Adherence to a Mediterranean dietary pattern and weight gain in a follow-up study: the SUN cohort

Abstract

Introduction: The promotion of Mediterranean Diets has generated some doubts, because of the concern that its high fat content might lead to the development of obesity. Methods: Longitudinal analysis of 6319 participants in the SUN cohort study. We used a validated semiquantitative food frequency questionnaire (136 items). Baseline adherence to a Mediterranean dietary pattern (MDP) was assessed using a score (score_1) including vegetables, fruits, cereals, nuts, pulses, fish, olive oil and moderate consumption of red wine (positively weighted), whereas meat and dairy products were negatively weighted. We assessed the association between the overall baseline adherence to the MDP (score_1) and subsequent weight change after 28 months of follow-up. We also built another score (score_2) to assess changes in diet during follow-up and appraised the association between the joint exposure to both scores and weight change during follow-up. Results: Participants in the first quartile of score_1 (lowest baseline adherence to MDP) showed a higher weight gain ( þ 0.73 kg) than those in the top quartile ( þ 0.45 kg). The results indicated an inverse dose-response relationship (P for trend ¼ 0.016). A similar inverse association was apparent when we used change in adherence to the MDP (score_2). However, both inverse associations did not remain statistically significant after adjusting for relevant confounders. Consumption of dairy products was inversely associated with weight gain. Conclusions: Although participants increased their average weight during the follow-up period, weight increments were smaller among those with a higher adherence to an 'a priori' defined MDP. Results did not remain statistically significant after multivariate adjustment.

Five-year incidence of obesity and its determinants: the ATTICA Study

“…The baseline evaluation was performed once and may be prone to measurement error; another drawback is the use of self-reported weight and height at follow-up. Although the validity of self-reported anthropometric data has been questioned (56)(57)(58) , our methodology is similar to those of other cross-sectional surveys and follow-up epidemiological studies in Europe, the USA and Australia (3,10,11,17,26,27,52) and therefore the results are comparable. We paid special attention to include in the analysis only subjects who had stable dietary habits at baseline and also those who firmly reported no change in their diet during the follow-up period.…”

“…Another limitation of the study was the response rate of 69 % at follow-up. Participation in epidemiological studies has been declining generally (59) ; however, our retention rate was among the lowest reported in the literature (3,10,13,27,52,55) . Moreover, we observed that participants who were lost to follow-up were more frequently smokers and sedentary at the baseline examination.…”

Compliance with the European and national nutritional objectives in a Mediterranean population

“…A clear example of a healthy dietary pattern is the 'traditional' Mediterranean diet, which has been shown to be protective against mortality for several causes and the development of coronary heart disease, stroke, hypertension and other chronic diseases (Martinez-Gonzalez et al, 2002;Psaltopoulou et al, 2004;Sanchez-Villegas et al, 2005;Trichopoulou et al, 2005). The nutritional objectives for the Spanish population are therefore based in the development of dietary guidelines within a Mediterranean context (Serra-Majem and Aranceta, 2001).…”

The association between body shape silhouette and dietary pattern among Mexican women

“…Several dietary patterns have been previously defined and associated with chronic diseases (8)(9)(10)(11)(12)(13) ; dietary patterns are culturally defined, however, and differ between ethnically diverse populations. There exist very few data on dietary patterns associated with obesity in the Mexican population.…”