34159db86e90ed9d977cf86b0c66502a nutrients-16-01604.pdf e8127df68df363702d7b17e094d7b021b8f118f7 nutrients-16-01604.pdf 6450ea19268fdc3ecf1d3334263a8ace0b759b6ad7a1763597d7eebfa64605ec nutrients-16-01604.pdf Title: The Mediterranean Diet in Pregnancy: Implications for Maternal Brain Morphometry in a Secondary Analysis of the IMPACT BCN Randomized Clinical Trial Subject: Introduction: A Mediterranean diet has positive effects on the brain in mid-older adults; however, there is scarce information on pregnant individuals. We aimed to evaluate the effect of a structured Mediterranean diet intervention on the cortical structure of the maternal brain during pregnancy. Methods: This study was a secondary analysis of the IMPACT BCN, a randomized clinical trial with 1221 high-risk pregnant women randomly allocated into three groups at 19–23 weeks of gestation: Mediterranean diet intervention, a mindfulness-based stress reduction program, or usual care. Maternal brain magnetic resonance imaging was performed during the third trimester of pregnancy in a random subgroup of participants. For this study, data from the Mediterranean diet and usual groups were analyzed. Maternal dietary intake, adherence to the Mediterranean diet and metabolite biomarkers were evaluated using a food frequency questionnaire, a 17-item dietary screener and plasma/urine samples, respectively. Results: The cluster-wise analysis showed that the Mediterranean diet group participants (n = 34) had significantly larger surface areas in the right precuneus (90%CI: <0.0001–0.0004, p < 0.001) and left superior parietal (90%CI: 0.026–0.033, p = 0.03) lobules compared to the usual care group participants (n = 37). A larger right precuneus area was associated with high improvements in adherence to the Mediterranean diet, a high intake of walnuts and high concentrations of urinary hydroxytyrosol. A larger left superior parietal area was associated with a high intake of walnuts and high concentrations of urinary hydroxytyrosol. Conclusions: The promotion of a Mediterranean diet during pregnancy has a significant effect on maternal brain structure. Keywords: Mediterranean diet; pregnancy; magnetic resonance; cortical area; randomized clinical trial Author: Ayako Nakaki, Yvan Gomez, Sara Castro-Barquero, Allegra Conti, Kilian Vellvé, Irene Casas, Mariona Genero, Lina Youssef, Laura Segalés, Leticia Benitez, Rosa Casas, Eduard Vieta, Nuria Bargallo, Nicola Toschi, Ramon Estruch, Fàtima Crispi, Eduard Gratacos and Francesca Crovetto Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Fri May 24 10:52:27 2024 CEST ModDate: Fri May 24 11:45:51 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 996408 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MWJZGO+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 YJUFXP+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 QOEELZ+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 FMQRRJ+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 SDIDBK+VnURWPalladioL Type 1 Custom yes yes yes 32 0 HGMNRX+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 48 0 LKBIFC+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 81 0 LKBIGD+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 87 0 LKBJAA+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 93 0 LKBJAB+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 99 0 LKBJAC+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 102 0 LKBJAD+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 105 0 LKBJJB+PalatinoLinotype-Roman TrueType MacRoman yes yes no 108 0 OHXQCJ+CMSY10 Type 1 Builtin yes yes yes 120 0 CKBPVA+EURM10 Type 1 Builtin yes yes yes 128 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes yes 136 0 LKBIFC+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 147 0 LKBOHH+SegoeUIHistoric TrueType WinAnsi yes yes no 153 0 LKBOMH+Calibri TrueType WinAnsi yes yes no 156 0 LKBOPI+ArialMT TrueType WinAnsi yes yes no 159 0 LKBIGD+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 162 0 LKBJAA+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 168 0 LKBJAB+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 174 0 LKBJAC+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 177 0 LKBJAD+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 180 0 LKBJJB+PalatinoLinotype-Roman TrueType MacRoman yes yes no 183 0 HHFREY+EURM7 Type 1 Builtin yes yes yes 190 0 FHBIAZ+EURB7 Type 1 Builtin yes yes yes 195 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-06-20 02:40:14 CEST RepresentationInformation: nutrients-16-01604.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-06-19 19:07:52 CEST Size: 996408 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 408 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 Population and Design Destination: subsection.2.1 Item: Title: Maternal Brain MR Acquisition and Processing Destination: subsection.2.2 Item: Title: Dietary Questionnaires and Biomarkers Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Characteristics of the Study Population Destination: subsection.3.1 Item: Title: Maternal Brain MR Results Destination: subsection.3.2 Item: Title: Association of Maternal Brain MR and Diet Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: The Mediterranean Diet in Pregnancy: Implications for Maternal Brain Morphometry in a Secondary Analysis of the IMPACT BCN Randomized Clinical Trial Author: Ayako Nakaki, Yvan Gomez, Sara Castro-Barquero, Allegra Conti, Kilian Vellvé, Irene Casas, Mariona Genero, Lina Youssef, Laura Segalés, Leticia Benitez, Rosa Casas, Eduard Vieta, Nuria Bargallo, Nicola Toschi, Ramon Estruch, Fàtima Crispi, Eduard Gratacos and Francesca Crovetto Subject: Introduction: A Mediterranean diet has positive effects on the brain in mid-older adults; however, there is scarce information on pregnant individuals. We aimed to evaluate the effect of a structured Mediterranean diet intervention on the cortical structure of the maternal brain during pregnancy. Methods: This study was a secondary analysis of the IMPACT BCN, a randomized clinical trial with 1221 high-risk pregnant women randomly allocated into three groups at 19 23 weeks of gestation: Mediterranean diet intervention, a mindfulness-based stress reduction program, or usual care. Maternal brain magnetic resonance imaging was performed during the third trimester of pregnancy in a random subgroup of participants. For this study, data from the Mediterranean diet and usual groups were analyzed. Maternal dietary intake, adherence to the Mediterranean diet and metabolite biomarkers were evaluated using a food frequency questionnaire, a 17-item dietary screener and plasma/urine samples, respectively. Results: The cluster-wise analysis showed that the Mediterranean diet group participants (n = 34) had significantly larger surface areas in the right precuneus (90%CI: <0.0001 0.0004, p < 0.001) and left superior parietal (90%CI: 0.026 0.033, p = 0.03) lobules compared to the usual care group participants (n = 37). A larger right precuneus area was associated with high improvements in adherence to the Mediterranean diet, a high intake of walnuts and high concentrations of urinary hydroxytyrosol. A larger left superior parietal area was associated with a high intake of walnuts and high concentrations of urinary hydroxytyrosol. Conclusions: The promotion of a Mediterranean diet during pregnancy has a significant effect on maternal brain structure. 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