Adherence to the Mediterranean Diet Is Associated with Lower Abdominal Adiposity in European Men and Women

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Given the lack of consistent evidence of the relationship between Mediterranean dietary patterns and body fat, we assessed the cross-sectional association between adherence to a modified Mediterranean diet, BMI, and waist circumference (WC). A total of 497,308 individuals (70.7% women) aged 25-70 y from 10 European countries participated in this study. Diet was assessed at baseline using detailed validated country-specific questionnaires, and anthropometrical measurements were collected using standardized procedures. The association between the degree of adherence to the modified-Mediterranean Diet Score (mMDS) (including high consumption of vegetables, legumes, fruits and nuts, cereals, fish and seafood, and unsaturated: saturated fatty acids ratio; moderate alcohol intake; and low consumption of meat and meat products and dairy products) and BMI (kg.m(-2)) or WC (cm was modeled through mixed-effects linear regression, controlling for potential confounders. Overall, the mMDS was not significantly associated with BMI. Higher adherence to the Mediterranean diet was significantly associated with lower WC, for a given BMI, in both men (-0.09; 95% CI -0.14 to -0.04) and women (-0.06; 95% CI -0.10 to -0.01). The association was stronger in men (-0.20; 95% CI -0.23 to -0.17) and women (-0.17; 95% CI -0.21 to -0.13) from Northern European countries. Despite the observed heterogeneity among regions, results of this study suggest that adherence to a modified Mediterranean diet, high in foods of vegetable origin and unsaturated fatty acids, is associated with lower abdominal adiposity measured by WC in European men and women. J. Nutr. 139: 1728-1737, 2009.


  • Dora Romaguera
  • Teresa Norat
  • Traci Mouw
  • Anne M. May
  • Christina Bamia
  • Nadia Slimani
  • Noemie Travier
  • Herve Besson
  • Jian'an Luan
  • Nick Wareham
  • Sabina Rinaldi
  • Elisabeth Couto
  • Francoise Clavel-Chapelon
  • Marie-Christine Boutron-Ruault
  • Vanessa Cottet
  • Domenico Palli
  • Claudia Agnoli
  • Salvatore Panico
  • Rosario Tumino
  • Paolo Vineis
  • Antonio Agudo
  • Laudina Rodriguez
  • Maria Jose Sanchez
  • Pilar Amiano
  • Aurelio Barricarte
  • Jose Maria Huerta
  • Timothy J. Key
  • Elisabeth A. Spencer
  • H. Bas Bueno-de-Mesquita
  • Frederike L. Buchner
  • Philippos Orfanos
  • Androniki Naska
  • Antonia Trichopoulou
  • Sabine Rohrmann
  • Rudolf Kaaks
  • Manuela Bergmann
  • Heiner Boeing
  • Ingegerd Johansson
  • Veronica Hellstrom
  • Marianne Uhre Jacobsen
  • Kim Overvad
  • Anne Tjonneland
  • Jytte Halkjaer
  • Eiliv Lund
  • Toni Braaten
  • Dragun Engeset
  • Andreani Odysseos
  • Elio Riboli
  • Petra H. M. Peeters
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Nutrition and Dietetics
Original languageEnglish
Pages (from-to)1728-1737
JournalJournal of Nutrition
Issue number9
Publication statusPublished - 2009
Publication categoryResearch