Association of the mediterranean diet with onset of diabetes in Women

A study investigated whether the Mediterranean (MED) diet is associated with a reduced risk of diabetes in a US population, and if so, what the possible underlying biological mechanistic pathways might be.
25,317 women were followed up for 20 years in a prospective epidemiological cohort study. Each participant’s MED intake score (range, 0 to 9) was computed from self-reported dietary intake, representing adherence to Mediterranean diet intake. Moderate alcohol consumption was included as one of 9 key elements of the Mediterranean diet (defined as being in the range of 5 to 15 g/d).
2,307 of the participants developed type 2 diabetes. Higher baseline MED intake (defined as MED score ≥6 vs ≤3) was associated with a 30% reduction in future risk of diabetes; biomarkers of insulin resistance, adiposity, high-density lipoprotein, and inflammation contributed most to explaining this inverse association.
In post hoc subgroup analyses, the significant reduced prevalence among consumers of a MED diet of type 2 diabetes was seen only among women who had BMI of at least 25 at baseline but not those who had BMI of less than 25 (eg, women with BMI <25, age- and energy-adjusted HR for MED score ≥6 vs ≤3, 1.01; 95% CI, 0.77-1.33; P for trend = .92; women with BMI ≥25: HR, 0.76; 95% CI, 0.67-0.87).
In this cohort study, higher MED, including moderate alcohol intake scores were associated with a 30% relative risk reduction in type 2 diabetes during a 20-year period, for those with a BMI of 25 or more, which could be explained in large part by biomarkers of insulin resistance, BMI, lipoprotein metabolism, and inflammation.
Source: Ahmad S, Demler OV, Sun Q, et al. Association of the Mediterranean Diet With Onset of Diabetes in the Women’s Health Study. JAMA Netw Open. 2020;3(11):e2025466.