title: Mediterranean-style dietary pattern, reduced risk of metabolic syndrome traits, and incidence in the Framingham Offspring Cohort.
abstract: 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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111-1524, USA.
authors.forename: Marcella E
authors.initials: ME
authors.lastname: Rumawas
authors.forename: James B
authors.initials: JB
authors.lastname: Meigs
authors.forename: Johanna T
authors.initials: JT
authors.lastname: Dwyer
authors.forename: Nicola M
authors.initials: NM
authors.lastname: McKeown
authors.forename: Paul F
authors.initials: PF
authors.lastname: Jacques
mesh_terms: D015331:Cohort Studies; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk