Summary: In a large randomised trial in pregnant women, a nutritionist-designed video promoting the Mediterranean diet improved dietary adherence and reduced the incidence of gestational diabetes from 25.1% to 20.7%, along with fewer adverse maternal and neonatal outcomes.
PICO Summary
| Element | Detail |
|---|---|
| Population | 1,750 consecutive pregnant women; randomised controlled trial, Spain. |
| Intervention | A nutritionist-designed video promoting a Mediterranean diet and physical activity (n≈875). |
| Comparison | Standard care with verbal and printed advice (n≈875). |
| Outcome | The video group increased their Mediterranean Diet Adherence Screener score (mean difference 0.41; 95% CI 0.23–0.60; p<0.001), mainly via more olive oil and nuts and fewer juices and sweets. GDM incidence fell from 25.1% to 20.7% (p=0.025), with significant reductions in gestational hypertension, episiotomy, and neonatal intensive care admissions. |
Mediterranean-diet video in pregnancy
RCT · pregnant women · to delivery
A nutritionist-designed Mediterranean-diet video improved adherence and cut gestational diabetes from 25.1% to 20.7%, with fewer adverse maternal and neonatal outcomes.
Expert Commentary
This is a strong and practically important trial, and its scale of 1,750 women gives it more weight than most dietary-intervention studies in pregnancy. The intervention is clever precisely because it is scalable: many health systems lack the nutritionists to deliver intensive in-person counselling, and a well-made video that women can rewatch and share with family who cook meals addresses a real implementation gap. The results are coherent and clinically meaningful, with improved diet adherence translating into a roughly four-percentage-point absolute fall in gestational diabetes and, notably, downstream reductions in hypertension and neonatal intensive care admissions, which speaks to genuine maternal-neonatal benefit rather than a surrogate alone. This aligns with the St Carlos and ESTEEM Mediterranean-diet trials while extending them to low-cost delivery. The honest limits are that the video content and population are Spanish, so cultural adaptation would be needed elsewhere, and adherence everywhere is shaped by food cost and access. Can I use this with my patients? Yes, confidently. It supports recommending a Mediterranean dietary pattern specifically, rather than generic healthy-eating advice, early in pregnancy for women at risk of gestational diabetes, and supports using accessible video education as a legitimate delivery tool.
References
Martín-O’Connor R, Ramos-Levi AM, Saviron-Cornudella R, et al. Nutritionist-guided video intervention improves adherence to Mediterranean diet and reduces the rate of gestational diabetes mellitus: a randomized clinical trial. Nutrients. 2025;17(22):3533. doi:10.3390/nu17223533