Adherence to the Mediterranean Diet and Determinants Among Pregnant Women: The NELA Cohort

The Mediterranean diet represents one of the most studied dietary patterns; however, there is no single tool for measuring the grade of adherence and no single set of criteria for adapting these indices to pregnant women. We characterized the adherence to the Mediterranean diet (MDA) of pregnant women participating in the NELA (Nutrition in Early Life and Asthma) cohort and identified the sociodemographic determinants and lifestyle habits associated with a higher risk of a low MDA. Maternal diet during gestation was assessed by a validated Food Frequency Questionnaire (FFQ) (n = 665). We estimated the Relative Mediterranean Diet score (rMED), Alternative Mediterranean Diet score (aMED), and the Alternate Healthy Eating Index-2010 (AHEI-2010). Multivariate regression models were performed to identify the sociodemographic and lifestyle factors associated with each index. Mothers with a lower age and more previous deliveries had a greater probability of low MDA (p < 0.05). For the aMED index only, mothers with university education and/or who practiced sport activities for two or more hours per week had a lower probability of a low MDA (p < 0.01). The three indices classified the NELA cohort as having a medium level of adherence. These results may be improved by designing intervention strategies and dietary recommendations for both maternal and offspring health.

Automated summary

This study assessed the adherence to the Mediterranean diet among pregnant women and found that younger mothers with more previous deliveries were more likely to have a low adherence. Additionally, mothers with university education and those who engaged in sports activities for two or more hours per week had a lower risk of low adherence to the Mediterranean diet. The NELA cohort was classified as having a medium level of adherence according to the three indices used in the study. The results suggest the potential for intervention strategies and dietary recommendations to improve the health of both mothers and offspring.