A South Asian Mediterranean‐style diet is associated with favorable adiposity measures and lower diabetes risk: The MASALA cohort

Abstract Objective The Mediterranean diet is associated with lower risks for type 2 diabetes (T2D) and cardiovascular disease in certain populations, although data among diverse groups are limited. This study evaluated cross‐sectional and prospective associations between a novel South Asian Mediterranean‐style (SAM) diet and cardiometabolic risk among US South Asian individuals. Methods The study included 891 participants at baseline in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Culturally relevant foods were grouped into nine categories to construct the SAM score. The study examined associations of this score with cardiometabolic risk factors and incident T2D. Results At baseline, higher adherence to the SAM diet was associated with lower glycated hemoglobin (−0.43% ± 0.15% per 1‐unit increase in SAM score; p = 0.004) and lower pericardial fat volume (−1.22 ± 0.55 cm 3 ; p = 0.03), as well as a lower likelihood of obesity (odds ratio [OR]: 0.88, 95% CI: 0.79–0.98) and fatty liver (OR: 0.82, 95% CI: 0.68–0.98). Over the follow‐up (~5 years), 45 participants developed T2D; each 1‐unit increase in SAM score was associated with a 25% lower odds of incident T2D (OR: 0.75, 95% CI: 0.59–0.95). Conclusions A greater intake of a SAM diet is associated with favorable adiposity measures and a lower likelihood of incident T2D.