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

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 VineisAntonio 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, Jonas Manjer, Elisabet Wirfalt, Marianne Uhre Jakobsen, Kim Overvad, Anne Tjonneland, Jytte Halkjaer, Eiliv Lund, Toni Braaten, Dragun Engeset, Andreani Odysseos, Elio Riboli, Petra H. M. Peeters

Research output: Contribution to journalJournal articleResearchpeer-review


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.
Original languageEnglish
JournalJournal of Nutrition
Issue number9
Pages (from-to)1728-1737
Number of pages10
Publication statusPublished - 2009
Externally publishedYes


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