Adhesion to the Mediterranean Diet in Diabetic Patients With Poor Control

Clin Investig Arterioscler. Sep-Oct 2019;31(5):210-217. doi: 10.1016/j.arteri.2019.03.005. Epub 2019 Jul 2.
[Article in English, Spanish]


Objective: To analyse the relationship between the level of adherence to the Mediterranean diet and the control of cardiovascular risk factors.

Method: A descriptive, observational study was conducted on patients diagnosed with Diabetes Mellitus type 2, with poor blood glucose control and a Body Mass Index greater than 25kg/m2. The relationship between the adherence to the Mediterranean diet and cardiovascular risk factors was evaluated before and after education about the Mediterranean diet. The patients were given a questionnaire on the level of adherence to the Mediterranean diet (the Mediterranean diet score), at the beginning of the study and at 6 month after having education about the Mediterranean diet in the Primary Care medical and nursing clinics. An analysis was carried out on the variables including, gender, age, weight, height, and Body Mass Index, as well as the analytical parameters of blood glucose, glycosylated haemoglobin, total, HDL, LDL cholesterol, and triglycerides. The relationship between the primary variable, 'adherence to the Mediterranean diet', and the rest of the variables was calculated before and after the educational intervention.

Results: The initial 'adherence to the Mediterranean diet score' in the questionnaire was relatively low (6.22). Excess weight, as well as to have an elevated Body Mass Index are associated with a lower adherence to the Mediterranean diet, as well as low adherence to treatment (P<.00 and P<.02, respectively). The values of HDL cholesterol values increased with greater adherence (P<.04). Elevated LDL and total cholesterol are associated with a lower adherence to the Mediterranean diet (P<.01 and P<.05, respectively), similar to that of elevated triglycerides (P<.00). Elevated baseline blood glucose levels are also associated with low adherence to the Mediterranean diet (P<.04), as well as the increase in glycosylated haemoglobin (P<.06). Thus the cardiovascular risk increases with low adherence (P<.08). After the educational intervention, a moderate increase was observed in the adherence to the Mediterranean diet (a score of 6.84) as well as a notable improvement in the control of the cardiovascular risk factors.

Conclusions: Adherence to the Mediterranean diet is associated with improved control of cardiovascular risk factors.

Keywords: Diabetes; Dieta mediterránea; Hipercolesterolemia; Hypercholesterolaemia; Mediterranean diet; Obesidad; Obesity.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Glucose / metabolism
  • Body Mass Index
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diet, Mediterranean / statistics & numerical data*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Lipids / blood
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Patient Education as Topic
  • Risk Factors
  • Surveys and Questionnaires


  • Blood Glucose
  • Glycated Hemoglobin A
  • Lipids