A modified Mediterranean diet against gestational diabetes mellitus

  • Sha Xiao Department of Obstetrics and Gynecology, Tianjin First Center Hospital, Tianjin, China
  • Qianqian Zhang Department of Obstetrics and Gynecology, Tianjin First Center Hospital, Tianjin, China
  • Ming Zhang Department of Obstetrics and Gynecology, Tianjin First Center Hospital, Tianjin, China
  • Rong Hu Department of Obstetrics and Gynecology, Tianjin First Center Hospital, Tianjin, China
  • Rong Liu Department of Obstetrics and Gynecology, Tianjin First Center Hospital, Tianjin, China
Keywords: Gestational diabetes mellitus (GDM), Mediterranean-like diet, diet intervention, improved outcomes


Healthy lifestyle is reported to reduce the prevalence of gestational diabetes mellitus (GDM). The association between Mediterranean diet (MD) and GDM incidence remains unclear in China. Therefore, we aim to establish a Chinese-habit-based MD recipe and explore its effects on GDM. This study recruited gestational age women who were planning a pregnancy in the near future with at least one risk factor for GDM. The participants were randomly allocated into the control and MD groups. They were required to follow diet interventions at least 6 months prior to pregnancy until delivery. Average dietary intake, glucose and insulin metabolism in 26–28-week of gestation, and maternal and neonatal outcomes were analyzed to assess the effects of MD. The clinical outcomes of 580 participants, with 294 in the MD group and 286 in the control group, were analyzed. It was revealed that the MD group had a high intake of protein, vitamins, and dietary fibers, whereas low intake of fat, resulting in improved insulin and glucose metabolism. Meanwhile, women and their newborns in the MD group showed a reduced proportion of complications. The modified MD intervention started before pregnancy shows a preventive effect against GDM and also benefits the mother and their newborns in other outcomes.


Download data is not yet available.


Buchanan TA, Xiang AH. Gestational diabetes mellitus. J Clin Invest 2005; 115(3): 485–91. doi: 10.1172/JCI200524531

Briana DD, Boutsikou M, Marmarinos A, Gourgiotis D, Malamitsi-Puchner A. Perinatal sclerostin concentrations in abnormal fetal growth: the impact of gestational diabetes. J Matern Fetal Neonatal Med 2018; 32(13): 2228–32. doi: 10.1080/14767058.2018.1430135

Huynh J, Xiong G, Bentley-Lewis R. A systematic review of metabolite profiling in gestational diabetes mellitus. Diabetologia 2014; 57(12): 2453–64. doi: 10.1007/s00125-014-3371-0

Rimar Z, Milas V, Medimurec M, Mesic I. Respiratory distress syndrome in newborns of gestational age of over 32 weeks. Coll Antropol 2014; 38(2): 621–6.

Shah BR, Retnakaran R, Booth GL. Increased risk of cardiovascular disease in young women following gestational diabetes mellitus. Diabetes Care 2008; 31(8): 1668–9. doi: 10.2337/dc08-0706

Salas-Salvado J, Bullo M, Estruch R, Ros E, Covas MI, Ibarrola-Jurado N, et al. Prevention of diabetes with Mediterranean diets: a subgroup analysis of a randomized trial. Ann Intern Med 2014; 160(1): 1–10. doi: 10.7326/M13-1725

Kesse-Guyot E, Ahluwalia N, Lassale C, Hercberg S, Fezeu L, Lairon D. Adherence to Mediterranean diet reduces the risk of metabolic syndrome: a 6-year prospective study. Nutr Metab Cardiovasc Dis 2013; 23(7): 677–83. doi: 10.1016/j.numecd.2012.02.005

Estruch R, Ros E, Martinez-Gonzalez MA. Mediterranean diet for primary prevention of cardiovascular disease. N Engl J Med 2013; 369(7): 676–7. doi: 10.1056/NEJMoa1200303

Rodriguez-Bernal CL, Rebagliato M, Iniguez C, Vioque J, Navarrete-Munoz EM, Murcia M, et al. Diet quality in early pregnancy and its effects on fetal growth outcomes: the Infancia y Medio Ambiente (Childhood and Environment) Mother and Child Cohort Study in Spain. Am J Clin Nutr 2010; 91(6): 1659–66. doi: 10.3945/ajcn.2009.28866

Babadi M, Khorshidi A, Aghadavood E, Samimi M, Kavossian E, Bahmani F, et al. The effects of probiotic supplementation on genetic and metabolic profiles in patients with gestational diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Probiotics Antimicrob Proteins 2019; 11(4): 1227–35. doi: 10.1007/s12602-018-9490-z

Ludwig D, Luoto R, Kinnunen TI, Aittasalo M, Kolu P, Raitanen J, et al. Primary prevention of gestational diabetes mellitus and large-for-gestational-age newborns by lifestyle counseling: a cluster-randomized controlled trial. PLoS Med 2011; 8(5): e1001036. doi: 10.1371/journal.pmed.1001036

American Diabetes A. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010; 33 Suppl 1: S62–9. doi: 10.2337/dc10-S062

Persson LÅ, Al Wattar BH, Dodds J, Placzek A, Beresford L, Spyreli E, et al. Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM): a pragmatic multicentre randomised trial. PLoS Med 2019; 16(7): e1002857. doi: 10.1371/journal.pmed.1002857

Polley BA, Wing RR, Sims CJ. Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes Relat Metab Disord 2002; 26(11): 1494–502. doi: 10.1038/sj.ijo.0802130

Tognon G, Lissner L, Saebye D, Walker KZ, Heitmann BL. The Mediterranean diet in relation to mortality and CVD: a Danish cohort study. Br J Nutr 2014; 111(1): 151–9. doi: 10.1017/S0007114513001931

Perez-Ferre N, Del Valle L, Torrejon MJ, Barca I, Calvo MI, Matia P, et al. Diabetes mellitus and abnormal glucose tolerance development after gestational diabetes: a three-year, prospective, randomized, clinical-based, Mediterranean lifestyle interventional study with parallel groups. Clin Nutr 2015; 34(4): 579–85. doi: 10.1016/j.clnu.2014.09.005

Zhang H, Su S, Yu X, Li Y. Dietary epigallocatechin 3-gallate supplement improves maternal and neonatal treatment outcome of gestational diabetes mellitus: a double-blind randomised controlled trial. J Hum Nutr Diet 2017; 30(6): 753–8. doi: 10.1111/jhn.12470

McGowan CA, McAuliffe FM. The influence of maternal glycaemia and dietary glycaemic index on pregnancy outcome in healthy mothers. Br J Nutr 2010; 104(2): 153–9. doi: 10.1017/S0007114510000425

Chowdhury A, Sarkar J, Chakraborti T, Pramanik PK, Chakraborti S. Protective role of epigallocatechin-3-gallate in health and disease: a perspective. Biomed Pharmacother 2016; 78: 50–9. doi: 10.1016/j.biopha.2015.12.013

Asemi Z, Samimi M, Tabassi Z, Esmaillzadeh A. The effect of DASH diet on pregnancy outcomes in gestational diabetes: a randomized controlled clinical trial. Eur J Clin Nutr 2014; 68(4): 490–5. doi: 10.1038/ejcn.2013.296

Schwingshackl L, Hoffmann G. Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis of observational studies. Cancer Med 2015; 4(12): 1933–47. doi: 10.1002/cam4.539

Liyanage T, Ninomiya T, Wang A, Neal B, Jun M, Wong MG, et al. Effects of the Mediterranean diet on cardiovascular outcomes-a systematic review and meta-analysis. PLoS One 2016; 11(8): e0159252. doi: 10.1371/journal.pone.0159252

Asemi Z, Samimi M, Tabassi Z, Sabihi SS, Esmaillzadeh A. A randomized controlled clinical trial investigating the effect of DASH diet on insulin resistance, inflammation, and oxidative stress in gestational diabetes. Nutrition 2013; 29(4): 619–24. doi: 10.1016/j.nut.2012.11.020

Letenneur L, Proust-Lima C, Le Gouge A, Dartigues JF, Barberger-Gateau P. Flavonoid intake and cognitive decline over a 10-year period. Am J Epidemiol 2007; 165(12): 1364–71. doi: 10.1093/aje/kwm036

Artal R, Catanzaro RB, Gavard JA, Mostello DJ, Friganza JC. A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus. Appl Physiol Nutr Metab 2007; 32(3): 596–601. doi: 10.1139/H07-024

Olmedo-Requena R, Gomez-Fernandez J, Amezcua-Prieto C, Mozas-Moreno J, Khan KS, Jimenez-Moleon JJ. Pre-pregnancy adherence to the mediterranean diet and gestational diabetes mellitus: a case-control study. Nutrients 2019; 11(5): 1003. doi: 10.3390/nu11051003

International Weight Management in Pregnancy Collaborative G. Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. BMJ 2017; 358: j3119. doi: 10.1136/bmj.j3119

He JR, Yuan MY, Chen NN, Lu JH, Hu CY, Mai WB, et al. Maternal dietary patterns and gestational diabetes mellitus: a large prospective cohort study in China. Br J Nutr 2015; 113(8): 1292–300. doi: 10.1017/S0007114515000707

Tobias DK, Zhang C, Chavarro J, Bowers K, Rich-Edwards J, Rosner B, et al. Prepregnancy adherence to dietary patterns and lower risk of gestational diabetes mellitus. Am J Clin Nutr 2012; 96(2): 289–95. doi: 10.3945/ajcn.111.028266

Karamanos B, Thanopoulou A, Anastasiou E, Assaad-Khalil S, Albache N, Bachaoui M, et al. Relation of the Mediterranean diet with the incidence of gestational diabetes. Eur J Clin Nutr 2013; 68(1): 8–13. doi: 10.1038/ejcn.2013.177

Roman-Vinas B, Ribas Barba L, Ngo J, Martinez-Gonzalez MA, Wijnhoven TM, Serra-Majem L. Validity of dietary patterns to assess nutrient intake adequacy. Br J Nutr 2009; 101 Suppl 2: S12–20. doi: 10.1017/S0007114509990547

Jacques PF, Tucker KL. Are dietary patterns useful for understanding the role of diet in chronic disease? Am J Clin Nutr 2001; 73(1): 1–2. doi: 10.1093/ajcn/73.1.1

How to Cite
XiaoS., ZhangQ., ZhangM., HuR., & LiuR. (2022). A modified Mediterranean diet against gestational diabetes mellitus. STEMedicine, 3(3), e129. https://doi.org/10.37175/stemedicine.v3i3.129
Research articles