Mediterranean diet in relation to body mass index and waist-to-hip ratio

Objective: The Mediterranean diet is rich in fat and starch, and hence may be related to overweight. We therefore investigated the relationship between adherence to a Mediterranean diet and body mass index (BMI) and waist-to-hip ratio (WHR). Design and setting: Data were obtained from the control group of a network of case-control studies on cancer conducted in major teaching and general hospitals in four Italian areas between 1991 and 2002. An interviewer-administered validated 78-item food-frequency questionnaire was used to obtain information on the subjects' habitual diet. Information on socio-economic factors, lifestyle habits and anthropometric measures was also collected. A Mediterranean diet score (MDS) was derived on the basis of eight characteristics of the Mediterranean diet. Subjects: Subjects were 6619 patients (3090 men, 3529 women) admitted to hospital for a wide spectrum of acute, non-neoplastic conditions, unrelated to known risk factors for cancer and long-term modifications of diet. Results: In multiple linear regression models adjusted for age, study centre, education, tobacco smoking, occupational physical activity and total energy intake, the MDS was not related to BMI (β = 0.05 for men and -0.04 for women) or WHR (β = 0.000 and 0.001, respectively) in both sexes. Conclusions: Adherence to the major characteristics of the Mediterranean diet is unrelated to BMI and WHR, confirming previous data from Greece and Spain.