Iberoamerican Journal of Medicine
https://iberoamjmed.com/article/doi/10.53986/ibjm.2023.0021
Iberoamerican Journal of Medicine
Original article

Mediterranean Diet Quality Index (MDQI) of the pregnant women

Índice de calidad de la dieta mediterránea (MDQI) en mujeres embarazadas

Fatih Sırıken, Arif Aktuğ Ertekin, Bengü Depboylu, Ayla Gülden Pekcan, Emre Zafer, Hakan Öztürk

Downloads: 0
Views: 748

Abstract

Introduction: This study aimed to determine pregnant women's nutritional status and habits in the middle and low-income groups and the level of compliance with the Mediterranean diet. The Mediterranean diet supports healthy fetal growth and development by providing sufficient nutrients for pregnant women and protecting against the development of obstetrical pathologies.
Materials and Methods: One hundred and thirty-two pregnant women aged 17-45 were included. The demographic characteristics and anthropometric measurements, systolic blood pressure, fasting, and postprandial blood glucose values were noted.24-hour recall was determined and The Mediterranean Diet Quality Index (MDQI) developed by Gerber et al. was used to assess nutritional status. Nutritional habits and food attitude changes during gestation were recorded.
Results: Overall, 15.2% of the pregnant women had good, 54.5% had medium-good, and %29.5 had medium-poor adherence to MDQI. The dietary macronutrient intakes were close to the daily dietary recommended intakes (DRI); however, micronutrient intakes were below the recommendations. Pre-pregnancy mean BMI was found to be 26.4 kg/m2.
Conclusions: According to the mean pre-pregnant BMI, the pregnant women were overweight, and their adherence to the Mediterranean diet needed to be improved. General measures should be taken to improve pregnant women's diets and micronutrient intakes, even in the Mediterranean countries where this diet is the daily nutrition habit of local inhabitant pregnant women.

Keywords

Pregnancy; Nutrition; Mediterranean diet quality index

Resumen

Introducción: La dieta mediterránea contribuye a un crecimiento y desarrollo fetal saludable, proporcionando suficientes nutrientes a mujeres embarazadas y protegiendo contra el desarrollo de patologías obstétricas. Este estudio tiene como objetivo determinar el estado nutricional y los hábitos de mujeres embarazadas de grupos de ingresos medios y bajos y su nivel de cumplimiento de la dieta mediterránea.
Materiales y métodos: Se incluyeron y siguieron a 132 gestantes de entre 17 y 45 años. Se anotaron sus características demográficas y medidas antropométricas, presión arterial sistólica, y glucemia en ayunas y posprandial. Para evaluar su estado nutricional se utilizaron registros dietéticos de consumo de 24 horas y el indice de calidad de la dieta mediterránea (MDQI). Se registraron los hábitos nutricionales y los cambios de actitud alimentaria durante la gestación.
Resultados: En general, la adherencia de las gestantes al MDQI fue buena en el 15,2%, media-buena en el 54.5%, y media-mala en el 29,5% de los casos. Las ingestas dietéticas de macronutrientes se aproximaron a las ingestas diarias recomendadas (IDR); sin embargo, la ingesta de micronutrientes estuvo por debajo de las recomendaciones. El IMC medio antes del embarazo era de 26,4 kg/m2.
Conclusiones: De acuerdo con el IMC medio previo al embarazo, las gestantes tenían sobrepeso y debían mejorar su adherencia a la dieta mediterránea. Es necesario tomar medidas generales para mejorar la dieta y la ingesta de micronutrientes de mujeres embarazadas, incluso en países mediterráneo donde esta dieta es el hábito nutricional diario de sus habitantes.

Palabras clave

Embarazo; Nutrición; Índice de calidad de la dieta mediterránea

References

1. Trichopoulou A, Martínez-González MA, Tong TY, Forouhi NG, Khandelwal S, Prabhakaran D, et al. Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med. 2014;12:112. doi: 10.1186/1741-7015-12-112.
2. Ganpule A, Yajnik CS, Fall CH, Rao S, Fisher DJ, Kanade A, et al. Bone mass in Indian children--relationships to maternal nutritional status and diet during pregnancy: the Pune Maternal Nutrition Study. J Clin Endocrinol Metab. 2006;91(8):2994-3001. doi: 10.1210/jc.2005-2431.
3. Tryggvadottir EA, Medek H, Birgisdottir BE, Geirsson RT, Gunnarsdottir I. Association between healthy maternal dietary pattern and risk for gestational diabetes mellitus. Eur J Clin Nutr. 2016;70(2):237-42. doi: 10.1038/ejcn.2015.145.
4. Brantsaeter AL, Haugen M, Samuelsen SO, Torjusen H, Trogstad L, Alexander J, et al. A dietary pattern characterized by high intake of vegetables, fruits, and vegetable oils is associated with reduced risk of preeclampsia in nulliparous pregnant Norwegian women. J Nutr. 2009;139(6):1162-8. doi: 10.3945/jn.109.104968.
5. Hajianfar H, Esmaillzadeh A, Feizi A, Shahshahan Z, Azadbakht L. Major Maternal Dietary Patterns during Early Pregnancy and Their Association with Neonatal Anthropometric Measurement. Biomed Res Int. 2018;2018:4692193. doi: 10.1155/2018/4692193.
6. Schoenaker DA, Soedamah-Muthu SS, Callaway LK, Mishra GD. Prepregnancy dietary patterns and risk of developing hypertensive disorders of pregnancy: results from the Australian Longitudinal Study on Women's Health. Am J Clin Nutr. 2015;102(1):94-101. doi: 10.3945/ajcn.114.102475.
7. Satalić Z, Barić IC, Keser I, Marić B. Evaluation of diet quality with the mediterranean dietary quality index in university students. Int J Food Sci Nutr. 2004;55(8):589-97. doi: 10.1080/09637480500086141.
8. Zaragoza-Martí A, Ruiz-Ródenas N, Herranz-Chofre I, Sánchez-SanSegundo M, Serrano Delgado VC, Hurtado-Sánchez JA. Adherence to the Mediterranean Diet in Pregnancy and Its Benefits on Maternal-Fetal Health: A Systematic Review of the Literature. Front Nutr. 2022;9:813942. doi: 10.3389/fnut.2022.813942.
9. Assaf-Balut C, García de la Torre N, Durán A, Fuentes M, Bordiú E, Del Valle L, Familiar C, et al. A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM): A randomized controlled trial: The St. Carlos GDM prevention study. PLoS One. 2017;12(10):e0185873. doi: 10.1371/journal.pone.0185873.
10. Olmedo-Requena R, Gómez-Fernández J, Amezcua-Prieto C, Mozas-Moreno J, Khan KS, Jiménez-Moleón JJ. Pre-Pregnancy Adherence to the Mediterranean Diet and Gestational Diabetes Mellitus: A Case-Control Study. Nutrients. 2019;11(5):1003. doi: 10.3390/nu11051003.
11. Silva-del Valle MA, Sánchez-Villegas A, Serra-Majem L. Association between the adherence to the Mediterranean diet and overweight and obesity in pregnant women in Gran Canaria. Nutr Hosp. 2013;28(3):654-9. doi: 10.3305/nh.2013.28.3.6377.
12. Assaf-Balut C, García de la Torre N, Fuentes M, Durán A, Bordiú E, Del Valle L, et al. A High Adherence to Six Food Targets of the Mediterranean Diet in the Late First Trimester is Associated with a Reduction in the Risk of Materno-Foetal Outcomes: The St. Carlos Gestational Diabetes Mellitus Prevention Study. Nutrients. 2018;11(1):66. doi: 10.3390/nu11010066.
13. Parisi F, Rousian M, Huijgen NA, Koning AHJ, Willemsen SP, de Vries JHM, et al. Periconceptional maternal 'high fish and olive oil, low meat' dietary pattern is associated with increased embryonic growth: The Rotterdam Periconceptional Cohort (Predict) Study. Ultrasound Obstet Gynecol. 2017;50(6):709-16. doi: 10.1002/uog.17408.
14. Okyay P, Abacıgil F. Türkiye Sağlık Okuryazarlığı Ölçekleri Geçerlilik ve Güvenirlilik Çalışması.T.C.Sağlık Bakanlığı, Mayıs,2016. Available from: https://acikders.ankara.edu.tr/pluginfile.php/114974/mod_resource/content/1/S
a%C4%9Fl%C4%B1k%20Okur%20Yazarl%C4%B1%C4%9F%C4%B1%20%C3%96l%C3%A7ekleri.pdf (accessed January 2023).
15. Dehne LI, Klemm C, Henseler G, Hermann-Kunz E. The German Food Code and Nutrient Data Base (BLS II.2). Eur J Epidemiol. 1999;15(4):355-9. doi: 10.1023/a:1007534427681.
16. Blunç NH, Yıldız E. The relationship between biochemical and hemoglobin results and quality index scores of the Mediterranean diet of pregnant women in the first and the third trimester. Progr Nutr. 2021;23(4):e2021197. doi:10.23751/pn.v23i4.11333.
17. Scali J, Richard A, Gerber M. Diet profiles in a population sample from Mediterranean southern France. Public Health Nutr. 2001;4(2):173-82. doi: 10.1079/phn200065.
18. Pekcan G. Beslenme drumunun saptanması. In: Baysal A, Aksoy M, Besler T, Bozkurt N, Keçecioğlu S, Mercanlıgil S, et al., editors. Diyet El Kitabı .6th ed. Hatipoğlu Yayınevi: Ankara; 2011.
19. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222. Obstet Gynecol. 2020;135(6):1492-5. doi: 10.1097/AOG.0000000000003892.
20. Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight Gain During Pregnancy: Reexamining the Guidelines. Rasmussen KM, Yaktine AL, editors. Washington (DC): National Academies Press (US); 2009.
21. Amati F, Hassounah S, Swaka A. The Impact of Mediterranean Dietary Patterns During Pregnancy on Maternal and Offspring Health. Nutrients. 2019;11(5):1098. doi: 10.3390/nu11051098.
22. Mariscal-Arcas M, Rivas A, Monteagudo C, Granada A, Cerrillo I, Olea-Serrano F. Proposal of a Mediterranean diet index for pregnant women. Br J Nutr. 2009;102(5):744-9. doi: 10.1017/S0007114509274769.
23. Havaš Auguštin D, Šarac J, Lovrić M, Živković J, Malev O, Fuchs N, et al. Adherence to Mediterranean Diet and Maternal Lifestyle during Pregnancy: Island-Mainland Differentiation in the CRIBS Birth Cohort. Nutrients. 2020;12(8):2179. doi: 10.3390/nu12082179.
24. Siega-Riz AM, Herrmann TS, Savitz DA, Thorp JM. Frequency of eating during pregnancy and its effect on preterm delivery. Am J Epidemiol. 2001;153(7):647-52. doi: 10.1093/aje/153.7.647.
25. Peraita-Costa I, Llopis-González A, Perales-Marín A, Diago V, Soriano JM, Llopis-Morales A, et al. Maternal profile according to Mediterranean diet adherence and small for gestational age and preterm newborn outcomes. Public Health Nutr. 2021;24(6):1372-84. doi: 10.1017/S1368980019004993.
26. Çelikkan N. Gebelik öncesi sezgisel yeme davranışı ile gebelike yeme farkındalığı ve beslenme durumunun gestasyonel vücut ağırlığı artışına etkisinin belirlenmesi. Yüksek Lisans Tezi, Lisansüstü Eğitim Enstitüsü,Gaziantep:Hasan Kalyoncu Üniv; 2021.
27. Doherty DA, Magann EF, Francis J, Morrison JC, Newnham JP. Pre-pregnancy body mass index and pregnancy outcomes. Int J Gynaecol Obstet. 2006;95(3):242-7. doi: 10.1016/j.ijgo.2006.06.021.
28. Trichopoulou A, Bamia C, Norat T, Overvad K, Schmidt EB, Tjønneland A, et al. Modified Mediterranean diet and survival after myocardial infarction: the EPIC-Elderly study. Eur J Epidemiol. 2007;22(12):871-81. doi: 10.1007/s10654-007-9190-6.
29. Marchi J, Berg M, Dencker A, Olander EK, Begley C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev. 2015;16(8):621-38. doi: 10.1111/obr.12288.
30. De Giuseppe R, Bocchi M, Maffoni S, Del Bo E, Manzoni F, Cerbo RM, et al. Mediterranean Diet and Lifestyle Habits during Pregnancy: Is There an Association with Small for Gestational Age Infants? An Italian Single Centre Experience. Nutrients. 2021;13(6):1941. doi: 10.3390/nu13061941.
31. Gernand AD, Schulze KJ, Stewart CP, West KP Jr, Christian P. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention. Nat Rev Endocrinol. 2016;12(5):274-89. doi: 10.1038/nrendo.2016.37.
32. Öztürk HNO. Gebe ve emzikli kadınların diyet kalite indekslerinin karşılaştırılması. Yüksek Lisans Tezi, Sağlık Bilimleri Enstitüsü Beslenme ve Diyetetik AD,Ankara:Gazi üniversitesi; 2019.
33. Nogay NH. Gebe kadınların beslenme durumlarının değerlendirilmesi. Electronic Journal of Vocational Colleges. 2011;1(1):51-7.
34. Bach-Faig A, Geleva D, Carrasco J, Ribas-Barba L, Serra-Majem L. Evaluating associations between Mediterranean diet adherence indexes and biomarkers of diet and disease. Public Health Nutr. 2006;9(8A):1110-7. doi: 10.1017/S1368980007668499.
35. Bondia-Pons I, Serra-Majem L, Castellote AI, López-Sabater MC. Compliance with the European and national nutritional objectives in a Mediterranean population. Eur J Clin Nutr. 2007;61(12):1345-51. doi: 10.1038/sj.ejcn.1602662.
36. Ma RC, Tutino GE, Lillycrop KA, Hanson MA, Tam WH. Maternal diabetes, gestational diabetes and the role of epigenetics in their long term effects on offspring. Prog Biophys Mol Biol. 2015;118(1-2):55-68. doi: 10.1016/j.pbiomolbio.2015.02.010.
37. Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of Gestational Weight Gain With Maternal and Infant Outcomes: A Systematic Review and Meta-analysis. JAMA. 2017;317(21):2207-25. doi: 10.1001/jama.2017.3635.
38. Radwan H, Hashim M, Hasan H, Abbas N, Obaid RRS, Al Ghazal H, et al. Adherence to the Mediterranean diet during pregnancy is associated with lower odds of excessive gestational weight gain and postpartum weight
retention: results of the Mother-Infant Study Cohort. Br J Nutr. 2022;128(7):1401-12. doi: 10.1017/S0007114521002762.
39. Di Renzo L, Marchetti M, Rizzo G, Gualtieri P, Monsignore D, Dominici F, et al. Adherence to Mediterranean Diet and Its Association with Maternal and Newborn Outcomes. Int J Environ Res Public Health. 2022;19(14):8497. doi: 10.3390/ijerph19148497.
40. Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, et al. Pre-Pregnancy BMI Influences the Association of Dietary Quality and Gestational Weight Gain: The SECOST Study. Int J Environ Res Public Health. 2019;16(19):3735. doi: 10.3390/ijerph16193735.
41. Hurrell A, Webster L, Chappell LC, Shennan AH. The assessment of blood pressure in pregnant women: pitfalls and novel approaches. Am J Obstet Gynecol. 2022;226(2S):S804-S818. doi: 10.1016/j.ajog.2020.10.026.
42. Minhas AS, Hong X, Wang G, Rhee DK, Liu T, Zhang Met al. Mediterranean-Style Diet and Risk of Preeclampsia by Race in the Boston Birth Cohort. J Am Heart Assoc. 2022;11(9):e022589. doi: 10.1161/JAHA.121.022589.


Submitted date:
03/15/2023

Reviewed date:
06/14/2023

Accepted date:
06/27/2023

Publication date:
06/27/2023

649aedbea953957a7f11cf36 iberoamericanjm Articles
Links & Downloads

Iberoam J Med

Share this page
Page Sections