A Mediterranean-style diet can reduce the risk of preeclampsia by at least 20%

A new study by Johns Hopkins Medicine that surveyed an ethnically diverse group of more than 8,000 women added evidence that a Mediterranean-style diet can reduce the risk of pre-eclampsia by at least 20%. Pre-eclampsia is a potentially fatal complication of pregnancy characterized by high blood pressure and organ damage that appears late in pregnancy or shortly after delivery. Worldwide, it is an important cause of maternal and fetal death and premature birth. In the United States, preeclampsia occurs in about 2%-6% of women, and twice as often in black women than in other racial groups.

A report on the new study, published April 20 in the journal Journal of the American Heart Associationfound that women who reported eating a Mediterranean-style diet had a 20% or more lower risk of pre-eclampsia overall, even after taking into account a variety of other risk factors.

The Mediterranean diet consists largely of vegetables, fruits, fish, nuts, olive oil, whole grains, and very limited amounts of red meat and processed foods. It has been linked for decades to a reduced risk of cardiovascular disease.

The United States is the only developed country that has seen an increase in maternal mortality and morbidity rates, so we are excited about this new finding that reinforces recommendations that a healthy diet is a safe way to help reduce the risk of pregnancy complications.”

Anum Minhas, MD, MHS, senior fellow in cardiology and lead author of the study

For the study, researchers surveyed 8,507 women enrolled in the Boston Birth Cohort Study between 1999 and 2014, a project originally designed to investigate genetic and environmental factors associated with premature births. Overall, 47% of the study participants were black, 28% were Hispanic and the remaining 25% were white or of other races. The average age was 28 years.

Participants were asked to complete a nutritional survey within 24-72 hours after birth, with questions focusing on how often Mediterranean-style foods were eaten throughout pregnancy. Based on the responses, a diet score was assigned to the participants and they were categorized into three groups for analysis and comparison. The higher results reflected a higher frequency of consumption of Mediterranean foods.

A total of 10% of the women surveyed (848) developed preeclampsia. After adjusting the categories for age, race, education, marital status, smoking, previous pregnancies, and obesity, the investigators reported:

  • Compared with women who scored in the lowest group, women who scored in the middle and higher group had 28% and 22% lower risks of pre-eclampsia.
  • Black women who followed a Mediterranean-style diet and scored in the highest group were 26% less likely to have pre-eclampsia compared to those who scored in the lowest group.
  • Women entering pregnancy with chronic hypertension had a nine-fold increased risk of pre-eclampsia compared to women who entered pregnancy without a previous history of hypertension.
  • Women with pre-existing diabetes and obesity had twice the risk of developing pre-eclampsia compared to women without these conditions.

In addition to the association of a healthy diet with pregnancy outcomes in general, the study suggests, Minhas says, that racial differences in preeclampsia rates in the United States may be related more to socioeconomic factors than genetic or biological factors because all racial groups benefited from the diet. .

Noel Mueller, PhD, associate professor at the Johns Hopkins Bloomberg School of Public Health and senior author of the study.

“These new findings are exciting in the context of other data showing that after pregnancy, greater adherence to a Mediterranean-style diet is associated with lower blood pressure, improved blood lipids and a reduced risk of future cardiovascular diseases such as heart attacks and strokes. Erin Michus, MD, associate director of Preventive Cardiology at Johns Hopkins Medicine and co-author of this study. “Lifestyle is influential – one can alter the course of his health by following a healthy diet, along with regular physical activity and not smoking.”

Sharon Smith, PhD, an epidemiologist and program officer in the Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, agreed. “The results of this observational study suggest that a heart-healthy diet is associated with lower blood pressure in pregnant women who are at risk for pre-eclampsia,” Smith said. “The results in black women are particularly encouraging due to the higher rates of preeclampsia and negative outcomes compared to other groups. We look forward to future dietary studies confirming these findings in an effort to reduce maternal mortality and associated health disparities.”


Journal reference:

Minhas, A.; et al. (2022) The Mediterranean-style diet and risk of pre-eclampsia by race in a Boston birth cohort. Journal of the American Heart Association. doi.org/10.1161/JAHA.121.022589.


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