title: Mediterranean diet adherence during pregnancy and fetal growth: INMA (Spain) and RHEA (Greece) mother-child cohort studies.
abstract: Dietary intake of specific nutrients or food groups during pregnancy could influence fetal growth, but scant evidence is available on effects of dietary patterns. The aim of this study was to evaluate the impact of Mediterranean diet (MD) adherence during pregnancy on fetal growth in two population-based mother-child cohorts in Spain and Greece. We studied 2461 mother-newborn pairs from the Spanish multi-centre 'INMA' study (Atlantic area: INMA-Atlantic; Mediterranean area: INMA-Mediterranean), and 889 pairs from the 'RHEA' study in Crete, Greece. Maternal diet during pregnancy was assessed by FFQ and MD adherence was evaluated through an a priori score. Fetal growth restriction was based on a customised model, and multivariate log-binomial and linear regression models were used to adjust for several confounders. MD scores differ significantly between the cohorts with women in INMA-Atlantic reporting higher intakes of fish and dairy products, while women in the Mediterranean area reported higher intakes of cereals, vegetables and fruits. Women with high MD adherence had a significantly lower risk of delivering a fetal growth-restricted infant for weight (risk ratios: 0·5; 95 % CI 0·3, 0·9) in the INMA-Mediterranean cohort. Stratified analysis by smoking revealed that higher MD adherence increased birth weight and birth length in smoking mothers, whereas this effect was not apparent in non-smoking mothers. The results of the present study show that several types of MD exist across European Mediterranean regions. High MD adherence may modify the detrimental effect of smoking on birth size, but overall effects of diet were not universal for the studies in this analysis.
authors: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece. lchatzi@med.uoc.gr
authors: Leda
authors: L
authors: Chatzi
authors: Michelle
authors: M
authors: Mendez
authors: Raquel
authors: R
authors: Garcia
authors: Theano
authors: T
authors: Roumeliotaki
authors: Jesús
authors: J
authors: Ibarluzea
authors: Adonina
authors: A
authors: Tardón
authors: Pilar
authors: P
authors: Amiano
authors: Aitana
authors: A
authors: Lertxundi
authors: Carmen
authors: C
authors: Iñiguez
authors: Jesus
authors: J
authors: Vioque
authors: Manolis
authors: M
authors: Kogevinas
authors: Jordi
authors: J
authors: Sunyer
mesh_terms: D000328:Adult; D000818:Animals; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D038441:Diet, Mediterranean / Q000208:ethnology / Q000523:psychology; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D010349:Patient Compliance / Q000208:ethnology; D011247:Pregnancy; D015995:Prevalence; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires