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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. Effects of Mediterranean diet during pregnancy on the onset of overweight or obesity in the offspring: a randomized trial. Int J Obes (Lond) 2024:10.1038/s41366-024-01626-z. [PMID: 39289583 DOI: 10.1038/s41366-024-01626-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 08/26/2024] [Accepted: 08/29/2024] [Indexed: 09/19/2024]
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. 33%, absolute risk difference = -27%, 95% CI -41% to -12%, p < 0.001; number needed to treat 3, 95% CI 2 to 8, intention to treat 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 CT and MD 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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Affiliation(s)
- Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Via Gaetano Salvatore 486, 80131, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Via Gaetano Salvatore 486, 80131, Naples, Italy
| | - Giorgio Bedogni
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
- Department of Primary Health Care, Internal Medicine Unit Addressed to Frailty and Aging, S. Maria delle Croci Hospital, AUSL Romagna, Viale Randi 5, 48121, Ravenna, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Via Gaetano Salvatore 486, 80131, Naples, Italy
| | - Davide Costabile
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Via Gaetano Salvatore 486, 80131, Naples, Italy
| | - Mariella Cuomo
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Via Gaetano Salvatore 486, 80131, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Lorenzo Chiariotti
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Via Gaetano Salvatore 486, 80131, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Via Gaetano Salvatore 486, 80131, Naples, Italy
| | - Annalisa Agangi
- Neonatal Intensive Care Unit, Villa Betania Evangelical Hospital, Via Argine 604, 80147, Naples, Italy
| | - Marcello Napolitano
- Neonatal Intensive Care Unit, Villa Betania Evangelical Hospital, Via Argine 604, 80147, Naples, Italy
| | - Francesco Messina
- Neonatal Intensive Care Unit, Villa Betania Evangelical Hospital, Via Argine 604, 80147, Naples, Italy
| | - Annalisa Passariello
- Department of Pediatric Cardiology, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Via Gaetano Salvatore 486, 80131, Naples, Italy.
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