Mediterranean Diet and 10-year (2002-2012) Incidence of Diabetes and Cardiovascular Disease in Participants with Prediabetes: The ATTICA study

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Mediterranean Diet and 10-year (2002-2012) Incidence of Diabetes and Cardiovascular Disease in Participants with Prediabetes: The ATTICA study

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Incidence of Diabetes and CVD

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Original Data

Rev Diabet Stud, 2016, 13(4):226-235

DOI 10.1900/RDS.2016.13.226

Mediterranean Diet and 10-year (2002-2012) Incidence of Diabetes and Cardiovascular Disease in Participants with Prediabetes: The ATTICA study

Theodosios D. Filippatos¹, Demosthenes B. Panagiotakos¹, Ekavi N. Georgousopoulou¹, Evangelia Pitaraki¹, Georgia-Maria Kouli¹, Christina Chrysohoou², Dimitrios Tousoulis², Christodoulos Stefanadis², Christos Pitsavos², the ATTICA Study Group

¹Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
²First Cardiology Clinic, School of Medicine, University of Athens, Greece
Address correspondence to: Demosthenes B. Panagiotakos, Department of Nutrition and Dietetics, School of Health Science and Education, 70 Eleftheriou Venizelou Ave., 17671 Athens, Greece, e-mail: dbpanag@hua.gr

Manuscript submitted December 10, 2015; resubmitted February 12, 2016; accepted March 3, 2016.

Keywords: prediabetes, Mediterranean diet, impaired fasting glucose, cardiovascular disease, diabetes incidence

Abstract

BACKGROUND: Prediabetes has been related to an increased risk of developing diabetes and cardiovascular disease (CVD). AIM: The aim of the present study was to examine the effect of the Mediterranean diet on diabetes and CVD risk in subjects with impaired fasting glucose (IFG, i.e. fasting plasma glucose 100-125 mg/dl). METHODS: During 2001-2002, 3042 men and women (>18y) were enrolled for the study. The participants showed no clinical evidence of CVD or any other chronic disease, and were living in the greater Athens (Greece) area. In 2011 and 2012, the 10-year follow-up examinations were performed, including a working sample of n = 1875 participants without diabetes at baseline. Adherence to the Mediterranean diet at baseline evaluation was assessed using the MedDietScore (range 0-55). RESULTS: The prediabetic subjects (n = 343) had a significantly higher incidence of diabetes (25% vs. 10%, p < 0.001) and CVD (17.8% vs. 12.3%, p = 0.007) compared with subjects with normal glucose values. A significant trend towards lower diabetes and CVD incidence was observed with medium and high adherence to the Mediterranean diet compared with low adherence (p < 0.001). High adherence to the Mediterranean diet (>35/55 score) was associated with lower 10-year incidence of diabetes and CVD. In multiple logistic regression models, participants with high levels of adherence to the Mediterranean diet were significantly less affected by diabetes and CVD than those with low adherence levels. CONCLUSION: High adherence to the Mediterranean diet is associated with a low risk of developing diabetes and CVD in prediabetic subjects.

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