Effect of Mediterranean Diet During Pregnancy on the Onset of Overweight and Obesity in the Offspring (PREMEDI)

June 6, 2022 updated by: Roberto Berni Canani, MD, PhD, Federico II University

Effect of Mediterranean Diet During Pregnancy on the Onset of Overweight and Obesity at 24 Months in the Offspring

The first 1,000 days of life, from the conception to 24 months, are crucial to achieve long-term health outcomes and represent a strategic period to intervene under prevention and public health perspective. Nutritional exposures during this critical period of life can influence the future disease susceptibility. Maternal diet during pregnancy has been linked to offspring overweight/obesity risk and it could represent a potential target for overweight/obesity prevention. The Mediterranean Diet (MD) is considered one of the healthiest dietary models, which impacts beneficially the gut microbiome (GM), providing high amounts of fiber, antioxidants polyphenols and vitamins, and a balanced ratio of essential fatty acids (ω6:ω3). Notably, the MD beneficial effects are due to the synergistic and interactive combinations of nutrients, and the modulation of gene expression through epigenetic changes. Unofrtunately, the MD mechanisms during pregnancy in the prevention of childhood overweight/obesity are not yet fully known.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The PREMEDI study has been designed to evaluate the effects of Mediterranean Diet during pregnancy on the occurrence of overweight/obesity at 24 months in the offspring.

Study Type

Interventional

Enrollment (Actual)

100

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Naples, Italy, 80131
        • University of Naples Federico II

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 35 years (ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • women
  • caucasian ethnicity
  • aged between 20 and 35 years

Exclusion Criteria:

  • proven presence of infections during pregnancy and at delivery,
  • twin pregnancy,
  • ongoing malignancies,
  • major gastrointestinal tract malformations,
  • immunodeficiencies,
  • diabetes and other chronic diseases at each organ or apparatus level,
  • chronic intestinal inflammatory diseases,
  • gastrointestinal function disorders,
  • celiac disease;
  • history of abdominal surgery with intestinal resection,
  • neuropsychiatric disorders,
  • central nervous system disorders,
  • vegan diet.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: PREVENTION
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
NO_INTERVENTION: Pregnant women at standard diet
obstetrical and gynecological follow-up
EXPERIMENTAL: Pregnant women at mediterranean diet
obstetrical and gynecological follow-up + nutritional counseling
The Mediterranean diet (MD) is highly regarded as a healthy balanced diet. It is distinguished by a beneficial fatty acid profile that is rich in both monounsaturated and polyunsaturated fatty acids, high levels of polyphenols and other antioxidants, high intake of fiber and other low glycemic carbohydrates, and relatively greater vegetable than animal protein intake. Specifically, olive oil, assorted fruits, vegetables, cereals, legumes, and nuts; moderate consumption of fish, poultry, and red wine; and a lower intake of dairy products, red meat, processed meat and sweets characterize the traditional MD.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The effects of Mediterranean Diet in pregnancy on the occurrence of overweight/obesity at 24 months in the offspring
Time Frame: After 24 months from the delivery
The children body growth indices are evaluated at 24 months
After 24 months from the delivery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The effect of Mediterranean Diet pregnancy on the composition of maternal gut microbiota through analysis of gut microbiota composition.
Time Frame: after 9 months (at the end of the pregnancy)
Fecal bacteria DNA will be extracted using standard technique outlined by the Earth Microbiome Project. 16S V4-region amplicon libraries will be produced using previously described primers and sequenced using the IlluminaMiSeqplatform (150bpx2). Bacterial load will be determined by qPCR using a standard curve derived from a plasmid containing a single copy of the 16S rRNAencoding gene. Sequence data has been deposited in MG RAST under accession numbers 4571868.3-4571924.3 and project number 10023. Paired end reads will be quality trimmed and processed for OTU (operational taxonomic unit) clustering using UPARSE pipeline, set at 0.97% identity cutoff. Taxonomic status will be assigned to the high quality (<1% incorrect bases) candidate OTUs using the "parallel_assign_taxonomy_rdp.py" script of QIIME software. Multiple sequence alignment and phylogenetic reconstruction will be performed using PyNast and FastTree.
after 9 months (at the end of the pregnancy)
The effect of Mediterranean diet in pregnancy on the production of short chain fatty acids (butyrate and propionate) in the intestinal tract.
Time Frame: after 9 months (at the end of the pregnancy)
Fecal SCFAs concentration Frozen feces weighing 1g will be diluted with saline solution, vortexed, and centrifuged. Supernatants will be filtered and stored at -20°C until analysis. Frozen fecal extracts will be acidified and extracted in duplicate. A quantity of the pooled extract containing acidified butyrate, propionate or acetate will be transferred into a 2ml glass vial and loaded onto an Agilent Technologies 7890 gas chromatograph (GC) system. Detection will be achieved using a flame ionization detector. Peaks will be identified using a mixed external standard and quantified by peak height/internal standard ratio. To examine whether fecal butyrate levels correlates with bacterial diversity (Shannon diversity index) and evenness (Pielou's evenness index) and abundance patterns across multiple groups we will calculate the Spearman correlation using the cor.test function implemented in R (http://www.r-project.org/
after 9 months (at the end of the pregnancy)
The adherence to Mediterranean Diet in the enrolled women
Time Frame: from 0 to 9 months (at the end of pregnancy)
Women Mediterranean Diet adherence score is evaluated through the "Med Diet Score"
from 0 to 9 months (at the end of pregnancy)
The effect of dietary counseling on dietary habits
Time Frame: from 0 to 9 months (at the end of pregnancy)
The diet composition in macro- and micronutrients is evaluated
from 0 to 9 months (at the end of pregnancy)
The effect of Mediterranean diet in pregnancy on the maternal weight gain and complications
Time Frame: from 0 to 9 months (at the end of pregnancy)
To evaluate the effect of Mediterranean diet in pregnancy on the maternal weight gain and complications (gestational hypertension, infections, gestational diabetes, preeclampsia, use of cesarean)
from 0 to 9 months (at the end of pregnancy)
The effect of Mediterranean diet in pregnancy on perinatal and fetal complications
Time Frame: from 0 to 9 months (at the end of pregnancy)
Perinatal and fetal complications occurrence are evaluated
from 0 to 9 months (at the end of pregnancy)
The effect of Mediterranean Diet in pregnancy on the duration of breastfeeding and the composition of breast milk
Time Frame: from 0 to 4 months lactation
The effect of Mediterranean Diet in pregnancy on the duration of breastfeeding and the composition of breast milk (short chain fatty acids, bacterial DNA, adipocytokines.
from 0 to 4 months lactation
The effect of Mediterranean Diet on the occurrence of allergies and use of antibiotics in the first 2 years of life.
Time Frame: Every 6 months from offspring birth to 2 years
The occurrence of allergies and the use of antibiotics in the first 2 years of life are evaluated
Every 6 months from offspring birth to 2 years
The effect of Mediterranean Diet on the epigenetic modulation of genes involved in the regulation of immune system and metabolic pathways in the offspring
Time Frame: At delivery
The evaluation of the effect of Mediterranean Diet during pregnancy on the epigenetic modulation of genes involved in the immune system and metabolic pathways in the offspring through the cord blood epigenome-wide association study
At delivery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Roberto Berni Canani, Department of Traslational Medical Science, University of Naples Federico II

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

November 30, 2017

Primary Completion (ACTUAL)

November 30, 2020

Study Completion (ACTUAL)

January 31, 2021

Study Registration Dates

First Submitted

November 2, 2017

First Submitted That Met QC Criteria

November 8, 2017

First Posted (ACTUAL)

November 9, 2017

Study Record Updates

Last Update Posted (ACTUAL)

June 8, 2022

Last Update Submitted That Met QC Criteria

June 6, 2022

Last Verified

June 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • 298/16

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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