| Summary: | Objective To assess the relation between adherence to a
Mediterranean diet and the incidence of diabetes among
initially healthy participants.
Design 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.
Setting Spanish university department.
Participants 13 380 Spanish university graduates without
diabetes at baseline followed up for a median of 4.4 years.
Main outcome measures 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.
Conclusion Adherence to a Mediterranean diet is
associated with a reduced risk of diabetes.
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