Assaf-Balut Carla, Garcia de la Torre Nuria, Durán Alejandra, Bordiu Elena, Del Valle Laura, Familiar Cristina, Valerio Johanna, Jimenez Inés, Herraiz Miguel Angel, Izquierdo Nuria, Runkle Isabelle, de Miguel María Paz, Montañez Carmen, Barabash Ana, Cuesta Martín, Rubio Miguel Angel, Calle-Pascual Alfonso Luis
Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
J Clin Med. 2019 Sep 19;8(9):1499. doi: 10.3390/jcm8091499.
An early antenatal dietary intervention could play an important role in the prevention of metabolic diseases postpartum. The aim of this study is to evaluate whether an early, specific dietary intervention reduces women's cardiovascular risk in the "fourth trimester". This prospective cohort study compares 1675 women from the standard-care group (ScG/n = 676), who received standard-care dietary guidelines, with the intervention group (IG/n = 999), who received Mediterranean diet (MedDiet)-based dietary guidelines, supplemented with extra-virgin olive oil and nuts. Cardiovascular risk was determined by the presence of metabolic syndrome (MetS) and insulin resistance syndrome (IrS) (HOMA-IR 3.5) at 12-14 weeks postpartum. MetS was less frequent in the IG (11.3 vs. 19.3%, < 0.05). The intervention was associated with a reduction in the relative risk of having MetS: 0.74 (95% CI, 0.60-0.90), but not in the risk of IrS. When analyzing the presence of having one or more components of the MetS, the IG had significantly higher rates of having 0 components and lower rates of having ≥1 (-trend = 0.029). An early MedDiet-based nutritional intervention in pregnancy is associated with reductions in postpartum rates of MetS.
早期的产前饮食干预在预防产后代谢疾病方面可能发挥重要作用。本研究的目的是评估早期的特定饮食干预是否能降低女性在“孕晚期”的心血管疾病风险。这项前瞻性队列研究将1675名来自接受标准护理饮食指南的标准护理组(ScG/n = 676)的女性与接受以地中海饮食(MedDiet)为基础的饮食指南、补充特级初榨橄榄油和坚果的干预组(IG/n = 999)的女性进行了比较。通过产后12至14周时代谢综合征(MetS)和胰岛素抵抗综合征(IrS)(HOMA-IR≥3.5)的存在情况来确定心血管疾病风险。干预组中MetS的发生率较低(11.3%对19.3%,P<0.05)。该干预与患MetS的相对风险降低有关:0.74(95%CI,0.60 - 0.90),但与IrS的风险无关。在分析MetS一个或多个组成部分的存在情况时,干预组中无组成部分的发生率显著更高,而有≥1个组成部分的发生率更低(P趋势 = 0.029)。孕期早期基于MedDiet的营养干预与产后MetS发生率的降低有关。