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Adherence to the Mediterranean dietary pattern is positively associated with plasma adiponectin concentrations in diabetic women^1,2,3

¹ From the Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (CSM and CJW); the Departments of Epidemiology (JEM and FBH) and Nutrition (FBH), Harvard School of Public Health, Boston, MA; the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM and FBH); the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the General Medicine Division and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (JBM)

Background: Although the typical diet of the Mediterranean region has received much recognition over the past several years for its association with substantial health benefits, it remains unknown whether its favorable effects are mediated through changes in adiponectin concentrations.

Objective: The objective was to determine whether adherence to a Mediterranean-type diet is associated with higher plasma adiponectin concentrations.

Design: This study was a prospective and cross-sectional evaluation of plasma adiponectin concentrations and dietary data from 987 diabetic women from the Nurses' Health Study who had no history of cardiovascular disease at the time blood was drawn in 1990.

Results: Women who scored highest on a 9-point scale that measures adherence to a Mediterranean-type dietary pattern tended to be older, were less likely to be current smokers, had lower body mass indexes and waist circumferences, and had higher total energy intakes, physical activities, and plasma adiponectin concentrations than did women with the lowest scores. Median plasma adiponectin concentrations were 23% higher in women who most closely followed a Mediterranean-type diet than in low adherers after adjustment for age and energy intake (P < 0.01). Body composition, lifestyle, and medical history explained some, but not all, of the observed association between diet and adiponectin concentrations because high adherers tended to have greater adiponectin concentrations than did moderate or low adherers, even after adjustment for these variables.

Conclusions: Our data suggest that, of the several components of the Mediterranean dietary pattern score, alcohol, nuts, and whole grains show the strongest association with adiponectin concentrations. Close adherence to a Mediterranean-type diet is associated with higher adiponectin concentrations.

Key Words: Mediterranean diet • adiponectin • cardiovascular disease risk

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