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Relationships of the Mediterranean dietary pattern with insulin resistance and diabetes incidence in the Multi-Ethnic Study of Atherosclerosis (MESA)
Open accessAbstract
Type 2 diabetes (T2D) is a highly prevalent but preventable disorder. We assessed the association between an a priori Mediterranean diet (MeDiet) score and fasting glucose and insulin at baseline and incident T2D after a 6-year follow-up in the Multi-Ethnic Study of Atherosclerosis. Dietary intake was measured at baseline using a 127-item FFQ in 5390 men and women aged 45–84 years free of prevalent diabetes and clinical CVD. A MeDiet score was created based on the intake of ten food components: vegetables; whole grains; nuts; legumes; fruits; ratio of monounsaturated:saturated fat; red and processed meat; dairy products; fish; alcohol. Multivariable linear and proportional hazards models were used to estimate the association of the MeDiet, categorised in quintiles, with baseline insulin and glucose, and incident diabetes, respectively. The models were adjusted for demographic, physiological and behavioural characteristics. After multivariable adjustment, individuals with a higher MeDiet score had lower baseline mean insulin levels (Q1: 5·8 (95 % CI 5·6, 6·0) μmol/l; Q5: 4·8 (95 % CI 4·6, 5·0) μmol/l; P for trend < 0·0001). A higher MeDiet score was also associated with significantly lower glucose levels after basic adjustment, but was attenuated after adjustment for waist circumference. During the follow-up, 412 incident diabetes events accrued. The MeDiet was not significantly related to the risk of incident diabetes (P for trend = 0·64). In summary, greater consistency with a Mediterranean-style diet, reflected by a higher a priori MeDiet score, was cross-sectionally associated with lower insulin levels among non-diabetics, and with lower blood glucose before adjustment for obesity, but not with a lower incidence of diabetes.
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“In particular, there is evidence that the adherence to the MD is inversely associated with adiposity [58], IR [59], and risk of type 2 diabetes mellitus [60] and cardiovascular disease [61].”
From Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS) (2019) · cites this paper as [59]
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Metadata
- Authors
- Abiemo, E. E., Alonso, A., Nettleton, J. A., Steffen, L. M., Bertoni, A. G., Jain, A., & Lutsey, P. L.
- Affiliations
- University of Minnesota (US)
- The University of Texas Health Science Center at Houston (US)
- Wake Forest University Health Sciences (US)
- Johns Hopkins University (US)
- Corresponding author
- Lutsey, Pamela L.
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-08-30
- Volume
- 109
- Issue
- 8
- Pages
- 1490-1497
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- PMC
- PMC4002212
- OpenAlex
- W2151687706
- Cited by
- 112
- References
- 24
- Citations by year
- 2025: 6 · 2024: 7 · 2023: 7 · 2022: 10 · 2021: 11 · 2020: 7 · 2019: 8 · 2018: 10 · 2017: 8 · 2016: 8 · 2015: 11 · 2014: 12 · 2013: 7
- FWCI
- 9.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal Of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc095169-003, n01hc95163-22-0-1, n01hc95159-40-0-1)
- National Heart, Lung, and Blood Institute (N01 HC-95159, N01-HC095169, N01 HC095163, N01-HC-095159, N01-HC-95159 to N01-HC-95169, N01 HC95169)
- National Institute of Diabetes and Digestive and Kidney Diseases (K01DK082729)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
- Keywords
- Mediterranean diet, type 2 diabetes, insulin resistance, insulin, fasting blood glucose, diabetes incidence, diet score, Multi-Ethnic Study of Atherosclerosis, waist circumference, obesity, whole grains, nuts, Fabaceae, fish consumption, alcohol consumption, red and processed meat, dairy products
- MeSH terms
- Aged, Aged, 80 and over, Asian, Black or African American, Blood Glucose, Diabetes Mellitus, Type 2, Diet Surveys, Female, Hispanic or Latino, Humans, Insulin, Insulin Resistance, Male, Middle Aged, United States, Incidence, Multivariate Analysis, Proportional Hazards Models, Diet, Mediterranean, White People, Atherosclerosis
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