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Medical nutrition therapy for gestational diabetes mellitus based on Mediterranean Diet principles: a subanalysis of the St Carlos GDM Prevention Study
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  • Published on:
    Is added certain portion on Mediterranean Diet highly necessary?
    • Alfonso Calle-Pascual, Professor Hospital Clínico San Carlos
    • Other Contributors:
      • Carla Assaf-Balut, Nutrtitionist
      • Nuria Garcia de la Torre, MDPhD
      • Miguel A. Rubio, MDPhD

    We thank the authors for their question and interest in our article. The two cited articles (1,2) are very interesting but differ from what we wanted to show with the St. Carlos GDM Prevention Study (3). The first one is a case-control study analyzing associations of DASH and Mediterranean diets with GDM (1). The second one evaluates the effect of a nutritional intervention with a Mediterranean diet on postpartum development of glucose disorders in women with prior GDM (2). The St. Carlos GDM Prevention Study was a randomized controlled trial that analyzed the effect a nutritional intervention with a MedDiet, supplemented with extra virgin olive oil and nuts, on GDM development.
    The motive women were given extra virgin olive oil was to ensure a high compliance with the MedDiet. Not only women increased their intake in these two foods, but also increased their overall MEDAS score (3). This also seemed to translate in a substitution of unhealthy foods for healthy ones. For example, a substitution of unhealthy snacks for nuts and of processed sauces and dressings for olive oil and olive oil-based sauces. The ultimate message we were hoping to convey is that extra virgin olive oil and nuts should be consumed more, with less restrictions. Current Spanish guidelines advise a controlled consumption of these foods in pregnancy.
    The type of medical nutrition therapy used in GDM treatment is not standardized and can be different between centers. Due to the results found...

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    Conflict of Interest:
    None declared.
  • Published on:
    Is added certain portion on Mediterranean Diet highly necessary?
    • Rathi Paramastri, Nutritionist/Master Student in Nutrition and Health Sciences Taipei Medical University, School of Nutrition and Health Sciences
    • Other Contributors:
      • Usman Iqbal, Researcher, Lecturer

    It’s appreciated for addressing an interesting area of research about the efficacy of medical nutrition treatment based on the Mediterranean Diet (MedDiet).
    The study was a secondary analysis of the St Carlos GDM Prevention Study, conducted between January and December 2015 in Hospital Clinico San Carlos (Madrid, Spain). The author used MedDiet-MNT in order to observe its effects on mother’s glycemic level and also the prenatal outcome.
    According to this study, there were two groups. Both groups received dietary recommendation to follow MD guideline, the difference was just in intervention group, they added portion for virgin olive oil and nuts. Basically both groups had similar diet recommendation, so further clinical experiment is highly needed to determine the exact effect of adding portion in extra virgin olive oil and nuts on lowering risk of GDM.
    Although this diet had several benefits, the use of adding portion on extra virgin oil and pistachios in the intervention group treatment still becomes a question. In the other study, traditional Mediterranean diet had positive effect on lowering risk of GDM in pregnant women (Izadi, 2016), this outcome also occurred in the study conducted by Perez,Ferre (2014) that MD could reduce risk of GDM. So, if the traditional way has been reported successful in lowering GDM risk, is that really necessary to modify the basic guideline of MedDiet?

    1. Izadi V, Tehrani H, Haghighatdoost F, et.a...

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    Conflict of Interest:
    None declared.