Dietary Choices Are Linked to Higher Rates of Preeclampsia Among Latinas

For pregnant Latinas, food choices could reduce the risk of preeclampsia, a dangerous type of high blood pressure, and a diet based on cultural food preferences, rather than on U.S. government benchmarks, is more likely to help ward off the illness, a new study shows.

Researchers at the USC Keck School of Medicine found that a combination of solid fats, refined grains, and cheese was linked to higher rates of preeclampsia among a group of low-income Latinas in Los Angeles. By contrast, women who ate vegetables, fruits, and meals made with healthy oils were less likely to develop the illness.

The combination of vegetables, fruits, and healthy oils, such as olive oil, showed a stronger correlation with lower rates of preeclampsia than did the Healthy Eating Index-2015, a list of dietary recommendations designed by the U.S. Department of Agriculture and the Department of Health and Human Services.

The study, published in February by the Journal of the American Heart Association, yielded important information on which food combinations affect pregnant Latinas, said Luis Maldonado, the lead investigator and a postdoctoral scholar at the Department of Population and Public Health Sciences at USC Keck. It suggests that dietary recommendations for pregnant Latinas should incorporate more foods from their culture, he said.

“A lot of studies that have been done among pregnant women in general have been predominantly white, and diet is very much tied to culture,” Maldonado said. “Your culture can facilitate how you eat because you know what your favorite food is.”

Preeclampsia is estimated to occur in about 5% of pregnancies in the U.S. and is among the leading causes of maternal morbidity, according to the Centers for Disease Control and Prevention. It typically occurs during the third trimester of pregnancy and is associated with obesity, hypertension, and chronic kidney disease, among other conditions.

There isn’t a way to cure or predict preeclampsia. The disease can damage the heart and liver and lead to other complications for both the mother and the baby, including preterm birth and even death.

Rates of preeclampsia have increased in the past two decades nationally. In California, rates of preeclampsia increased by 83% and hypertension by 78% from 2016 to 2022, according to the most recent data available, and the conditions are highest among Black residents and Pacific Islanders.

Maldonado said 12% of the 451 Latina women who participated in the study developed preeclampsia, a number almost twice the national average. More than half of the participants, who averaged 28 years old, had pre-pregnancy risks, such as diabetes and high body mass index.

Maldonado and his team used data from the Maternal and Developmental Risks from Environmental and Social Stressors Center, a USC research group that studies the effects of environmental exposures and social stressors on the health of mothers and their children.

The subjects, who were predominantly low-income Latinas in Los Angeles, completed two questionnaires about their diet during the third trimester of their pregnancy. The researchers identified two significant patterns of eating: one in which the most consumed foods were vegetables, oils, fruits, whole grains, and yogurt; and a second in which the women’s diet consisted primarily of solid fats, refined grains, cheese, added sugar, and processed meat.

Women who followed the first eating pattern had a lower rate of preeclampsia than those who followed the second.

When Maldonado and his team tested for a correlation between lower rates of preeclampsia and the Healthy Eating Index-2015, they found it was not statistically significant except for women who were overweight before pregnancy.

The Healthy Eating Index includes combinations of nutrients and foods, like dairy and fatty acids. Maldonado said more research is needed to determine the exact profile of fruits, vegetables, and oils that could benefit Latina women.

When it comes to diet, the right messaging and recommendations are vital to helping pregnant Latinas make informed decisions, said A. Susana Ramírez, an associate professor of public health communication at the University of California-Merced.

Ramírez has conducted studies on why healthy-eating messages, while well intended, have not been successful in Hispanic communities. She found that the messaging has led some Latinos to believe that Mexican food is unhealthier than American food.

Ramírez said we need to think about promoting diets that are relevant for a particular population. “We understand now that diet is enormously important for health, and so to the extent that any nutrition counseling is culturally consonant, that will improve health overall,” Ramírez said.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.