The Mediterranean-style diet has done it again. Adhering to a Mediterranean-style diet is associated with a lower risk of developing preeclampsia among low-income women from urban communities, according to the results of a new study in the Journal of the American Heart Association.1
Preeclampsia is a major cause of maternal and fetal morbidity and mortality; Black women and patients with preexisting cardiometabolic disorders (chronic hypertension, obesity, and diabetes) are at increased risk for preeclampsia, noted the study authors. In an earlier study, the researchers found that greater adherence to a Mediterranean‐style diet during pregnancy was associated with reduced risks of preterm birth and low birth weight.2 Because of the shared risk factors between cardiovascular disease, preterm birth, and preeclampsia, they hypothesized that adherence to a Mediterranean-style diet would lower the risk of preeclampsia in racially and ethnically diverse low-income women.
To study their hypothesis, the researchers used data from the Boston Birth Cohort in which participants were recruited from Boston Medical Center, which serves predominantly low-income, minority populations. Dietary data were available for 8507 participants and a food frequency questionnaire was administered to women 24 to 72 hours after they gave birth. Questionnaires included information regarding maternal intake of various foods by weekly frequency for the duration of pregnancy and were used to calculate a Mediterranean‐style diet score (MSDS) that assessed level of adherence to this diet.
“Specifically, we used food groups associated with Mediterranean diet (vegetables, fruits, legumes, grains, dairy, and seafood). Rice and pasta were included under whole grains,” reported the study authors. “Dairy was considered low‐fat dairy, and meat was considered red/processed meat.”
The study authors used logistic regression to calculate odds ratios of preeclampsia with demographic, clinical, and socioeconomic models. Women with preexisting hypertension or diabetes were excluded from the study. The relationship between MSDS and preeclampsia was stratified by Black vs non‐Black race.
Nearly Half of Women Who Developed Preeclampsia Were Black
A total of 848 (10%) of women developed preeclampsia, 47% were Black, 28% were Hispanic, 12% were White, and the remaining were of other race/ethnicity. As expected, women with preexisting hypertension had 9 times the odds of developing preeclampsia (95% CI, 7.33–11.04) compared with women without hypertension. Women with preexisting diabetes and obesity had 2.17 (95% CI, 1.62–2.92) and 2.07 (95% CI, 1.76–2.42) times the odds of preeclampsia compared with women without those conditions, respectively. Patients with these preexisting conditions were excluded from the diet analysis.
Women who had greater adherence to the Mediterranean diet during pregnancy, had greater than 20% lower odds of developing preeclampsia. This trend remained in the subgroup of Black participants with those in the lowest tertile of MSDS having the highest adjusted odds (1.72; 95% CI, 1.16–2.55) for preeclampsia compared with non‐Black women in the highest tertile of MSDS.
The study authors concluded that the Mediterranean-style diet may help lower preeclampsia risk. “This finding remains significant after adjusting for various sociodemographic and preexisting clinical risk factors. Black women may be the most likely to benefit from a Mediterranean‐style diet,” they concluded.
1. Minhas AS, Hong X, Wang G, et al. Mediterranean-style diet and risk of preeclampsia by race in the Boston birth cohort. J Am Heart Assoc. 2022;0:e022589. doi:10.1161/JAHA.121.022589
2. Rhee DK, Ji Y, Hong X, Pearson C, Wang X, Caulfield LE. Mediterranean‐style diet and birth outcomes in an urban, multiethnic, and low‐income US population. Nutrients. 2021;13:1188. doi:10.3390/nu13041188