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

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 (6SD) of 5.7 6 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: 20.059 kg/y; 95% CI: 20.111, 20.008 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. Am J Clin Nutr 2010;92:1484–93.