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Community and International Nutrition

Adherence to a Mediterranean Diet Is Associated with Reduced 3-Year Incidence of Obesity¹

² IDIBELL, Institut Català d' Oncologia, L'Hospitalet de Llobregat, 08907, Barcelona, Spain; ³ Carolina Population Center and Department of Nutrition, University of North Carolina, Chapel Hill; ⁴ Dirección de Salud de Guipúzcoa, 30014 San Sebastián, Spain; ⁵ Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; ⁶ Consejería de Sanidad y Consumo, 4008 Murcia, Spain; ⁷ Escuela Andaluza de Salud Pública, 18080 Granada, Spain; and ⁸ Consejería de Sanidad y Servicios Sociales de Asturias, 44001 Oviedo, Spain

^* To whom correspondence should be addressed. E-mail: mmendez{at}ico.scs.es.

Few studies have prospectively examined dietary patterns and adult weight change, and results to date are inconsistent. This study examines whether a Mediterranean diet (MD) pattern is associated with reduced 3-y incidence of obesity using data from the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The sample included 17,238 women and 10,589 men not obese and aged 29–65 y at baseline (1992–96). Height and weight were measured at baseline; weight was self-reported in a follow-up survey a mean of 3.3 y later. Detailed dietary history data, collected using a validated method, were used to construct a MD score. Logistic regression models were used to estimate odds of becoming overweight or obese. Among initially overweight subjects, 7.9% of women and 6.9% of men became obese, whereas 13.8% of normal weight men and 23.0% women became overweight. High MD adherence was associated with significantly lower likelihood of becoming obese among overweight subjects, with stronger associations after adjusting for underreporting of dietary data. Associations (odds ratios with 95% CI) were similar in women (0.69, 0.54–0.89) and men (0.68, 0.53–0.89). Adjusting for the plausibility of reported dietary intakes increased the magnitude of these associations, which were 0.8 without this adjustment. MD adherence was not associated with incidence of overweight in initially normal-weight subjects. Nonetheless, results suggest that promoting eating habits consistent with MD patterns may be a useful part of efforts to combat obesity.

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