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Cited by 10Birth, Development, and HealthNutritional Studies and DietGestational Diabetes Research and Management

Effects of Mediterranean Diet during Pregnancy on the Onset of Overweight or Obesity in the Offspring: A Randomized Trial

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Coppola, Serena, Paparo, Lorella, Bedogni, Giorgio, Nocerino, Rita, Costabile, Davide, Cuomo, Mariella, Chiariotti, Lorenzo, Carucci, Laura +5 more·2025·International Journal of Obesity
DOI 10.1038/s41366-024-01626-zPMC PMC11683001

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Abstract

BACKGROUND/OBJECTIVES: The PREMEDI study was designed to assess the efficacy of nutritional counseling aimed at promoting Mediterranean Diet (MD) during pregnancy on the incidence of overweight or obesity at 24 months in the offspring. METHODS: PREMEDI was a parallel-arm randomized-controlled trial. 104 women in their first trimester of pregnancy were randomly assigned in a 1:1 ratio to standard obstetrical and gynecological care alone (CT) or with nutritional counseling promoting MD. Women enrolled in the MD arm were provided with 3 sessions of nutritional counseling (one session per trimester). The main outcome was the proportion of overweight or obesity among the offspring at the age of 24 months. Maternal MD-adherence and weight gain during pregnancy were also evaluated. Lastly, the evaluation of epigenetic modulation of metabolic pathways in the offspring was analyzed in cord blood. RESULTS: Five women in the MD arm and 2 in the CT arm were lost to follow-up, so a total of 97 completed the study. At 24 months, children of MD mothers were less likely to have overweight or obesity than those of the CT mothers (6% vs. 30%, absolute risk difference = -24%, 95% CI -38% to -9%, p = 0.003, number needed to treat 4, 95% CI 2 to 12, per-protocol analysis). A significantly higher increase of MD-adherence during the trial was observed in the MD arm compared to the CT arm. A similar body weight gain at the end of pregnancy was observed in the two arms. The mean (SD) methylation rate of the leptin gene in cord blood was 30.4 (1.02) % and 16.9 (2.99) % in the MD and CT mothers, respectively (p < 0.0001). CONCLUSIONS: MD during pregnancy could be an effective strategy for preventing pediatric overweight or obesity at 24 months. This effect involves, at least in part, an epigenetic modification of leptin expression.

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  • Maternal adherence to a Mediterranean diet during pregnancy is associated with a lower risk of overweight/obesity at 24 months in offspring, suggesting that dietary quality may exert early programming effects.

    “Interestingly, maternal adherence to a Mediterranean diet during pregnancy has been associated with a lower risk of overweight/obesity at 24 months in offspring, suggesting that dietary quality may exert early programming effects [185].”

    From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [185]

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Cited by

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Authors
Coppola, S., Paparo, L., Bedogni, G., Nocerino, R., Costabile, D., Cuomo, M., Chiariotti, L., Carucci, L., Agangi, A., Napolitano, M., Messina, F., Passariello, A., & Berni Canani, R.
Affiliations
  • University of Naples Federico II (IT)
  • Ospedale "Santa Maria delle Croci" di Ravenna (IT)
  • Ospedale Monaldi (IT)
ORCID
Venue
International Journal of Obesity
Publisher
Springer Science and Business Media LLC
Published
2024-09-18
Volume
49
Issue
1
Pages
101-108
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
DOI
10.1038/s41366-024-01626-z
PMC
PMC11683001
OpenAlex
W4402601275
Cited by
10
References
1
Citations by year
2026: 7 · 2025: 3
FWCI
6.77
Type
journal article
Language
en
Update notices
correction (2024-11-12)
Open access
Licence
Locations
  • International Journal of Obesity (publishedVersion, cc-by-nc-nd)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by-nc-nd)
Funders
  • Università degli Studi di Napoli Federico II
  • European Commission (PE00000003, PE0000003)
  • Ministero della Salute (PE00000003, CUP E63C22002570006)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Keywords
Mediterranean diet, pregnancy, maternal nutrition, nutrition counseling, childhood obesity, childhood overweight, epigenetics, umbilical cord blood, gestational weight gain
MeSH terms
Adult, Child, Preschool, Female, Fetal Blood, Humans, Pregnancy, Prenatal Exposure Delayed Effects, Leptin, Diet, Mediterranean, Epigenesis, Genetic, Overweight, Pediatric Obesity

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