Disclosure: Nutritionist and nutritional epidemiologist Petra Hooyenga (author) provides genomics informed preconception nutrition care at Sydney North Women’s Health, PARKWAY San Clinic, 172 Fox Valley Rd, Wahroonga, NSW 2076.
As healthcare professionals caring for pregnant patients, staying abreast of the latest scientific insights can empower us to provide evidence-based guidance and improve outcomes. The purpose of this post is to highlight how science in nutrition and health can be translated to clinically relevant information for health practitioners and their patients. Drawing from three recent key publications—a review article titled “Mediterranean Diet and Oxidative Balance During Pregnancy: Molecular Insights into Mitigating the Impact of Environmental Pollution” by Kontopidou et al. (2026), the “2025 National Guidelines on the Mediterranean Diet: Executive Summary of a Joint Report by Italian Scientific Societies and the National Institute of Health Task Force on Clinical Practice Guidelines” by Veronese et al. (2025), and a narrative review titled “Impact of ultra-processed food consumption during pregnancy on maternal and child health outcomes: A comprehensive narrative review of the past five years” by Morales-Suarez-Varela et al. (2024)—we’ll explore healthy diet and optimised nutrition during pregnancy, associated health risks from poor diet, and practical strategies involving diet and environment.
Understanding Healthy Diet and Optimised Nutrition During Pregnancy
Pregnancy is a dynamic period marked by increased metabolic demands, where the body experiences heightened oxygen consumption and mitochondrial activity to support fetal growth and placental function. According to Kontopidou et al. (2026), this creates a state of “heightened oxidative demand,” where reactive oxygen species (ROS)—molecules produced during normal cellular processes—play a dual role. In balanced amounts, ROS help regulate key pathways like gene expression and angiogenesis. However, when production exceeds the body’s antioxidant defences, oxidative stress ensues, disrupting redox homeostasis.
The Mediterranean diet (MD)—rich in fruits, vegetables, whole grains, olive oil, nuts, and fish—stands out across the articles for its antioxidant properties and role in optimised nutrition. Kontopidou et al. (2026) highlight how MD-derived bioactives, such as polyphenols and omega-3 fatty acids, regulate oxidative stress pathways by enhancing antioxidant enzyme expression (e.g., superoxide dismutase and glutathione peroxidase) and reducing ROS production. Veronese et al. (2025) provide high-quality evidence from systematic reviews, showing MD adherence reduces risks of gestational complications and supports overall healthy longevity, with benefits extending to improved pregnancy outcomes. In contrast, Morales-Suarez-Varela et al. (2024) emphasise that high consumption of ultra-processed foods (UPF)—characterised by high sugars, oils, fats, sodium, calories, and additives, with low fiber—leads to poor overall diet quality and negative nutrition biomarkers during pregnancy.
Figure 1: from “Mediterranean Diet and Oxidative Balance During Pregnancy: Molecular Insights into Mitigating the Impact of Environmental Pollution” by Kontopidou et al. (2026)
Health Risks Associated with Poor Diet for Mother and Baby
Poor diet, including high UPF intake, is linked to tangible clinical risks. Kontopidou et al. (2026) detail how oxidative imbalances contribute to complications such as preeclampsia, gestational diabetes mellitus (GDM), intrauterine growth restriction (IUGR), and fetal growth restriction (FGR). For the mother, this may manifest as vascular dysfunction, hypertension, endothelial inflammation, and accelerated cellular ageing (e.g., telomere shortening). For the baby, redox imbalances can impair trophoblast invasion, nutrient transport, and vascular remodelling in the placenta, leading to reduced oxygen and nutrient delivery, heightened risks of low birth weight, preterm birth, and long-term offspring issues like cardiometabolic diseases. Complementing these insights, Veronese et al. (2025) highlight high-quality evidence linking poor dietary patterns to poorer pregnancy outcomes, including increased incidence of metabolic issues. Morales-Suarez-Varela et al. (2024) add that high UPF consumption is positively associated with adverse maternal outcomes like GDM, excessive gestational weight gain, poor glycemic control, elevated inflammatory markers, and hypertensive disorders, as well as child outcomes such as adiposity gain, negative growth and development impacts, potential adverse mental disorders, and indicators of poor nutrition.
Figure 2: from “Mediterranean Diet and Oxidative Balance During Pregnancy: Molecular Insights into Mitigating the Impact of Environmental Pollution” by Kontopidou et al. (2026)
The Role of Diet and Environmental Factors in Mitigating Oxidative Stress and Related Mechanisms
Diet emerges as a powerful, modifiable factor in restoring oxidative balance and mitigating related mechanisms such as inflammation and detoxification. Kontopidou et al. (2026) describe the MD as a “nutrigenomic intervention,” where its compounds modulate redox signalling to support placental health and counter metabolic adaptations, including through activation of detoxification pathways against environmental pollutants. Veronese et al. (2025) attribute MD benefits to its anti-inflammatory effects and nutrient-dense profile, aiding metabolic regulation and obesity prevention, with high-strength recommendations for reducing GDM, preeclampsia, hypertension, and excessive weight gain. Environmental pollution adds complexity, exacerbating oxidative stress through exposure to toxins like heavy metals or air pollutants. Kontopidou et al. (2026) explore how these induce ROS via mitochondrial disruption and inflammatory pathways, but the MD offers molecular protection by activating detoxification enzymes and modulating redox-sensitive genes (e.g., via NRF2 and NF-κB pathways). Morales-Suarez-Varela et al. (2024) note that UPF’s composition promotes inflammation and poor nutrition biomarkers, which may intersect with oxidative mechanisms through elevated inflammatory markers.Overall, adherence to the MD, while minimising UPF, is positioned as a strategy to optimise oxidative biomarkers, reduce inflammation, and promote healthy pregnancy outcomes.
Key Points to Communicate with Patients About Diet and Environment
When discussing these topics with pregnant patients, keep messages clear, actionable, and evidence-based. Here are summarised key points from the articles:
- Emphasise Antioxidant-Rich Foods: Encourage incorporating MD elements like leafy greens, berries, nuts, fatty fish, and olive oil to boost natural defences against oxidative stress and inflammation. Highlight how these can support placental function, fetal growth, and reduce risks like GDM and preeclampsia, as supported by Veronese et al. (2025) and Kontopidou et al. (2026).
- Balance and Variety: Advise a diverse diet to maximise bioactives while minimising potential contaminants (e.g., choose low-mercury fish). Stress that small, consistent changes can make a difference, and warn against high UPF intake, which is linked to poor diet quality and adverse outcomes like weight gain and hypertensive disorders, per Morales-Suarez-Varela et al. (2024).
- Benefits for Fetal Development and Long-Term Health: Share that healthy diets like the MD promote optimal fetal growth, reduce preterm birth and low birth weight risks, and may support better childhood health (e.g., lower adiposity and metabolic risks), as indicated by Veronese et al. (2025) and Morales-Suarez-Varela et al. (2024).
- Environmental Awareness: Suggest practical steps like avoiding high-pollution areas during peak times, using air purifiers, or opting for organic produce where feasible to reduce toxin exposure, as noted in Kontopidou et al. (2026).
- Monitor and Personalise: Remind patients that individual factors (e.g., obesity or pre-existing conditions) can amplify risks, so regular check-ins are key.
Frame these as supportive habits rather than strict rules, tying them back to benefits like healthier blood pressure, better baby growth, and potential lifelong advantages for the child.
Figure 3: from Veronese et al. 2025 National Guidelines on the Mediterranean Diet: Executive Summary of a Joint Report by Italian Scientific Societies and the National Institute of Health Task Force on Clinical Practice Guidelines. Nutrition Reviews. 2025, Vol. 00(00):1–14.
Navigating Complexity: The Nutrigenomic Advantage
While understanding these dietary modulators is valuable, the intricacies of nutritional care—such as tailoring the MD to specific needs, addressing UPF avoidance, or managing pollutant interactions—often exceed the scope of most medical health professionals in pregnancy care. A powerful advantage lies in nutrigenomic-informed preconception care, which can help both men and women prepare for a healthy pregnancy by addressing vulnerabilities in underlying genetic pathways such as oxidative stress, nutrient metabolism, detoxification, and inflammation. For optimal patient support, refer to a clinical nutritionist with expertise in prenatal nutrition. They can provide nutrigenomic-, and pathology informed personalised dietary plans and targeted interventions, and assess dietary adherence and health progress on a regular basis. By collaborating across disciplines, we can translate this science into better care, ultimately fostering healthier pregnancies, and starting healthy longevity at the earliest opportunity pre-conception.
References
- Kontopidou, E.; Kourti, A.; Athanasiadis, A.; Itziou, A. Mediterranean Diet and Oxidative Balance During Pregnancy: Molecular Insights into Mitigating the Impact of Environmental Pollution. Curr. Issues Mol. Biol. 2026, 48, 115. https://doi.org/10.3390/cimb48010115
- Veronese, N.; Gianfredi, V.; Volpe, M.; Zanetti, M.; Onder, G.; Silano, M.; Nucci, D.; Fontana, L.; Laviano, A.; Sieber, C.; Maggi, S.; on behalf of the Italian Mediterranean Guideline Group. 2025 National Guidelines on the Mediterranean Diet: Executive Summary of a Joint Report by Italian Scientific Societies and the National Institute of Health Task Force on Clinical Practice Guidelines. Nutrition Reviews. 2025, Vol. 00(00):1–14. Downloaded from https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuaf263/8415611
- Morales-Suarez-Varela, M.; Rocha-Velasco, O.A. Impact of ultra-processed food consumption during pregnancy on maternal and child health outcomes: A comprehensive narrative review of the past five years. Clin. Nutr. ESPEN 2024, doi:10.1016/j.clnesp.2024.12.006
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