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.

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Background:  Epidemiologic and experimental studies suggest that higher intake of dairy products could be associated with lower risk of hypertension and obesity. Differences in nutrient composition of distinct dairy products suggest that their effect on these outcomes might be heterogeneous. However, little experimental research has examined the potentially different effects of low‐ and whole‐fat dairy products on blood pressure (BP) and weight change. The present study aimed to assess whether supplementing diets with low‐ or whole‐fat dairy products would differentially affect BP levels and weight. Methods:  A randomised crossover trial in 45 normotensive volunteers (18–24 years old, 49% female) was conducted. Participants alternatively received 3.5 servings/day of whole‐fat or low‐fat dairy products (milk and yogurt) in addition to their usual diet during two 8‐week periods, with a 4‐week washout period between both interventions. Weight and BP were measured at the beginning and end of each intervention. Results:  Whole‐fat dairy supplementation significantly increased systolic BP [2.1 mmHg, 95% confidence interval (CI) = 0.1–4.0, P = 0.04] and weight (1.0 kg, 95% CI = 0.5–1.5, P = 0.0002), but not diastolic BP (P = 0.34). Weight and BP did not change significantly after the low‐fat dairy intervention (P > 0.10). There were no significant differences in the effect of low‐fat or whole‐fat dairy products on BP (P > 0.60), but whole‐fat dairy increased weight significantly compared to low‐fat dairy (1.2 kg, 95% CI = 0.5–1.8, P = 0.0007). Conclusions:  In a young nonhypertensive population, dietary supplementation with whole‐fat dairy products, compared to low‐fat dairy, was associated with weight gain. No differential effects were observed for levels of BP.