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Mediterranean-style dietary pattern, reduced risk of metabolic syndrome traits, and incidence in the Framingham Offspring Cohort
Open accessAbstract
Background The benefit of the Mediterranean-style dietary pattern in mitigating metabolic risk factors for type 2 diabetes and cardiovascular disease has not been well investigated among nondiabetic Americans.Objective The aim of this study was to examine the prospective association between the Mediterranean-style dietary pattern and metabolic syndrome.Design The Mediterranean-style dietary pattern score (MSDPS) was used to characterize a Mediterranean-style dietary pattern in the Framingham Heart Study Offspring Cohort. We examined the longitudinal association between MSDPS and metabolic syndrome traits (including homeostasis model assessment-insulin resistance, fasting glucose, waist circumference, triglyceride, HDL cholesterol, and systolic and diastolic blood pressure) among 2730 participants of the Framingham Heart Study Offspring Cohort without type 2 diabetes (baseline median age: 54 y; 55% women), who were followed from the fifth (baseline) to the seventh study examinations (mean follow-up time: 7 y), and metabolic syndrome incidence (according to the National Cholesterol Education Program Adult Treatment Panel III definition) in 1918 participants free of the condition at baseline.Results A higher MSDPS was associated with lower homeostasis model assessment-insulin resistance (P = 0.02), waist circumference (P < 0.001), fasting plasma glucose (P = 0.03), and triglycerides (P < 0.001) and higher HDL cholesterol (P = 0.02) after adjustment for the corresponding baseline values and for several confounding factors associated with type 2 diabetes risk. Participants in the highest quintile category of the MSDPS had a lower incidence of metabolic syndrome than those in the lowest quintile category (38.5% compared with 30.1%; P = 0.01).Conclusion Our study suggests that the consumption of a diet consistent with the principles of the Mediterranean-style diet may protect against metabolic syndrome in Americans.
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“10%-15% reduction in plasma TG levels with Mediterranean diet”
From The Forgotten Lipids: Triglycerides, Remnant Cholesterol, and Atherosclerotic Cardiovascular Disease Risk (2019) · cites this paper as [135]
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“Epidemiological and clinical trial evidence suggests that the Mediterranean-style dietary pattern 398,399 is associated with decreased triglyceride levels.”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [399]
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“Rumawas et al. 2009 [25] Study: Prospective Subjects: America, 1918, no risk marker Duration: 7 y Primary outcome: MetS components, incidence Yes No effect Yes Yes Yes MDP associated with lower HOMA-IR and lower incidence of MetS Very good control for confounders Kesse-guyot et al. 2012 [30] Study:…”
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“5 grams) of olive oil/day; (3) consumption of 2 or more servings (1 serving = 200 grams) of vegetables/ day; (4) consumption of 3 or more pieces of fruit/day; (5) consumption of less than 1 serving (1 serving = 100 grams) of red meat or hamburger or sausages/day; (6) consumption of less than 1 serving ( = 12 grams) of…”
BackgroundVisceral Adiposity and Cancer: Role in Pathogenesis and Prognosis
Crudele, L., Piccinin, E., & Moschetta, A. (2021) · Nutrients · doi:10.3390/nu13062101 · Cited by 114
“Therefore, given that MS, hyperinsulinemia, and obesity are risk factors for tumor initiation and progression, and since the MD-style pattern reduces the development of MS and central obesity by acting on lipids levels and glucose metabolism, it is reliable argument that MD may be protective against cancer onset and g…”
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“with those in the lowest quintile category (38·5 %; P1⁄40·01)((26)).”
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A Rice-Based Traditional Dietary Pattern Is Associated with Obesity in Korean Adults
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“A Mediterranean-style dietary pattern was associated with less abdominal obesity, less insulin resistance, less dyslipidemia, and lower incidence of metabolic syndrome among nondiabetic Americans (12), and a tradiional diet based on rice and beans was associated with ower risk of overweight/obesity in Brazilian adults…”
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“Western((1,2)), healthy or prudent((3)), Mediterranean((4))) are associated with an increased or decreased risk for developing metabolic disorders and chronic diseases, the primary focus of the present study will be limited to presenting the existing evidence on vegetarian dietary patterns and the risk of developing t…”
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“While this scoring systemattempts to remove the limitations of prior MedD adherence scores for a non-Mediterranean population, it is a complex calculation that, to date, has only been applied by one group outside of the original application studies(94,95).”
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“population supported the previous findings [13].”
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“(2009)((24)) T: 1918; M: 798; F: 1120; mean age 54 years; 7-year FUP; longitudinal; USA Mediterranean-style dietary pattern score; based on the Mediterranean; diet pyramid; thirteen components; score ranges from 0 to 100 points Age, sex, EI, smoking dose, BMI, and change in BMI among participants without MetS at the b…”
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“Diet compositions and dietary patterns vary according to age, gender, and ethnicity [26], and previous studies have demonstrated that food compositions and dietary patterns are associated with components of metabolic syndrome, that is, abdominal obesity, blood pressure, and lipid levels [16,27].”
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Dietary nutrient intake and metabolic syndrome risk in Chinese adults: a case–control study
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“In recent years, research studies have examined the effect of specific foods and dietary patterns on MetS [12-16].”
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Mediterranean Diet and Its Association with Cardiovascular Disease Risk Factors: A Scoping Review
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“Among the prospective observational studies, only three surveys((11,25,26)) evaluated the association between the Medi-”
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Diet quality and cardiovascular outcomes: A systematic review and meta‐analysis of cohort studies
Taylor, R., Haslam, R. L., Herbert, J., Whatnall, M. C., Trijsburg, L. E., de Vries, J. H. M., Josefsson, M. S., Koochek, A., Nowicka, P., Neuman, N., et al. (2023) · Nutrition & Dietetics · doi:10.1111/1747-0080.12860 · Cited by 63
Latest Evidence of the Effects of the Mediterranean Diet in Prevention of Cardiovascular Disease
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“…modulation of neural and cardiovascular mechanisms (Liese et al. 2003; Furukawa et al. 2004; Heine et al. 2004; Lawrence et al. 2004; McKeown et al. 2004; Möhlig et al. 2004; Schulze and Hu 2004; He et al. 2006; Mechirova et al. 2009; Singh et al. 2009c; Rumawas et al. 2009; Sawada and Yokoi 2010).”
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“As final conclusion, the variety of the available data supports the rationale for recommending the PN combination of nutraceuticals with lifestyle changes and a balanced diet as an effective approach to dyslipidemic patients [4, 5, 17].”
BackgroundThe association between diet quality indices and obesity: Tehran Lipid and Glucose Study.
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“In the Framingham Heart Study Offspring Cohort between 1991 and 2008, the prevalence of obesity and insulin resistance increased substantially in association with increases in total fat and protein intake in adults aged 25 years (Franco et al. 2009; Rumawas et al. 2009).”
Gómez-Delgado, F., Alcala-Diaz, J. F., García‐Ríos, A., Delgado‐Lista, J., Ortiz-Morales, A. M., Rangel-Zúñiga, O. A., Tinahones, F. J., González-Guardia, L., Malagón, M. M., Bellido‐Muñoz, E., et al. (2014) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201300723 · Cited by 46
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“The Mediterranean diet, high in fruits, vegetables, nuts, cereals, fish, and olive oil with moderate red wine consumption and minimal amounts of red meat and dairy products, has been linked to beneficial effects on vascular disease, blood pressure, glycemic control, and lipids [82, 83].”
Bruno, E., Gargano, G., Villarini, A., Traina, A., Johansson, H. A., Mano, M. P., de Magistris, M. S., Simeoni, M., Consolaro, E., Mercandino, A., et al. (2015) · International Journal of Cancer · doi:10.1002/ijc.29689 · Cited by 44
“In this study, the authors found that women who adhered to more dietary recommendations for preventing cancer were also less likely to develop MetS.”
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“The Mediterranean diet has long been reported to be associated with the attenuation of CVD risk factors, such as decreased total cholesterol, TAG, blood pressure, homeostasis model assessment-estimated insulin resistance (HOMA-IR), BMI and C-reactive protein levels and increased HDL levels, in randomised intervention…”
Grosso, G., Stepaniak, U., Micek, A., Topór‐Mądry, R., Stefler, D., Szafraniec, K., Bobák, M., & Pająk, A. (2015) · Metabolism · doi:10.1016/j.metabol.2015.02.007 · Cited by 45
“For each participant, daily intakes (in grams) of vegetables, legumes, fruits and nuts, cereals, fish and seafood, dairy products, meat and meat products (including red meat, poultry, and processed meat), and alcohol were estimated.”
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“[14] Rumawas ME, Meigs JB, Dwyer JT, et al.”
BackgroundInfluentialAssociation between dietary patterns and metabolic syndrome in a sample of Tehranian adults
Farhangi, M. A., Jahangiry, L., Jafarabadi, M. A., & Najafi, M. (2015) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2015.05.011 · Cited by 37
Cocate, P. G., Natali, A. J., de Oliveira, A., Alfenas, R. D. C. G., & Hermsdorff, H. H. M. (2015) · The journal of nutrition health & aging · doi:10.1007/s12603-015-0521-0 · Cited by 38
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“To name a few, the Mediterranean-style pattern in America (13) and the traditional pattern in Korea (14) were inversely associated with incidence and prevalence of metabolic syndrome and its individual components, whereas the Western pattern in Mexico (15) and the carbohydrate pattern in Thailand (16) were associated…”
BackgroundHassannejad, R., Kazemi, I., Sadeghi, M., Mohammadifard, N., Roohafza, H., Sarrafzadegan, N., Talaei, M., & Mansourian, M. (2017) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2017.10.025 · Cited by 37
Mediterranean Diet and the Metabolic Syndrome: The End of the Beginning
Esposito, K., & Giugliano, D. (2010) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2009.0095 · Cited by 36
Therapies for diabetic dyslipidaemia
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“Specifically, a diet high in vegetables, fruits, nuts, omega-3 fatty acids, olive oil and whole grains but low in refined carbohydrates, saturated fats and trans fats was associated with reduced risks for T2D, including lower levels of insulin resistance, abdominal obesity, fasting glucose and triglycerides, and impro…”
BackgroundMirmiran, P., Moslehi, N., Mahmoudof, H., Sadeghi, M., & Azizi, F. (2015) · Intern J Endocrinol Metab · doi:10.5812/ijem.26128v2 · Cited by 35
“Most previous studies reported the possible protective effect of adherence to the MedDiet on MetS prevalence and its progression (5, 6); however, most investigations had preliminary cross-sectional designs (5, 6), and only three studies investigated prospectively the association between adherence to the MedDiet and de…”
BackgroundResultInfluentialA practical approach to the metabolic syndrome: review of current concepts and management
Tota-Maharaj, R., DeFilippis, A. P., Blumenthal, R. S., & Blaha, M. J. (2010) · Current Opinion in Cardiology · doi:10.1097/hco.0b013e32833cd474 · Cited by 35
Adherence to Mediterranean Diet and Metabolic Syndrome in BRCA Mutation Carriers
Bruno, E., Manoukian, S., Venturelli, E., Oliverio, A., Rovera, F. A., Iula, G., Morelli, D., Peissel, B., Azzollini, J., Roveda, E., et al. (2017) · Integrative Cancer Therapies · doi:10.1177/1534735417721015 · Cited by 35
Tsai, Y.-T., Liu, J., Tu, Y., Lee, M., Chen, P.-R., Hsu, H., Chen, M.-F., & Chien, K. (2012) · PubMed · Cited by 34
Circulating Retinoic Acid Levels and the Development of Metabolic Syndrome
Liu, Y., Chen, H., Mu, D., Fan, J., Song, J., Yuan, Ž., Li, D., & Xia, M. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-4038 · Cited by 34
Cross-Talk between Diet-Associated Dysbiosis and Hand Osteoarthritis
Silvestre, M. P., Rodrigues, A. M., Canhão, H. M., Marques, C., Teixeira, D., Calhau, C., & Branco, J. (2020) · Nutrients · doi:10.3390/nu12113469 · Cited by 35
Metadata
- Authors
- Rumawas, M. E., Meigs, J. B., Dwyer, J. T., McKeown, N. M., & Jacques, P. F.
- Affiliations
- Tufts University (US)
- Corresponding author
- Jacques, Paul F
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2009-12
- Volume
- 90
- Issue
- 6
- Pages
- 1608-1614
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3152203
- OpenAlex
- W2135320605
- Cited by
- 246
- References
- 31
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 10 · 2023: 8 · 2022: 10 · 2021: 15 · 2020: 13 · 2019: 12 · 2018: 11 · 2017: 10 · 2016: 20 · 2015: 22 · 2014: 27 · 2013: 18 · 2012: 26
- FWCI
- 21.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- USDA (58-1950-7-707)
- NIH (NO1-HC-25195)
- National Institute of Diabetes and Digestive and Kidney Diseases (K24 DK080140)
- 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
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
- Keywords
- Mediterranean diet, metabolic syndrome, metabolic syndrome incidence, insulin resistance, waist circumference, fasting blood glucose, triglycerides, HDL cholesterol, blood pressure, Framingham Offspring cohort, type 2 diabetes risk
- MeSH terms
- Female, Humans, Insulin Resistance, Male, Middle Aged, Prospective Studies, Risk, Cohort Studies, Incidence, Metabolic Syndrome, Diet, Mediterranean
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