follow-up assessments of the children were conducted every few months until their second birthday. Statistical analyses were performed to compare the results between the two groups.

Study findings

Monitoring MD during pregnancy reduced the likelihood of children being overweight or obese by age two. In the MD group, no children were obese and 6% were overweight, while in the control group, 8% and 22% of children who were obese and overweight, respectively, were overweight.

The absolute risk difference, defined as subtracting the mean risk in the control group from the mean risk in the treatment group, was significant. For this purpose, the number needed to treat (NNT) was four, indicating that one case of childhood obesity or overweight was prevented for every four women following MD.

Mothers’ weight gain during pregnancy was similar in both groups, indicating that MD did not affect weight gain. Children born to mothers in the MD group had slightly higher birth weights than those in the control group.

Further analysis showed that MD was associated with higher methylation in the promoter of the leptin gene. Therefore, MD may affect gene expression related to weight regulation in the offspring.

Results

The findings of the study emphasize the importance of maternal nutrition in preventing childhood obesity, as monitoring MD during pregnancy reduces the risk of obesity or overweight in children.

A key strength of the current study is the experimental design, which provides robust evidence compared to previous observational studies that have yielded mixed results. The researchers also investigated possible underlying mechanisms, including changes in the leptin gene, that may explain how MD affects obesity risk.

However, notable limitations of the current study include the small sample size and the fact that genetic analysis was limited to a few samples, which may affect the generalizability of the results. Additional limitations include the inability to blind participants and the lack of other MD adherence biomarkers.

Future research should include larger trials with more diverse populations and investigate additional biomarkers of MD adherence. Additionally, additional studies are needed to determine the long-term effects of following MD during pregnancy on obesity and other health outcomes in later childhood and adulthood.