Mediterranean-Type Diet Adherence and Body Mass Index through 20 Years of Follow-Up: Results from the ATTICA Cohort Study (2002-2022)

Evangelia Damigou; Michael Georgoulis; Christina Chrysohoou; Fotios Barkas; Elpiniki Vlachopoulou; Petros S Adamidis; Evrydiki Kravvariti; Costas Tsioufis; Christos Pitsavos; Evangelos Liberopoulos; Petros P Sfikakis; Demosthenes Panagiotakos

doi:10.3390/nu16081128

Mediterranean-Type Diet Adherence and Body Mass Index through 20 Years of Follow-Up: Results from the ATTICA Cohort Study (2002-2022)

Nutrients. 2024 Apr 11;16(8):1128. doi: 10.3390/nu16081128.

Affiliations

¹ Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece.
² First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece.
³ Department of Internal Medicine, Medical School, University of Ioannina, 45500 Ioannina, Greece.
⁴ First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece.

Abstract

Evidence of the association between dietary habits and long-term body weight status is scarce. This study aimed to evaluate changes in Mediterranean-type diet (MTD) adherence in relation to body weight during 20 years of follow-up. Data from n = 1582 participants from the ATTICA cohort study (2002-2022) were used. MTD adherence was assessed via MedDietScore, and body weight status via body mass index (BMI) by 3 different measurements. We found that MTD adherence and changes in this adherence were inversely related to BMI at 20 years and the mean BMI during the 20-year follow-up. In multi-adjusted linear regression models, a 1/55 increase in baseline, 10-year, and 20-year MedDietScore was associated with a decrease of 0.05-0.13 kg/m² in BMI at 20 years and of 0.08-0.09 kg/m² in the mean BMI. Being consistently close to the MTD for 20 years was associated with a >90% decreased risk of maintaining overweight/obesity during the 20-year period. Strong, protective, long-lasting effects of the MTD were observed, even in those who deviated from the MTD in the follow-up (41% of the sample). Our results highlight the need to focus on the overall diet quality to minimize the risk of maintaining an excessive body weight during the life-course.

Keywords: Mediterranean diet; body mass index; dietary habits; obesity predisposition; obesity risk; weight trajectories.

MeSH terms

Adult
Body Mass Index*
Body Weight
Cohort Studies
Diet, Mediterranean* / statistics & numerical data
Feeding Behavior
Female
Follow-Up Studies
Humans
Male
Middle Aged
Obesity*
Overweight
Patient Compliance / statistics & numerical data

Grants and funding

The study has been funded by research grants from the Hellenic Cardiological Society (HCS2002) and the Hellenic Atherosclerosis Society (HAS2003). E.D. has received scholarship from the Hellenic Atherosclerosis Society.