Improving Adherence to the Mediterranean Diet in Early Pregnancy Using a Clinical Decision Support System; A Randomised Controlled Clinical Trial

Abstract

Prenatal health is important for both mother and child. Additionally, the offspring’s development is affected by the mother’s diet. The aim of this study was to assess whether a Clinical Decision Support System (CDSS) can improve adherence to the Mediterranean diet in early pregnancy and whether this change is accompanied by changes in nutritional status and psychological parameters. We designed a three month randomised controlled clinical trial which was applied to 40 healthy pregnant women (20 in the CDSS and 20 in the control group). Medical history, biochemical, anthropometric measurements, dietary, and a psychological distress assessment were applied before and at the end of the intervention. Pregnant women in the CDSS group experienced a greater increase in adherence to the Mediterranean diet, as assessed via MedDietScore, in the first trimester of their pregnancy compared to women in the control group (p < 0.01). Furthermore, an improved nutritional status was observed in pregnant women who were supported by CDSS. Anxiety and depression levels showed a greater reduction in the CDSS group compared to the control group (p = 0.048). In conclusion, support by a CDSS during the first trimester of pregnancy may be beneficial for the nutritional status of the mother, as well as for her anxiety and depression status.

Anemia in Pregnant Women as a Cultural Phenomenon: A Literature Review

“…The relationship between anemia and various causal factors is reviewed in 5 articles by Rekha et al (2019); Mohammed et al (2019); Teshome et al (2020); Agbozo et al (2020); Muthuraj et al (2023). Detection of anemia and malnutrition and interventions to treat anemia are described in 4 articles by Angraini et al (20230, Citrakesumasari et al (2020), Nahrisah et al (2020), Papandreou et al (2023), and 1 article on the impact of anemia in pregnant women on babies born is explained by Sah et al (2022). The results of the article review can be seen in 1 below:…”

“…Providing information about local food that contains iron (Darmawati et al, 2020) as well as health education based on local wisdom (Darmawati et al, 2022). Papandreou et al, 2023 stated that the group of pregnant women were more compliant (p<0.01) when given a local food diet in early pregnancy and experienced an increase in nutritional status. Anxiety and depression decreased among pregnant women who received local traditional food menus (p=0.048), compared to the control group.…”

“…Previous literature studies did not explain the supportive environment that pregnant women need to follow food habits during their pregnancy. Angraini et al (20230, Citrakesumasari et al (2020), Nahrisah et al (2020), Papandreou et al (2023), and 1 article on the impact of anemia in pregnant women on babies born is explained by Sah et al (2022). The results of the article review can be seen in 1 below: because religious beliefs that fasting for pregnant women is a spiritual practice so as not to harm pregnancy (Workneh et al, 2023 ).…”

“…Providing information about local food that contains iron as well as health education based on local wisdom (Darmawati et al, 2022). Papandreou et al, 2023…”

Mediterranean Diet and Physical Activity Nudges versus Usual Care in Women with Rheumatoid Arthritis: Results from the MADEIRA Randomized Controlled Trial

“…A CDSS platform was used for the delivery of the patient education, as previously detailed [ 41 , 42 ]. The specific CDSS was developed during 2016 and has been used in clinical practice as a complementary tool for the hospital’s dieticians and as a patient nudge tool [ 41 , 43 ]. CDSS platforms are employed to improve the delivery of healthcare interventions by facilitating medical decisions through the provision of targeted knowledge and health information [ 44 ].…”