Influence of Mediterranean Diet Adherence and Dietary Habits During Gestation on Several Maternal and Neonatal Biochemical, Genetic and Anthropometric Markers

Resumo

Pregnancy is a physiological stage in which fetal development takes place. The maternal nutritional status during pregnancy will affect health outcomes in the mother and the fetus-newborn. Therefore, the study of the effect of the mother’s lifestyle, including exercise and diet, on certain maternal and fetal health markers becomes essential. It seems that a high Mediterranean diet (MD) adherence and exercise during pregnancy can confer a protective effect against different diseases that may affect the mother and the newborn. Unfortunately, evidence is very scarce and many questions remain still unrevealed. In this present International Doctoral Thesis, we address knowledge gaps and provide a novel insight on: I) the assessment of the MD adherence during pregnancy and its relationship with sociodemographic, lifestyle and pregnancy-related determinants; II) the role of MD adherence during pregnancy on materno-fetal cardiometabolic health; III) the role of MD adherence during pregnancy on maternal sleep quality and mental health and; IV) the influence of MD during pregnancy on materno-fetal genetics. Our results suggest that two out of five MD indices that were investigated (i.e., the Mediterranean Diet Score and the Mediterranean Food Pattern) could be recommended to assess the diet's positive or negative cardiometabolic impact during pregnancy (Study I). Moreover, older age, lower body mass index, greater overall physical fitness, greater cardiorespiratory fitness, muscle strength, and elements of a healthy lifestyle such as avoiding tobacco and meeting physical activity recommendations were associated with higher adherence to the MD during gestation (Study II). A greater MD adherence during pregnancy was associated with better values of maternal lipid and inflammatory markers (Study III) and a cardioprotective effect during gestation (Study IV). However, we could not find an association between maternal MD adherence and neonatal lipid, glycemic and inflammatory markers. Furthermore, we observed that the effects of an exercise intervention during pregnancy on postpartum body composition might be enhanced by following a MD during pregnancy (Study V). Regarding maternal mental health, a greater MD adherence was associated with better sleep quality, lower negative affect, depressive symptoms, and anxiety, and with higher emotional regulation, resilience, positive affect, and health-related quality of life along the pregnancy course (Studies VI, VII and VIII). A greater MD adherence was also associated with lower depressive symptoms and postpartum depression risk (Study IX). Moreover, a concurrent exercise program during pregnancy appeared to be effective to reduce gestational weight gain. Interestingly, the exercise program also proved an effect, albeit lower, on gestational weight gain in those women with a genetic predisposition to obesity (Study X). Additionally, we found that placental telomere length might be positively influenced by lifestyle factors such as MD adherence combined with exercise during gestation (Study XI). Overall, the findings from the present International Doctoral Thesis highlight the positive role of lifestyle factors, such as MD adherence and exercise during pregnancy, on several materno-fetal health outcomes such as cardiometabolic health, postpartum body composition, sleep quality, mental health, and placental telomere length.