title: Mediterranean diet adherence in individuals with prediabetes and unknown diabetes: the Di@bet.es Study.
abstract: OBJECTIVE
  Mediterranean diet (MedDiet) is causally related to diabetes and is a dietary pattern recommended to individuals with diabetes. We investigated MedDiet adherence in individuals with prediabetes and unknown (PREDM/UKDM) or known diabetes (KDM) compared to those with normal glucose metabolism (NORMAL).
  
  
  METHODS
  This was a national, population-based, cross-sectional, cluster-sampling study. MedDiet adherence was scored (MedScore, mean ± SD 24 ± 5) using a qualitative food frequency questionnaire. Logistic regression was used to examine the association between MedScore and PREDM/UKDM or KDM versus control subjects.
  
  
  RESULTS
  We evaluated 5,076 individuals. Mean age was 50 years, 57% were female, 826 (582/244) were PREDM/UKDM, 478 were KDM and 3,772 were NORMAL. Mean age increased across MedScore tertiles (46, 51 and 56 years, p < 0.0001). Higher age-adjusted adherence to MedDiet (5-unit increment in the MedScore) was associated with lower and nondifferent odds (OR, 95% CI) of prevalent PREDM/UKDM (0.88, 0.81-0.96, p = 0.001) and KDM (0.97, 0.87-1.07, p = 0.279), respectively, compared to individuals in the NORMAL group.
  
  
  CONCLUSIONS
  In a representative sample of the whole Spanish population, MedDiet adherence is independently associated with PREDM/UKDM. Therapeutic intervention may be, in part, responsible for the lack of differences in adherence observed between the KDM and NORMAL groups. However, reverse causation bias cannot be ruled out in cross-sectional studies.
authors.affiliation: Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain. eortega1@clinic.ub.es
authors.forename: E
authors.initials: E
authors.lastname: Ortega
authors.forename: J
authors.initials: J
authors.lastname: Franch
authors.forename: C
authors.initials: C
authors.lastname: Castell
authors.forename: A
authors.initials: A
authors.lastname: Goday
authors.forename: L
authors.initials: L
authors.lastname: Ribas-Barba
authors.forename: F
authors.initials: F
authors.lastname: Soriguer
authors.forename: J
authors.initials: J
authors.lastname: Vendrell
authors.forename: R
authors.initials: R
authors.lastname: Casamitjana
authors.forename: A
authors.initials: A
authors.lastname: Bosch-Comas
authors.forename: E
authors.initials: E
authors.lastname: Bordiú
authors.forename: A
authors.initials: A
authors.lastname: Calle-Pascual
authors.forename: R
authors.initials: R
authors.lastname: Carmena
authors.forename: L
authors.initials: L
authors.lastname: Castaño
authors.forename: M
authors.initials: M
authors.lastname: Catalá
authors.forename: E
authors.initials: E
authors.lastname: Delgado
authors.forename: S
authors.initials: S
authors.lastname: Gaztambide
authors.forename: J
authors.initials: J
authors.lastname: Girbés
authors.forename: A
authors.initials: A
authors.lastname: López-Alba
authors.forename: M T
authors.initials: MT
authors.lastname: Martínez-Larrad
authors.forename: E
authors.initials: E
authors.lastname: Menéndez
authors.forename: I
authors.initials: I
authors.lastname: Mora-Peces
authors.forename: G
authors.initials: G
authors.lastname: Pascual-Manich
authors.forename: G
authors.initials: G
authors.lastname: Rojo-Martínez
authors.forename: M
authors.initials: M
authors.lastname: Serrano-Rios
authors.forename: I
authors.initials: I
authors.lastname: Urrutía
authors.forename: S
authors.initials: S
authors.lastname: Valdés
authors.forename: J A
authors.initials: JA
authors.lastname: Vázquez
authors.forename: R
authors.initials: R
authors.lastname: Gomis
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004034:Diet Surveys; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011236:Prediabetic State / Q000453:epidemiology*; D015995:Prevalence; D013030:Spain / Q000453:epidemiology
chemical_list: D001786:Blood Glucose