Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study.
OBJECTIVE
To assess the relation between adherence to a Mediterranean diet and the incidence of diabetes among initially healthy participants.


METHODS
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.


METHODS
Spanish university department.


METHODS
13 380 Spanish university graduates without diabetes at baseline followed up for a median of 4.4 years.


METHODS
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.


CONCLUSIONS
Adherence to a Mediterranean diet is associated with a reduced risk of diabetes.
Department of Preventive Medicine and Public Health, Medical School-Clinica Universitaria, University of Navarra, Pamplona, Spain. mamartinez@unav.es
M A
MA
Martínez-González
C
C
de la Fuente-Arrillaga
J M
JM
Nunez-Cordoba
F J
FJ
Basterra-Gortari
J J
JJ
Beunza
Z
Z
Vazquez
S
S
Benito
A
A
Tortosa
M
M
Bes-Rastrollo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D038441:Diet, Mediterranean; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance