Abstract
Women with chronic diseases are susceptible to inflammation and stress during pregnancy. Dietary factors such as vegetable consumption can influence the level of inflammation markers in the body, which research has shown to be associated with stress levels. This study examined the moderating role of vegetable intake in the association between chronic disease history and stress levels via anti-inflammatory cytokine interleukin-10 (IL-10) in pregnant women. We recruited 239 pregnant women from antenatal clinics and used an electronic food frequency questionnaire to survey their vegetable intake. Plasma samples were collected at enrollment and assayed for IL-10. Perceived stress scale was completed one month after the assessment of dietary intake. The relationships among chronic disease history, vegetable intake, IL-10 levels, and stress levels were explored using moderated mediation analysis. Pregnant women with chronic diseases demonstrated elevated stress levels and decreased IL-10 levels compared to those without chronic conditions. However, a significant interaction was observed between vegetable intake and chronic disease history in modulating IL-10 levels (B = 0.09, p = 0.007). Specifically, consuming vegetables was positively associated with IL-10 levels in women with chronic diseases, while this association was not observed in women without chronic conditions. When consuming high levels of vegetables, women with chronic diseases were found to experience lower stress levels than those without (B = -0.43; Boot SE = 0.28; LLCI = -1.06; ULCI = -0.01). It is crucial for pregnant women with chronic diseases to consume a vegetable-rich diet, which could benefit their mental health by potentially reducing inflammation during pregnancy.