Adherence to the Mediterranean diet, long-term weight change, and incident overweight or obesity: the Seguimiento Universidad de Navarra (SUN) cohort

Am J Clin Nutr. 2010 Dec;92(6):1484-93. doi: 10.3945/ajcn.2010.29764. Epub 2010 Oct 20.


Background: The Mediterranean dietary pattern might be a potential tool for the prevention of obesity.

Objectives: We studied the association between adherence to 6 previously published scores used to assess the adherence to the Mediterranean diet and weight change. We also assessed the risk of relevant weight gain (≥ 5 kg) or the risk of developing overweight or obesity.

Design: The study population included 10,376 Spanish men and women who were university graduates (mean age = 38 y) and were followed up for a mean (± SD) of 5.7 ± 2.2 y. Diet was assessed at baseline with a 136-item, previously validated food-frequency questionnaire. Weight was assessed at baseline and biennially during follow-up.

Results: Participants with the lowest adherence (≤ 3 points) to the Mediterranean dietary score (MDS) proposed by Trichopoulou et al (range: 0-9; N Engl J Med 2003;348:2599-608) exhibited the highest average yearly weight gain, whereas participants with the highest (≥ 6 points) adherence exhibited the lowest weight gain (adjusted difference: -0.059 kg/y; 95% CI: -0.111, -0.008 kg/y; P for trend = 0.02). This inverse association was extended to other a priori-defined MDSs. The group with the highest adherence to the MDS also showed the lowest risk of relevant weight gain (≥ 5 kg) during the first 4 y of follow-up (odds ratio: 0.76; 95% CI: 0.64, 0.90).

Conclusions: Adherence to the Mediterranean dietary pattern is significantly associated with reduced weight gain. This dietary pattern can be recommended to slow down age-related weight gain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Diet, Mediterranean*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / etiology
  • Obesity / prevention & control*
  • Odds Ratio
  • Overweight / etiology
  • Overweight / prevention & control*
  • Risk Factors
  • Spain
  • Surveys and Questionnaires
  • Weight Gain*