title: Mediterranean diet and glycaemic load in relation to incidence of type 2 diabetes: results from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC).
abstract: OBJECTIVE
  The role of diet in the prevention of diabetes remains uncertain. The aim of this study was to investigate two different dietary aspects, i.e. adherence to the Mediterranean diet and glycaemic load (GL), in relation to diabetes occurrence.
  
  
  METHODS
  We analysed data from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC). From a total of 22,295 participants, actively followed for a median of 11.34 years, 2,330 cases of incident type 2 diabetes were recorded. All participants completed a validated, interviewer-administered semi-quantitative food frequency questionnaire at enrolment. From this information, we calculated a ten point Mediterranean diet score (MDS), reflecting adherence to the traditional Mediterranean diet, as well as the dietary GL. We estimated HRs and the corresponding 95% CIs of diabetes using Cox proportional hazards regression models adjusted for potential confounders.
  
  
  RESULTS
  A higher MDS was inversely associated with diabetes risk (HR 0.88 [95% CI 0.78, 0.99] for MDS ≥ 6 vs MDS ≤ 3). GL was positively associated with diabetes (HR 1.21 [95% CI 1.05, 1.40] for the highest vs the lowest GL quartile). A significant protection of about 20% was found for a diet with a high MDS and a low GL.
  
  
  CONCLUSIONS
  A low GL diet that also adequately adheres to the principles of the traditional Mediterranean diet may reduce the incidence of type 2 diabetes.
authors: Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, via La Masa, 19, 20156, Milan, Italy.
authors: M
authors: M
authors: Rossi
authors: F
authors: F
authors: Turati
authors: P
authors: P
authors: Lagiou
authors: D
authors: D
authors: Trichopoulos
authors: L S
authors: LS
authors: Augustin
authors: C
authors: C
authors: La Vecchia
authors: A
authors: A
authors: Trichopoulou
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose
references: BMJ. 2008 Jun 14;336(7657):1348-51
references: 18511765
references: Eur J Clin Nutr. 2002 Nov;56(11):1049-71
references: 12428171
references: Am J Epidemiol. 2005 Feb 1;161(3):219-27
references: 15671254
references: Am J Clin Nutr. 2007 Oct;86(4):988-94
references: 17921375
references: Am J Clin Nutr. 2008 Mar;87(3):627-37
references: 18326601
references: Am J Clin Nutr. 2007 Mar;85(3):724-34
references: 17344493
references: Am J Clin Nutr. 1981 Mar;34(3):362-6
references: 6259925
references: JAMA. 1997 Feb 12;277(6):472-7
references: 9020271
references: Epidemiology. 1995 Jan;6(1):74-7
references: 7888451
references: Arch Intern Med. 2007 Nov 26;167(21):2310-6
references: 18039989
references: Br J Nutr. 2006 Aug;96(2):384-92
references: 16923235
references: BMJ. 1995 Dec 2;311(7018):1457-60
references: 8520331
references: Diabetes Res Clin Pract. 2010 Aug;89(2):97-102
references: 20546959
references: Arch Intern Med. 2004 Nov 8;164(20):2235-40
references: 15534160
references: N Engl J Med. 2003 Jun 26;348(26):2599-608
references: 12826634
references: Diabetes Care. 1997 Apr;20(4):545-50
references: 9096978
references: Am J Clin Nutr. 2010 Oct;92(4):912-21
references: 20810975
references: Am J Clin Nutr. 2005 Nov;82(5):935-40
references: 16280422
references: Br J Nutr. 2005 Dec;94(6):917-21
references: 16351768
references: BMJ. 2008 Sep 11;337:a1344
references: 18786971
references: Am J Clin Nutr. 2002 Jul;76(1):5-56
references: 12081815
references: Prog Lipid Res. 2009 Jan;48(1):44-51
references: 19032965
references: N Engl J Med. 2001 Sep 13;345(11):790-7
references: 11556298
references: Nat Med. 2006 Jan;12(1):62-6
references: 16397571
references: Eur J Clin Nutr. 2009 Nov;63 Suppl 4:S188-205
references: 19888274
references: Am J Clin Nutr. 2010 Feb;91(2):381-90
references: 20007304
references: Arch Intern Med. 2007 Nov 26;167(21):2304-9
references: 18039988
references: Diabetes Care. 2011 Jan;34(1):14-9
references: 20929998
references: J Nutr Metab. 2011;2011:623076
references: 21804937
references: Br J Cancer. 2008 Jul 8;99(1):191-5
references: 18594542
references: N Engl J Med. 2013 Apr 4;368(14):1279-90
references: 23432189
references: Am J Clin Nutr. 2008 Jan;87(1):126-31
references: 18175745
references: Lancet. 2007 Aug 25;370(9588):667-75
references: 17720018
references: Cancer Epidemiol Biomarkers Prev. 2000 Sep;9(9):869-73
references: 11008902
references: Public Health Nutr. 2002 Dec;5(6B):1113-24
references: 12639222
references: Am J Clin Nutr. 2011 Dec;94(6):1525-32
references: 22049168
references: Metabolism. 2012 Jan;61(1):47-55
references: 21803381
references: Nutr Cancer. 2009;61(6):756-66
references: 20155613
references: Eur J Nutr. 2010 Dec;49(8):459-64
references: 20390288
references: Public Health Nutr. 2008 Feb;11(2):214-7
references: 17686205
references: Diabetes Care. 2004 Nov;27(11):2701-6
references: 15505008
references: Am J Clin Nutr. 2010 Oct;92(4):905-11
references: 20685945
references: Public Health Nutr. 2006 Dec;9(8A):1077-82
references: 17378944
references: Am J Clin Nutr. 2010 Sep;92(3):620-5
references: 20631204
references: Am J Clin Nutr. 1994 Jun;59(6):1265-9
references: 8198048
references: Cancer Epidemiol Biomarkers Prev. 2003 Oct;12(10):1091-4
references: 14578148
references: Diabetes Care. 2011 Sep;34(9):1913-8
references: 21788627
references: Am J Epidemiol. 2012 Dec 15;176(12):1185-92
references: 23186748