Association between a mediterranean lifestyle and Type 2 diabetes incidence: a prospective UK biobank study

• Published in: Cardiovascular diabetology Vol. 22; no. 1; pp. 1 - 271
• Main Authors: Maroto-Rodriguez, Javier, Ortolá, Rosario, Carballo-Casla, Adrián, Iriarte-Campo, Víctor, Salinero-Fort, Miguel Ángel, Rodríguez-Artalejo, Fernando, Sotos-Prieto, Mercedes
• Format: Journal Article
• Language: English
• Published: London BioMed Central 04-10-2023; BMC
• Subjects: Adult-onset diabetes; Biobanks; Body mass index; Cardiovascular disease; Cardiovascular diseases; Cholesterol; Chronic illnesses; Cohort; Diabetes; Diabetes mellitus (non-insulin dependent); Diet; Ethnicity; Exercise; Family medical history; Food; Food consumption; Hypertension; Lifestyle medicine; Lifestyles; Medicin och hälsovetenskap; Metabolism; Olive oil; Physical activity; Prevention; Primary care; Public health; Regression analysis; Self report; England; Scotland; United Kingdom > UK; Wales
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-023-01999-x

BackgroundThere is mounting evidence that the Mediterranean diet prevents type 2 diabetes, but little is known about the role of Mediterranean lifestyles other than diet and among non-Mediterranean populations. This work aimed to examine the association between a comprehensive Mediterranean-type lifestyle and type 2 diabetes incidence in a British adult population.MethodsWe used data from 112,493 individuals free of cardiovascular disease and type 2 diabetes mellitus, aged 40–69 years, from the UK Biobank cohort, who were followed from 2009 to 2010 to 2021. The Mediterranean lifestyle was assessed through the 25-item MEDLIFE index, which comprises three blocks: (a) “Mediterranean food consumption”, (b) “Mediterranean dietary habits”, (c) “Physical activity, rest, social habits, and conviviality”. Diabetes incidence was obtained from clinical records. Cox proportional-hazards regression models were used to analyze associations and adjusted for the main potential confounders.ResultsAfter a median follow-up of 9.4 years, 2,724 cases of type 2 diabetes were ascertained. Compared to the first quartile of MEDLIFE adherence, the hazard ratios (95% confidence interval) for increasing quartiles of adherence were 0.90 (0.82–0.99), 0.80 (0.72–0.89) and 0.70 (0.62–0.79) (p-trend < 0.001). All three blocks of MEDLIFE were independently associated with lower risk of diabetes.ConclusionsHigher adherence to the MEDLIFE index was associated with lower risk of type 2 diabetes in the UK Biobank. A Mediterranean-type lifestyle, culturally adapted to non-Mediterranean populations, could help prevent diabetes.