Protective role of the Mediterranean diet on several cardiovascular risk factors: Evidence from Sicily, southern Italy

Background and aims: Epidemiological studies conducted in European countriesdemonstrated that the adoption of a Mediterranean diet protect against clustered risk factorsbut those evaluating such benefits specifically in southern Italy are scarce. Thus, the aim of thisstudy was to assess the association between the adherence to the Mediterranean diet and cardiovascularrisk factors obesity, diabetes, and hypertension.Methods and results: A cross-sectional population-based survey including 3090 subjects was conductedin Sicily, southern Italy. Food intake was evaluated through a validated food frequencyquestionnaire and adherence to the dietary pattern was assessed using the MedDietScore. Linearand logistic regression models were performed to estimate odds ratios (ORs) and respective confidenceintervals (CIs). After adjusting for confounding factors such as age and gender, participantsin the highest tertile of the MedDietScore were less likely to be obese (OR 0.35, 95% CI:0.24e0.51), hypertensive (OR 0.73, 95% CI: 0.55e0.97), and diabetic (OR 0.43, 95% CI: 0.24e0.77). Linear inverse relation between the MedDietScore and BMI (r2 Z 0.34, P < 0.001), waistcircumference (r2 Z 0.17, P < 0.001), and waist-to-hip ratio (r2 Z 0.06, P < 0.001) was found.Conclusion: Despite the prevalence rates of nutrition-related diseases are high in Sicily, greateradherence to the Mediterranean dietary pattern is still associated with a better health status.