Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study
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OBJECTIVE: To assess the relation between adherence to a Mediterranean diet and the incidence of diabetes among initially healthy participants. DESIGN: Prospective cohort study with estimates of relative risk adjusted for sex, age, years of university education, total energy intake, body mass index, physical activity, sedentary habits, smoking, family history of diabetes, and personal history of hypertension. SETTING: Spanish university department. PARTICIPANTS: 13 380 Spanish university graduates without diabetes at baseline followed up for a median of 4.4 years. MAIN OUTCOME MEASURES: Dietary habits assessed at baseline with a validated 136 item food frequency questionnaire and scored on a nine point index. New cases of diabetes confirmed through medical reports and an additional detailed questionnaire posted to those who self reported a new diagnosis of diabetes by a doctor during follow-up. Confirmed cases of type 2 diabetes. RESULTS: Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes. The incidence rate ratios adjusted for sex and age were 0.41 (95% confidence interval 0.19 to 0.87) for those with moderate adherence (score 3-6) and 0.17 (0.04 to 0.75) for those with the highest adherence (score 7-9) compared with those with low adherence (score <3). In the fully adjusted analyses the results were similar. A two point increase in the score was associated with a 35% relative reduction in the risk of diabetes (incidence rate ratio 0.65, 0.44 to 0.95), with a significant inverse linear trend (P=0.04) in the multivariate analysis. CONCLUSION: Adherence to a Mediterranean diet is associated with a reduced risk of diabetes.
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These results are consistent with prior evidence suggesting a protective effect of the MedDiet against diabetes.
“Our results are consistent with prior evidence suggesting a protective effect of the MedDiet against diabetes ( 7 , 9 – 11 ).”
From Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet (2011) · cites this paper as [9]
Experimental — accuracy not yet measuredTwo prospective studies from Southern Europe suggested a lower incidence of diabetes with increasing adherence to the MedDiet in previously healthy individuals or myocardial infarction survivors.
“Two prospective studies from Southern Europe suggested a lower incidence of diabetes with increasing adherence to the MedDiet in previously healthy individuals ( 9 ) or myocardial infarction survivors ( 10 ).”
From Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet (2011) · cites this paper as [9]
Several population-based and prospective epidemiological studies have shown that adherence to the Mediterranean diet might have a protective effect against cardiovascular disease, stroke, obesity, diabetes, hypertension, several types of cancers, allergic diseases, and Alzheimer and Parkinson's disease.
“Several population-based and prospective epidemiological studies have shown that adherence to the Mediterranean diet might have a protective effect against cardiovascular disease, stroke, obesity, diabetes, hypertension, several type of cancers, allergic diseases and, most recently, Alzheimer and Parkinson’s disease (7–18).”
From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [11]
Abundant intake of MUFAs or PUFAs with olive oil and seeds, in place of saturated or trans fatty acids, may reduce the risk of type 2 diabetes in at-risk patients by up to 83% over a median of 4.4 years, even in the absence of caloric restriction.
“Moreover, the abundant intake of MUFAs or PUFAs with olive oil and seeds, in place of saturated or trans fatty acids, may also reduce the risk of T2D in at-risk patients by up to 83% over a median of 4.4 years [44], even in the absence of caloric-restriction [45].”
From Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases (2020) · cites this paper as [44]
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- Authors
- Martínez-González, M. Á., Fuente-Arrillaga, C. D. L., Nunez-Cordoba, J. M., Basterra-Gortari, F. J., Beunza, J. J., Vazquez, Z., Benito, S., Tortosa, A., & Bes-Rastrollo, M.
- Affiliations
- Complejo Hospitalario de Navarra (ES)
- Universidad de Navarra (ES)
- ORCID
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2008-05-29
- Volume
- 336
- Issue
- 7657
- Pages
- 1348-1351
- ISSN
- 1756-1833 (ISSN-L)
- 0959-8138
- PMC
- PMC2427084
- OpenAlex
- W2002163484
- Cited by
- 517
- References
- 55
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 14 · 2023: 13 · 2022: 26 · 2021: 26 · 2020: 25 · 2019: 32 · 2018: 32 · 2017: 36 · 2016: 39 · 2015: 30 · 2014: 43 · 2013: 46 · 2012: 27
- FWCI
- 35.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Deposito Adademico Digital Universidad De Navarra (University of Navarra) (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Harvard University
- University of Minnesota
- Universidad de Navarra (PI070240, PI050976)
- Universidad de Cantabria
- Universidade de Santiago de Compostela
- Instituto de Salud Carlos III (PI040233, RD06/0045, PI07/0240, PI042241, PI050976, PI03/0678)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- Mediterranean diet, dietary adherence, type 2 diabetes, diabetes incidence, diet and diabetes risk, university graduates, food frequency questionnaire, diet score
- MeSH terms
- Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 2, Epidemiologic Methods, Female, Humans, Male, Middle Aged, Patient Compliance, Diet, Mediterranean
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