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Adherence to a Mediterranean dietary pattern and weight gain in a follow-up study: the SUN cohort



The promotion of Mediterranean Diets has generated some doubts, because of the concern that its high fat content might lead to the development of obesity.


Longitudinal analysis of 6319 participants in the SUN cohort study. We used a validated semiquantitative food frequency questionnaire (136 items). Baseline adherence to a Mediterranean dietary pattern (MDP) was assessed using a score (score_1) including vegetables, fruits, cereals, nuts, pulses, fish, olive oil and moderate consumption of red wine (positively weighted), whereas meat and dairy products were negatively weighted. We assessed the association between the overall baseline adherence to the MDP (score_1) and subsequent weight change after 28 months of follow-up. We also built another score (score_2) to assess changes in diet during follow-up and appraised the association between the joint exposure to both scores and weight change during follow-up.


Participants in the first quartile of score_1 (lowest baseline adherence to MDP) showed a higher weight gain (+0.73 kg) than those in the top quartile (+0.45 kg). The results indicated an inverse dose–response relationship (P for trend=0.016). A similar inverse association was apparent when we used change in adherence to the MDP (score_2). However, both inverse associations did not remain statistically significant after adjusting for relevant confounders. Consumption of dairy products was inversely associated with weight gain.


Although participants increased their average weight during the follow-up period, weight increments were smaller among those with a higher adherence to an ‘a priori’ defined MDP. Results did not remain statistically significant after multivariate adjustment.

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We are indebted to the participants of the SUN Study for their continued cooperation and participation. The Department of Health of the Navarre Regional Government and Spanish Ministry of Health (Fondo de Investigaciones Sanitarias, projects 01/0619 and 04/042241 and G03/140, Red Temática de Dieta y Enfermedad Cardiovascular) are gratefully acknowledged for supporting the present study. We would like to thank other members of the SUN Study Group: M Seguí-Gómez, A Alonso, RM Pajares, JA Martinez, M Delgado-Rodríguez, M Serrano-Martínez, M Marques, A Marti, M Muñoz, F Guillén-Grima and I Aguinaga and our advisors from the Department of Nutrition of the Harvard School of Public Health: A Ascherio, W Willett and FB Hu, who helped us to design the SUN cohort study.

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Sánchez-Villegas, A., Bes-Rastrollo, M., Martínez-González, M. et al. Adherence to a Mediterranean dietary pattern and weight gain in a follow-up study: the SUN cohort. Int J Obes 30, 350–358 (2006).

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  • Mediterranean dietary pattern
  • olive oil
  • overweight
  • weight gain
  • cohort study

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