{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T17:48:26Z","timestamp":1779904106642,"version":"3.53.1"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T00:00:00Z","timestamp":1559001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III of Spain","award":["PI14\/01563"],"award-info":[{"award-number":["PI14\/01563"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>We reported that a Mediterranean Diet (MedDiet), supplemented with extra-virgin olive oil (EVOO) and pistachios, reduces GDM incidence and several other adverse outcomes. In order to assess its translational effects in the real world we evaluated the effect of MedDiet from 1st gestational visit in GDM rate compared with control (CG) and intervention (IG) groups from the previously referred trial. As secondary objective we also compared adverse perinatal outcomes between normoglycemic and diabetic women. This trial is a prospective, clinic-based, interventional study with a single group. 1066 eligible normoglycaemic women before 12 gestational weeks were assessed. 932 women (32.4 \u00b1 5.2 years old, pre-gestational BMI 22.5 \u00b1 3.5 kg\/m2) received a motivational lifestyle interview with emphasis on daily consumption of EVOO and nuts, were followed-up and analysed. Binary regression analyses were used to examine the risk for each pregnancy outcome, pregnancy-induced hypertension, preeclampsia, gestational weight gain (GWG), caesarean-section, perineal trauma, preterm delivery, small (SGA) and large for gestational age (LGA), and Neonatal Intensive Care Unit admissions. GDM was diagnosed in 13.9%. This rate was significantly lower than the CG: RR 0.81 (0.73\u20130.93), p &lt; 0.001 and no different from the IG: RR 0.96 (0.85\u20131.07), p = 0.468. GWG was lower in diabetic women (10.88 \u00b1 6.46 vs. 12.30 \u00b1 5.42 Kg; p = 0.013). Excessive weight gain (EWG) was also lower in GDM [RR 0.91 (0.86\u20130.96); p &lt; 0.001] without a significant increase of insufficient weight gain. LGA were also lower (1 (0.8%) vs. 31 (3.9%); p &lt; 0.05)), and SGA were similar (5 (3.8%) vs. 30 (3.7%)). LGA were associated to EWG (RR 1.61 (1.35\u20131.91), p &lt; 0.001). Differences in other maternal-foetal outcomes were not found. In conclusions an early MedDiet nutritional intervention reduces GDM incidence and maternal-foetal adverse outcomes and should be universally applied as 1st line therapy. GDM might not be consider as a high risk pregnancy any longer.<\/jats:p>","DOI":"10.3390\/nu11061210","type":"journal-article","created":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T11:18:09Z","timestamp":1559042289000},"page":"1210","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Effectiveness of Following Mediterranean Diet Recommendations in the Real World in the Incidence of Gestational Diabetes Mellitus (GDM) and Adverse Maternal-Foetal Outcomes: A Prospective, Universal, Interventional Study with a Single Group. The St Carlos Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Nuria","family":"Garc\u00eda de la Torre","sequence":"first","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6217-3770","authenticated-orcid":false,"given":"Carla","family":"Assaf-Balut","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00e9s","family":"Jim\u00e9nez Varas","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"del Valle","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Dur\u00e1n","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Preventive Medicine Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00e1yade","family":"del Prado","sequence":"additional","affiliation":[{"name":"Preventive Medicine Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bordi\u00fa","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4562-5381","authenticated-orcid":false,"given":"Johanna Josefina","family":"Valerio","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel A.","family":"Herraiz","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Gynecology and Obstetrics Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Izquierdo","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Gynecology and Obstetrics Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jos\u00e9","family":"Torrej\u00f3n","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Angeles","family":"Cuadrado","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Clinical Laboratory Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paz","family":"de Miguel","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Familiar","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Runkle","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Barabash","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0495-6240","authenticated-orcid":false,"given":"Miguel A.","family":"Rubio","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3628-9323","authenticated-orcid":false,"given":"Alfonso L.","family":"Calle-Pascual","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico Universitario San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), 28040 Madrid, Spain"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1056\/NEJMoa0707943","article-title":"Hyperglycemia and adverse pregnancy outcomes","volume":"358","author":"Metzger","year":"2008","journal-title":"N. 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