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Mediterranean Diet Adherence and Health Literacy Levels in Pregnant Women with Gestational Diabetes: A Case-Control Study

Yıl 2024, Cilt: 8 Sayı: 3, 109 - 121, 04.12.2024

Öz

This study aims to investigate the relationship between adherence to the Mediterranean diet and health literacy levels of pregnant women with and without gestational diabetes (GDM). Nutrition during pregnancy is important as it affects maternal and infant health. Mediterranean diet is thought to be beneficial in the management of GDM and other pregnancy complications. Health literacy enables pregnant women to make informed decisions about nutrition and health management. This cross-sectional case-control study was conducted in a training-research hospital between October 2023 and April 2024. The study included 100 pregnant women with a gestational week ≥ 37, 50 with GDM and 50 without GDM. Questionnaire form including socio-demographic characteristics, Mediterranean Diet Adherence Scale (MEDAS) and Health Literacy in Pregnancy Scale (MHELIP) were administered to the pregnant women. In the study, it was determined that the mean MEDAS score of the pregnant women was 7.46 ± 2.18 and 58% of the pregnant women with GDM showed an acceptable level of compliance with the Mediterranean diet. The mean health literacy score was 81.18 ± 11.67. It was found that the diagnosis of gestational diabetes did not affect health literacy scores, but it varied according to pre-pregnancy BMI and employment status. In addition, it was found that there was a significant correlation between health literacy and adherence to the Mediterranean diet in pregnant women with GDM. It was thought that increasing compliance with the Mediterranean diet and health literacy levels during pregnancy may improve maternal and infant health.

Etik Beyan

Ethics committee approval (No. 98, dated 21.06.2023) was obtained from the Clinical Research Ethics Committee of Zeynep Kamil Women's and Children's Diseases Training and Research Hospital. After providing information about the study, pregnant women who voluntarily agreed to participate signed the “Informed Consent Form.”

Kaynakça

  • Abay, H., Alagöz, F. and Tekin, Ö.M. (2023). The Turkish validity and reliability of the maternal health literacy inventory in pregnancy. Midwifery, 25, 103774. DOI: 10.1016/j.midw.2023.103774
  • Abreu, F., Hernando, A., Goulão, L. F., Pinto, A. M., Branco, A., Cerqueira, A. and Sousa, J. (2023). Mediterranean diet adherence and nutritional literacy: an observational cross-sectional study of the reality of university students in a COVID-19 pandemic context. BMJ Nutrition, Prevention and Health, 6(2), 221. DOI: 10.1136/bmjnph-2023-000659
  • Albani, E.N., Togas, C., Kanelli, Z., Fradelos, E.C., Mantzouranis, G., Saridi, M. and Tzenalis, A. (2022). Is there an association between health literacy and adherence to the Mediterranean diet? A cross-secitonal study in Greece. Wiadomosci lekarskie, 9(2), 2181-2188. DOI: 10.36740/WLek202209201
  • Amati, F., Hassounah, S. and Swaka, A. (2019). The impact of Mediterranean dietary patterns during pregnancy on maternal and offspring health. Nutrients, 11(5), 1098. DOI: 10.3390/nu11051098
  • American Diabetes Association (2022). American Diabetes Association (ADA). Standards of medical care in diabetes. Classification and diagnosis of diabetes. Diabetes Care, 45(1), 17-38.
  • Assaf-Balut, C., García de la Torre, N.G., Durán, A., Fuentes, M., Bordiú, E., Del Valle, L. and Calle-Pascual, A.L. (2018). Medical nutrition therapy for gestational diabetes mellitus based on Mediterranean Diet principles: A subanalysis of the St Carlos GDM Prevention Study. BMJ Open Diabetes Research and Care, 6(1), e000550. DOI: 10.1136/bmjdrc-2018-00055
  • Biagi, C., Di Nunzio, M., Bordoni, A., Gori, D. and Lanari, M. (2019). Effect of adherence to Mediterranean diet during pregnancy on children’s health: a systematic review. Nutrients, 11(5), 997. DOI: 10.3390/nu11050997
  • Duarte, A., Martins, J., Lopes, C., Silva, M.J., Augusto, C., Martins, S.P. and Rosário, R. (2024). Health literacy and ıts association with the adoption of the Mediterranean diet: A cross-sectional study. Nutrients, 16(14), 2176. DOI: 10.3390/nu16142176
  • Filiz, E. and Bodur, S. (2022). Evaluation of the relationship between health literacy and health perception in pregnant women. Selcuk Health Journal, 3(1), 17-33.
  • Flor-Alemany, M., Sandborg, J., Migueles, J.H., Söderström, E., Henström, M., Marín-Jiménez, N. and Löf, M. (2024). Mediterranean Diet adherence and health-related quality of life during pregnancy: Is the Mediterranean diet beneficial in non-Mediterranean countries?. Nutrients, 16(5), 718. DOI: 10.3390/nu16050718
  • García de la Torre, N., Assaf-Balut, C., Jiménez Varas, I., Del Valle, L., Durán, A., Fuentes, M., and Calle-Pascual, A. L. (2019). Effectiveness of following Mediterranean diet recommendations in the real world in the incidence of gestational diabetes mellitus (GDM) and adverse maternal-foetal outcomes: a prospective, universal, interventional study with a single group. The St Carlos Study. Nutrients, 11(6), 1210. DOI: 0.3390/nu11061210
  • Ghanbari, S., Majlessi, F., Ghaffari, M. and Mahmoodi Majdabadi, M. (2020). Evaluation of health literacy of pregnant women in urban health centers of Shahid Beheshti Medical University. Daneshvar Medicine, 19(6), 1-12.
  • Gumus, D., Topal, G. G., Sevim, S. and Kizil, M. (2023). Adherence to Mediterranean diet and dietary changes according to the fear of COVID-19 during the pandemic: a cross-sectional study. Journal of Nutritional Science, 12, e56. DOI: 10.1017/jns.2023.40
  • Javadzade, S.H., Sharifirad, G., Reisi, M., Tavassoli, E. and Rajati, F. (2013). Health literacy among adults in Isfahan, Iran. Journal of Health System Research, 9(5), 540-549.
  • Kibret, K.T., Chojenta, C., Gresham, E., Tegegne, T.K. and Loxton, D. (2019). Maternal dietary patterns and risk of adverse pregnancy (hypertensive disorders of pregnancy and gestational diabetes mellitus) and birth (preterm birth and low birth weight) outcomes: a systematic review and meta-analysis. Public Health Nutrition, 22(3), 506-520. DOI: 10.1017/S1368980018002616
  • Kilfoyle, K.A., Vitko, M., O'Conor, R. and Bailey, S.C. (2016). Health literacy and women's reproductive health: a systematic review. Journal of Women's Health, 25(12), 1237-1255. DOI: 10.1089/jwh.2016.581
  • Martínez-González, M.A., García-Arellano, A., Toledo, E., Salas-Salvado, J., BuilCosiales, P., Corella, D. and Fiol, M. (2012). A 14-item Mediterranean diet assessment tool and obesity ındexes among high-risk subjects: the PREDIMED trial. PloS One, 7(8), e43134. DOI: 10.1371/journal.pone.0043134
  • Mohtashaminia, F., Hosseini, F., Jayedi, A., Mirmohammadkhani, M., Emadi, A., Takfallah, L. and Shab-Bidar, S. (2023). Adherence to the Mediterranean diet and risk of gestational diabetes: A prospective cohort study. BMC Pregnancy and Childbirth, 23(1), 647. DOI: 10.1186/s12884-023-05960-4
  • Nawabi, F., Krebs, F., Vennedey, V., Shukri, A., Lorenz, L. and Stock, S. (2021). Health literacy in pregnant women: A systematic review. International Journal of Environmental Research and Public Health, 18(7), 3847. DOI: 10.3390/ijerph18073847
  • Odabaş, T., Odabaş, O., and Meseri, R. (2024). Impact of Mediterranean diet in lowering risk of gestational diabetes mellitus: A cross-sectional study. Medicina Clínica (English Edition), 162(7), 321-327. DOI: 10.1016/j.medcle.2023.11.009
  • Patel, V.B. and Preedy, V.R. (2023). Eating disorders. Springer Nature, Cham.
  • Pehlivanoğlu, E.F.Ö., Balcıoğlu, H., Ünlüoğlu, İ. (2020). Akdeniz diyeti bağlılık ölçeği’nin türkçe’ye uyarlanması geçerlilik ve güvenilirliği. Osmangazi Tıp Dergisi, 42(2), 160-164. DOI: 10.20515/otd. 504188
  • Rahimi, M., Arghavanian, E.F., Khadivzadeh, T. and Mazloom, S.R. (2022). Assessment of the relationship between health literacy and self-care in Afghan pregnant mothers with chronic diseases. Journal of Health Literacy, 6(4), 59-68. DOI: 10.22038/jhl.2021.61007.1226
  • Reijnders, I.F., Mulders, A.G., van der Windt, M., Steegers, E.A. and Steegers-Theunissen, R.P. (2019). The impact of periconceptional maternal lifestyle on clinical features and biomarkers of placental development and function: a systematic review. Human Reproduction Update, 25(1), 72-94. DOI: 10.1093/humupd/dmy037
  • Sabetghadam, S., Keramat, A., Goli, S., Malary, M. and Chamani, R.S. (2023). Maternal health literacy, health information‐seeking behavior and pregnancy outcomes among Iranian pregnant women: A cross-sectional study. Community Health Equity Research and Policy, 44(1), 77-87. DOI: 10.1177/0272684X2210956
  • Sam-Yellowe, T.Y. (2024). Nutritional barriers to the adherence to the Mediterranean diet in non-Mediterranean populations. Foods, 13(11), 1750. DOI: 10.3390/foods13111750
  • Schröder, H., Fitó, M., Estruch, R., Martínez-González, M.A., Corella, D., Salas-Salvadó, J. and Covas, M.I. (2011). A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. The Journal of Nutrition, 141(6), 1140-1145. DOI: 10.3945/jn.110.135566
  • Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J. and Slonska, Z. (2012). Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health, 12, 1-13. DOI: 10.1186/1471-2458-12-80
  • Sørensen, K., Van den Broucke, S., Pelikan, J.M., Fullam, J., Doyle, G., Slonska, Z. and Brand, H. (2013). Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health, 13, 1-10. DOI: 10.1186/1471-2458-13-948
  • Staynova, R. and Yanachkova, V. (2022). Improving gestational diabetes management through patient education. In: Radenkovic, M. Gestational Diabetes Mellitus: New Developments. IntechOpen Limited, London, pp.59-68.
  • Taheri, S., Tavousi, M., Momenimovahed, Z., Direkvand-Moghadam, A., Tiznobaik, A., Suhrabi, Z., and Taghizadeh, Z. (2020). Development and psychometric properties of maternal health literacy inventory in pregnancy. PloS one, 15(6), e0234305. DOI: 10.1371/journal.pone.0234305
  • Taheri, S., Tavousi, M., Momenimovahed, Z., Direkvand-Moghadam, A., Rezaei, N., Sharifi, N. and Taghizadeh, Z. (2021). Determining health literacy level and its related factors among pregnant women referred to medical and health centers of Tehran in 2019: a cross-sectional study. Shiraz E-Medical Journal, 22(10), e109592. DOI: 10.5812/semj.109592
  • Wang, H., Li, N., Chivese, T., Werfalli, M., Sun, H., Yuen, L. and Yang, X. (2022). IDF diabetes atlas: estimation of global and regional gestational diabetes mellitus prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria. Diabetes Research And Clinical Practice, 183, 109050. DOI: 10.1016/j.diabres.2021.109050
  • Xu, J., Wang, H., Bian, J., Xu, M., Jiang, N., Luo, W. and Zhu, P. (2024). Association between the maternal Mediterranean diet and perinatal outcomes: A systematic review and meta-analysis. Advances in Nutrition, 15(2), 100159. DOI: 10.1016/j.advnut.2023.100159
  • Yassıbaş, E. and Bölükbaşı, H. (2023). Evaluation of adherence to the Mediterranean diet with sustainable nutrition knowledge and environmentally responsible food choices. Frontiers in Nutrition, 10, 1158155. DOI: 10.3389/fnut.2023.1158155

Gestasyonel Diyabetli Gebelerin Akdeniz Diyetine Uyum ve Sağlık Okuryazarlığı Düzeyleri: Bir Vaka-Kontrol Çalışması

Yıl 2024, Cilt: 8 Sayı: 3, 109 - 121, 04.12.2024

Öz

Bu çalışma, gestasyonel diyabeti olan ve olmayan gebelerin Akdeniz diyetine uyum ve sağlık okuryazarlığı seviyeleri arasındaki ilişkiyi araştırmayı amaçlamaktadır. Gebelik döneminde beslenme, anne ve bebek sağlığını etkilediğinden önem taşımaktadır. Akdeniz diyetinin, gestasyonel diyabet (GDM) ve diğer gebelik komplikasyonlarının yönetiminde faydalı olduğu düşünülmektedir. Sağlık okuryazarlığı, gebelerin beslenme ve sağlık yönetimi hakkında bilinçli kararlar alabilmelerini sağlamaktadır. Kesitsel tipte vaka-kontrol çalışması olan bu çalışma, Ekim 2023 ile Nisan 2024 tarihleri arasında bir eğitim-araştırma hastanesinde yürütülmüştür. Çalışmaya, GDM tanılı olan 50 ve olmayan 50 olmak üzere, gestasyon haftası ≥37 olan 100 gebe dahil edilmiştir. Gebelere; sosyodemografik özelliklerin yer aldığı anket formu, Akdeniz Diyeti Uyum Ölçeği (MEDAS) ve Gebelikte Sağlık Okuryazarlığı Ölçeği (MHELIP) uygulanmıştır. Çalışmada, gebelerin ortalama MEDAS puanının 7.46 ± 2.18 olduğu ve GDM tanılı gebelerin %58'inin Akdeniz diyetine kabul edilebilir düzeyde uyum gösterdiği belirlenmiştir. Ortalama sağlık okuryazarlığı puanı ise 81.18 ± 11.67 olarak belirlenmiştir. Gestasyonel diyabet tanısının sağlık okuryazarlığı puanlarını etkilemediği, ancak gebelik öncesi BKİ ve çalışma durumuna göre değişiklik gösterdiği bulunmuştur. Ayrıca, GDM tanılı gebelerde sağlık okuryazarlığı ile Akdeniz diyetine uyum arasında anlamlı korelasyon olduğu saptanmıştır. Gebelik döneminde Akdeniz diyetine uyumun ve sağlık okuryazarlığı düzeylerinin artırılmasının anne ve bebek sağlığı iyileştirebileceği düşünülmüştür.

Kaynakça

  • Abay, H., Alagöz, F. and Tekin, Ö.M. (2023). The Turkish validity and reliability of the maternal health literacy inventory in pregnancy. Midwifery, 25, 103774. DOI: 10.1016/j.midw.2023.103774
  • Abreu, F., Hernando, A., Goulão, L. F., Pinto, A. M., Branco, A., Cerqueira, A. and Sousa, J. (2023). Mediterranean diet adherence and nutritional literacy: an observational cross-sectional study of the reality of university students in a COVID-19 pandemic context. BMJ Nutrition, Prevention and Health, 6(2), 221. DOI: 10.1136/bmjnph-2023-000659
  • Albani, E.N., Togas, C., Kanelli, Z., Fradelos, E.C., Mantzouranis, G., Saridi, M. and Tzenalis, A. (2022). Is there an association between health literacy and adherence to the Mediterranean diet? A cross-secitonal study in Greece. Wiadomosci lekarskie, 9(2), 2181-2188. DOI: 10.36740/WLek202209201
  • Amati, F., Hassounah, S. and Swaka, A. (2019). The impact of Mediterranean dietary patterns during pregnancy on maternal and offspring health. Nutrients, 11(5), 1098. DOI: 10.3390/nu11051098
  • American Diabetes Association (2022). American Diabetes Association (ADA). Standards of medical care in diabetes. Classification and diagnosis of diabetes. Diabetes Care, 45(1), 17-38.
  • Assaf-Balut, C., García de la Torre, N.G., Durán, A., Fuentes, M., Bordiú, E., Del Valle, L. and Calle-Pascual, A.L. (2018). Medical nutrition therapy for gestational diabetes mellitus based on Mediterranean Diet principles: A subanalysis of the St Carlos GDM Prevention Study. BMJ Open Diabetes Research and Care, 6(1), e000550. DOI: 10.1136/bmjdrc-2018-00055
  • Biagi, C., Di Nunzio, M., Bordoni, A., Gori, D. and Lanari, M. (2019). Effect of adherence to Mediterranean diet during pregnancy on children’s health: a systematic review. Nutrients, 11(5), 997. DOI: 10.3390/nu11050997
  • Duarte, A., Martins, J., Lopes, C., Silva, M.J., Augusto, C., Martins, S.P. and Rosário, R. (2024). Health literacy and ıts association with the adoption of the Mediterranean diet: A cross-sectional study. Nutrients, 16(14), 2176. DOI: 10.3390/nu16142176
  • Filiz, E. and Bodur, S. (2022). Evaluation of the relationship between health literacy and health perception in pregnant women. Selcuk Health Journal, 3(1), 17-33.
  • Flor-Alemany, M., Sandborg, J., Migueles, J.H., Söderström, E., Henström, M., Marín-Jiménez, N. and Löf, M. (2024). Mediterranean Diet adherence and health-related quality of life during pregnancy: Is the Mediterranean diet beneficial in non-Mediterranean countries?. Nutrients, 16(5), 718. DOI: 10.3390/nu16050718
  • García de la Torre, N., Assaf-Balut, C., Jiménez Varas, I., Del Valle, L., Durán, A., Fuentes, M., and Calle-Pascual, A. L. (2019). Effectiveness of following Mediterranean diet recommendations in the real world in the incidence of gestational diabetes mellitus (GDM) and adverse maternal-foetal outcomes: a prospective, universal, interventional study with a single group. The St Carlos Study. Nutrients, 11(6), 1210. DOI: 0.3390/nu11061210
  • Ghanbari, S., Majlessi, F., Ghaffari, M. and Mahmoodi Majdabadi, M. (2020). Evaluation of health literacy of pregnant women in urban health centers of Shahid Beheshti Medical University. Daneshvar Medicine, 19(6), 1-12.
  • Gumus, D., Topal, G. G., Sevim, S. and Kizil, M. (2023). Adherence to Mediterranean diet and dietary changes according to the fear of COVID-19 during the pandemic: a cross-sectional study. Journal of Nutritional Science, 12, e56. DOI: 10.1017/jns.2023.40
  • Javadzade, S.H., Sharifirad, G., Reisi, M., Tavassoli, E. and Rajati, F. (2013). Health literacy among adults in Isfahan, Iran. Journal of Health System Research, 9(5), 540-549.
  • Kibret, K.T., Chojenta, C., Gresham, E., Tegegne, T.K. and Loxton, D. (2019). Maternal dietary patterns and risk of adverse pregnancy (hypertensive disorders of pregnancy and gestational diabetes mellitus) and birth (preterm birth and low birth weight) outcomes: a systematic review and meta-analysis. Public Health Nutrition, 22(3), 506-520. DOI: 10.1017/S1368980018002616
  • Kilfoyle, K.A., Vitko, M., O'Conor, R. and Bailey, S.C. (2016). Health literacy and women's reproductive health: a systematic review. Journal of Women's Health, 25(12), 1237-1255. DOI: 10.1089/jwh.2016.581
  • Martínez-González, M.A., García-Arellano, A., Toledo, E., Salas-Salvado, J., BuilCosiales, P., Corella, D. and Fiol, M. (2012). A 14-item Mediterranean diet assessment tool and obesity ındexes among high-risk subjects: the PREDIMED trial. PloS One, 7(8), e43134. DOI: 10.1371/journal.pone.0043134
  • Mohtashaminia, F., Hosseini, F., Jayedi, A., Mirmohammadkhani, M., Emadi, A., Takfallah, L. and Shab-Bidar, S. (2023). Adherence to the Mediterranean diet and risk of gestational diabetes: A prospective cohort study. BMC Pregnancy and Childbirth, 23(1), 647. DOI: 10.1186/s12884-023-05960-4
  • Nawabi, F., Krebs, F., Vennedey, V., Shukri, A., Lorenz, L. and Stock, S. (2021). Health literacy in pregnant women: A systematic review. International Journal of Environmental Research and Public Health, 18(7), 3847. DOI: 10.3390/ijerph18073847
  • Odabaş, T., Odabaş, O., and Meseri, R. (2024). Impact of Mediterranean diet in lowering risk of gestational diabetes mellitus: A cross-sectional study. Medicina Clínica (English Edition), 162(7), 321-327. DOI: 10.1016/j.medcle.2023.11.009
  • Patel, V.B. and Preedy, V.R. (2023). Eating disorders. Springer Nature, Cham.
  • Pehlivanoğlu, E.F.Ö., Balcıoğlu, H., Ünlüoğlu, İ. (2020). Akdeniz diyeti bağlılık ölçeği’nin türkçe’ye uyarlanması geçerlilik ve güvenilirliği. Osmangazi Tıp Dergisi, 42(2), 160-164. DOI: 10.20515/otd. 504188
  • Rahimi, M., Arghavanian, E.F., Khadivzadeh, T. and Mazloom, S.R. (2022). Assessment of the relationship between health literacy and self-care in Afghan pregnant mothers with chronic diseases. Journal of Health Literacy, 6(4), 59-68. DOI: 10.22038/jhl.2021.61007.1226
  • Reijnders, I.F., Mulders, A.G., van der Windt, M., Steegers, E.A. and Steegers-Theunissen, R.P. (2019). The impact of periconceptional maternal lifestyle on clinical features and biomarkers of placental development and function: a systematic review. Human Reproduction Update, 25(1), 72-94. DOI: 10.1093/humupd/dmy037
  • Sabetghadam, S., Keramat, A., Goli, S., Malary, M. and Chamani, R.S. (2023). Maternal health literacy, health information‐seeking behavior and pregnancy outcomes among Iranian pregnant women: A cross-sectional study. Community Health Equity Research and Policy, 44(1), 77-87. DOI: 10.1177/0272684X2210956
  • Sam-Yellowe, T.Y. (2024). Nutritional barriers to the adherence to the Mediterranean diet in non-Mediterranean populations. Foods, 13(11), 1750. DOI: 10.3390/foods13111750
  • Schröder, H., Fitó, M., Estruch, R., Martínez-González, M.A., Corella, D., Salas-Salvadó, J. and Covas, M.I. (2011). A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. The Journal of Nutrition, 141(6), 1140-1145. DOI: 10.3945/jn.110.135566
  • Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J. and Slonska, Z. (2012). Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health, 12, 1-13. DOI: 10.1186/1471-2458-12-80
  • Sørensen, K., Van den Broucke, S., Pelikan, J.M., Fullam, J., Doyle, G., Slonska, Z. and Brand, H. (2013). Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health, 13, 1-10. DOI: 10.1186/1471-2458-13-948
  • Staynova, R. and Yanachkova, V. (2022). Improving gestational diabetes management through patient education. In: Radenkovic, M. Gestational Diabetes Mellitus: New Developments. IntechOpen Limited, London, pp.59-68.
  • Taheri, S., Tavousi, M., Momenimovahed, Z., Direkvand-Moghadam, A., Tiznobaik, A., Suhrabi, Z., and Taghizadeh, Z. (2020). Development and psychometric properties of maternal health literacy inventory in pregnancy. PloS one, 15(6), e0234305. DOI: 10.1371/journal.pone.0234305
  • Taheri, S., Tavousi, M., Momenimovahed, Z., Direkvand-Moghadam, A., Rezaei, N., Sharifi, N. and Taghizadeh, Z. (2021). Determining health literacy level and its related factors among pregnant women referred to medical and health centers of Tehran in 2019: a cross-sectional study. Shiraz E-Medical Journal, 22(10), e109592. DOI: 10.5812/semj.109592
  • Wang, H., Li, N., Chivese, T., Werfalli, M., Sun, H., Yuen, L. and Yang, X. (2022). IDF diabetes atlas: estimation of global and regional gestational diabetes mellitus prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria. Diabetes Research And Clinical Practice, 183, 109050. DOI: 10.1016/j.diabres.2021.109050
  • Xu, J., Wang, H., Bian, J., Xu, M., Jiang, N., Luo, W. and Zhu, P. (2024). Association between the maternal Mediterranean diet and perinatal outcomes: A systematic review and meta-analysis. Advances in Nutrition, 15(2), 100159. DOI: 10.1016/j.advnut.2023.100159
  • Yassıbaş, E. and Bölükbaşı, H. (2023). Evaluation of adherence to the Mediterranean diet with sustainable nutrition knowledge and environmentally responsible food choices. Frontiers in Nutrition, 10, 1158155. DOI: 10.3389/fnut.2023.1158155
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Beslenme, Beslenme ve Diyetetik (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Simay Kundakçı 0000-0002-7962-2624

Pınar Geyik 0000-0003-4579-808X

Rabia Bağlayici 0009-0004-1832-6313

Şule Aktaç 0000-0002-2158-5015

Erken Görünüm Tarihi 30 Kasım 2024
Yayımlanma Tarihi 4 Aralık 2024
Gönderilme Tarihi 27 Eylül 2024
Kabul Tarihi 21 Ekim 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 8 Sayı: 3

Kaynak Göster

APA Kundakçı, S., Geyik, P., Bağlayici, R., Aktaç, Ş. (2024). Mediterranean Diet Adherence and Health Literacy Levels in Pregnant Women with Gestational Diabetes: A Case-Control Study. Arel Üniversitesi Sağlık Bilimleri Dergisi, 8(3), 109-121.

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