Home Medizin Vorgeburtliche Mittelmeerdiät reduziert Fettleibigkeit bei Nachkommen

Vorgeburtliche Mittelmeerdiät reduziert Fettleibigkeit bei Nachkommen

von NFI Redaktion

A recent study published in Nutrients investigated the relationship between adherence to the maternal Mediterranean diet (MedDiet) during pregnancy and the risk of overweight or obese offspring at the age of four years.

Prenatal Mediterranean diet reduces offspring obesity

Study: The strict adherence to a Mediterranean diet during pregnancy reduces overweight/obesity in children: A prospective study. Image Source: Marian Weyo/Shutterstock.com


The global childhood obesity epidemic affects millions of children under the age of five and leads to psychological comorbidities, low self-esteem, behavioral and emotional disorders, as well as long-term cardiovascular morbidity and cancer.

Additionally, the World Health Organization (WHO) report emphasizes the importance of balanced nutrition before birth in preventing childhood obesity.

The strict adherence to a Mediterranean diet by the mother during pregnancy could be a promising strategy for determining potential obesity risks in childhood. A stronger adherence to the diet has numerous health benefits for both mother and child.

Nevertheless, there are few studies examining the impact of prenatal nutrition on offspring obesity, yielding different results, thus requiring further research.

About the Study

In the present study, the researchers investigated whether maternal adherence to MedDiet is associated with offspring obesity at the age of four years, and assessed the influence of maternal factors on this relationship.

The team included 272 mother-child dyads from the ECLIPSES (Ensayo CLInico Para Suplementar con Hierro a EmbarazadaS) study for analysis.

The primary study outcome was overweight or obese offspring, based on gender- and age-specific Z-scores of body mass index (BMI) above the 85th percentile using WHO child growth standards.

The researchers obtained basic maternal data from questionnaires during personal interviews at enrollment, including medical history, age, education level, socioeconomic status, physical activity, smoking status, and alcohol consumption.

In addition to gestational age at birth and mode of delivery, they obtained data on child-related variables, including gender, length, and weight at birth.

The team assessed prenatal nutrition using standardized 45-component food frequency questionnaires (FFQs) at weeks 12, 24, and 36 of pregnancy, and calculated the relative MedDiet scores (rMedDiet). They measured offspring size and weight at four years of age.

They estimated daily total calorie intake using the REGAL food table and assessed household socioeconomic status using the Catalan occupation classification (CCO-2011).

The researchers assessed physical activity using the International Physical Activity Questionnaire (IPAQ) and categorized gestational weight gain (GWG) based on the 2009 Institute of Medicine (IOM) recommendations.

They conducted multivariate logistic regression modeling to determine the odds ratios (OR) for the association between prenatal nutrition and offspring obesity.

The randomized clinical trial ECLIPSES was conducted from 2013 to 2017 in Tarragona, Spain, to evaluate the effectiveness of maternal iron supplementation at different doses, taking into account initial hemoglobin levels during early pregnancy on maternal iron status at the end of pregnancy.

Primary care midwives recruited 791 pregnant women aged ≥ 18 years during the first prenatal visit (before the 12th week of pregnancy) for the study.


The mean maternal age was 32 years, 70% were ≥ 30 years old, and 42% were obese or overweight with body mass index values ≥ 25 kg m-2.

Most (86%) of the mothers were from Spain, 44% had a university education, 22% had a high socioeconomic status, and 17% smoked during pregnancy. Among the mothers, 29% showed low adherence to MedDiet, while 23% showed high adherence.

The mean prenatal rMedDiet score was 9.80, and 26% of the offspring were overweight or obese after four years, with the prevalence of obesity higher in males (63%) than in females (37%).

The team found significant anthropometric differences (height, weight, and body mass index) by gender. The mean body mass index and body weight of the offspring at four years of age were 16 kg m-2 and 18 kg, respectively.

Males had higher weight (19 versus 17 kg), higher BMI (16 versus 15.6), higher weight-for-age Z-score (0.5 versus 0.1), and higher BMI Z-score (0.7 versus 0.2) than females.

Overweight/obesity was less prevalent in offspring of mothers with a university degree, higher socioeconomic status, and higher prenatal rMedDiet values.

After adjusting for potential confounding variables, the team found that higher prenatal MedDiet adherence was associated with a reduced risk of offspring overweight or obesity (OR for the highest versus the lowest quartile, 0.3).

They arrived at similar results and stratified them by maternal age, BMI in early pregnancy, education level, smoking status, socioeconomic status, and GWG.

After confounder adjustment, the team found that every point increase in prenatal MedDiet was associated with a 19% lower risk of offspring overweight or obesity at the age of four years (OR: 0.8).

Smoking (OR: 2.5), pre-pregnancy overweight (OR: 2.5) or obesity (OR: 2.6), and excessive GWG (OR: 2.9) were significantly associated with offspring overweight or obesity after four years.

The protective effect of MedDiet on offspring weight was higher in pregnant women under 30 years old with overweight or obesity during the first pregnancy, in non-smokers, and in women with low socioeconomic status.


Overall, the study results showed that higher prenatal MedDiet adherence is associated with a reduced incidence of offspring overweight/obesity after four years, especially in mothers with a university degree under 30 years old from a low socioeconomic background who do not smoke. Future studies could explore whether the association persists across all stages of life.

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