Al Wattar BH, et al. - Through a multicenter randomized trial conducted in five maternity units (four in London and one in Birmingham) between September 12, 2014 and February 29, 2016, researchers evaluated if a Mediterranean-style diet decreased adverse pregnancy outcomes in high-risk women. A total of 7,950 women were screened and 1,252 pregnant women with metabolic risk factors were randomized to a Mediterranean-style diet (supplemented with mixed nuts and extra virgin olive oil) or routine antenatal care. Overall maternal (gestational diabetes or preeclampsia) and offspring outcomes (small-for-gestational-age, stillbirth, or admission to the neonatal care unit) were then evaluated in the Effect of Simple, Targeted Diet in Pregnant Women With Metabolic Risk Factors on Pregnancy Outcomes (ESTEEM) study. In comparison to those who had routine care, pregnant women on the Mediterranean-style diet ate more of the chief components of this diet and gained on average 1.25 kg less weight. In pregnant women who followed a Mediterranean diet, no statistically significant decreases in overall maternal and offspring complications were noted vs usual care. Gestational diabetes risk seemed 35% because of the intervention. A 33% decrease in gestational diabetes was exhibited by a meta-analysis of ESTEEM study results with a similar trial, however, it had no impact on other outcomes. Mediterranean-style diet may potentially decrease gestational weight gain and the risk of gestational diabetes, but the overall risk of adverse maternal and offspring complications in pregnancy was not diminished.