cd38f904c0060cd14472d8f7e30abced 289945.pdf 37da009a8dc1565268ff114fd009807bf41e55e9 289945.pdf c089d5bf967e5dc07d743fa5ebc6d32e3e8fd52c1ed665a877f643642e9e5511 289945.pdf Title: Effects of a Mediterranean Diet Intervention on Maternal Stress, Well-Being, and Sleep Quality throughout Gestation—The IMPACT-BCN Trial Subject: Stress and anxiety are frequent occurrences among pregnant women. We aimed to evaluate the effects of a Mediterranean diet intervention during pregnancy on maternal stress, well-being, and sleep quality throughout gestation. In a randomized clinical trial, 1221 high-risk pregnant women were randomly allocated into three groups at 19–23 weeks’ gestation: a Mediterranean diet intervention, a Mindfulness-Based Stress Reduction program, or usual care. All women who provided self-reported life-style questionnaires to measure their anxiety (State Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS)), well-being (WHO Five Well Being Index (WHO-5)), and sleep quality (Pittsburgh sleep quality index (PSQI)) at enrollment and at the end of the intervention (34–36 weeks) were included. In a random subgroup of 106 women, the levels of cortisol and related metabolites were also measured. At the end of the intervention (34–36 weeks), participants in the Mediterranean diet group had significantly lower perceived stress and anxiety scores (PSS mean (SE) 15.9 (0.4) vs. 17.0 (0.4), p = 0.035; STAI-anxiety mean (SE) 13.6 (0.4) vs. 15.8 (0.5), p = 0.004) and better sleep quality (PSQI mean 7.0 0.2 SE vs. 7.9 0.2 SE, p = 0.001) compared to usual care. As compared to usual care, women in the Mediterranean diet group also had a more significant increase in their 24 h urinary cortisone/cortisol ratio during gestation (mean 1.7 SE 0.1 vs. 1.3 SE 0.1, p < 0.001). A Mediterranean diet intervention during pregnancy is associated with a significant reduction in maternal anxiety and stress, and improvements in sleep quality throughout gestation. Keywords: Mediterranean diet; pregnancy; anxiety; well-being; sleep quality Author: Irene Casas, Ayako Nakaki, Rosalia Pascal, Sara Castro-Barquero, Lina Youssef, Mariona Genero, Leticia Benitez, Marta Larroya, Maria Laura Boutet, Giulia Casu, Alex Gomez-Gomez, Oscar J. Pozo, Ivette Morilla, Anabel Martínez-Àran, Eduard Vieta, María Dolores Gómez-Roig, Rosa Casas, Ramon Estruch, Eduard Gratacos, Fàtima Crispi and Francesca Crovetto Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu May 18 07:58:12 2023 CEST ModDate: Fri May 26 18:05:53 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1390911 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MELNXZ+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 LEQYSX+VnURWPalladioL Type 1 Custom yes yes no 15 0 DRYPXN+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 YGMXMS+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 TIPHPZ+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 GQWIGS+CMSY10 Type 1 Builtin yes yes no 32 0 HGMNRX+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 78 0 LAAFMG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 89 0 LAAFMI+PalatinoLinotype TrueType WinAnsi yes yes no 92 0 LAAFMK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 95 0 LAAJME+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 98 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 105 0 LAAFMG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 122 0 LAAFMH+PalatinoLinotype CID TrueType Identity-H yes yes yes 125 0 LAAFMI+PalatinoLinotype TrueType WinAnsi yes yes no 131 0 LAAFMK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 134 0 LAAJME+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 137 0 LAAFMG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 151 0 LAAFMI+PalatinoLinotype TrueType WinAnsi yes yes no 154 0 LAAFMK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 157 0 LAAJME+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 160 0 LAAFMG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 177 0 LAAFMI+PalatinoLinotype TrueType WinAnsi yes yes no 180 0 LAAFMK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 183 0 LAAJME+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 186 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-03-16 02:37:45 CET RepresentationInformation: 289945.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-03-15 08:56:34 CET Size: 1390911 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 406 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design, Population and Ethics Destination: subsection.2.1 Item: Title: Interventions and Measurements Destination: subsection.2.2 Children: Item: Title: Mediterranean Diet Program Destination: subsubsection.2.2.1 Item: Title: Usual Care (Control Group) Destination: subsubsection.2.2.2 Item: Title: Outcomes Destination: subsection.2.3 Item: Title: Data Collection Destination: subsection.2.4 Item: Title: Sample Collection Destination: subsection.2.5 Item: Title: Statistical Analysis Destination: subsection.2.6 Item: Title: Results Destination: section.3 Children: Item: Title: Study Population and Pregnancy Outcomes Destination: subsection.3.1 Item: Title: Effects of Mediterranean Diet on Stress, Anxiety, Well-Being, Sleep Quality and Mindful State Destination: subsection.3.2 Children: Item: Title: Life-Style Questionnaires Destination: subsubsection.3.2.1 Item: Title: Cortisol Assessment Destination: subsubsection.3.2.2 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.A. Info: Title: Effects of a Mediterranean Diet Intervention on Maternal Stress, Well-Being, and Sleep Quality throughout Gestation The IMPACT-BCN Trial Author: Irene Casas, Ayako Nakaki, Rosalia Pascal, Sara Castro-Barquero, Lina Youssef, Mariona Genero, Leticia Benitez, Marta Larroya, Maria Laura Boutet, Giulia Casu, Alex Gomez-Gomez, Oscar J. Pozo, Ivette Morilla, Anabel Martínez-Àran, Eduard Vieta, María Dolores Gómez-Roig, Rosa Casas, Ramon Estruch, Eduard Gratacos, Fàtima Crispi and Francesca Crovetto Subject: Stress and anxiety are frequent occurrences among pregnant women. We aimed to evaluate the effects of a Mediterranean diet intervention during pregnancy on maternal stress, well-being, and sleep quality throughout gestation. In a randomized clinical trial, 1221 high-risk pregnant women were randomly allocated into three groups at 19 23 weeks’ gestation: a Mediterranean diet intervention, a Mindfulness-Based Stress Reduction program, or usual care. All women who provided self-reported life-style questionnaires to measure their anxiety (State Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS)), well-being (WHO Five Well Being Index (WHO-5)), and sleep quality (Pittsburgh sleep quality index (PSQI)) at enrollment and at the end of the intervention (34 36 weeks) were included. In a random subgroup of 106 women, the levels of cortisol and related metabolites were also measured. At the end of the intervention (34 36 weeks), participants in the Mediterranean diet group had significantly lower perceived stress and anxiety scores (PSS mean (SE) 15.9 (0.4) vs. 17.0 (0.4), p = 0.035; STAI-anxiety mean (SE) 13.6 (0.4) vs. 15.8 (0.5), p = 0.004) and better sleep quality (PSQI mean 7.0 0.2 SE vs. 7.9 0.2 SE, p = 0.001) compared to usual care. As compared to usual care, women in the Mediterranean diet group also had a more significant increase in their 24 h urinary cortisone/cortisol ratio during gestation (mean 1.7 SE 0.1 vs. 1.3 SE 0.1, p < 0.001). A Mediterranean diet intervention during pregnancy is associated with a significant reduction in maternal anxiety and stress, and improvements in sleep quality throughout gestation. 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