The study—a large prospective study across European countries—included 11,994 patients with type 2 diabetes as well as a stratified group of 15,798 participants who were selected from a total cohort of 340,234 participants (with 3.99 million person-years of follow-up). This group was selected from 8 European cohorts that participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.
Researchers used the relative Mediterranean diet score (rMED) (with a score range of 0 to 18) to evaluate adherence to the MDP on the basis of reported consumption of 9 classic dietary components of the Mediterranean diet.
Cox proportional hazards regression—which was modified for the case-cohort design—was also used to estimate the association between rMED and the risk of developing type 2 diabetes, adjusting for confounders.
Researchers found that compared with individuals with low adherence to the MDP (rMED: 0 to 6 points) (p for trend 0.013), the multiple adjusted hazard ratios of type 2 diabetes in participants with medium adherence to MDP (rMED: 7 to 10 points) and high adherence to MDP (rMED: 11 to 18 points) were 0.93 (95% CI; 0.86 to 1.01) and 0.88 (0.79 to 0.97), respectively. In addition, the link between the rMED and type 2 diabetes was attenuated in people younger than 50 years old, in participants who were obese, and when alcohol, meat, and olive oil components were eliminated from the score.
The study concluded that adherence to the MDP (as defined by the rMED) was linked to a small reduction in the risk of developing type 2 diabetes in this European population.
The InterAct Consortium. Mediterranean diet and type 2 diabetes risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Study: The InterAct project. Diabetes Care. 2011;34(9):1913-1918. doi: 10.2337/dc11-0891.