Adherence to the Mediterranean diet and body fat distribution in reproductive aged women

N S Boghossian, E H Yeung, S L Mumford, C Zhang, A J Gaskins, J Wactawski-Wende, E F Schisterman, BioCycle Study Group, N S Boghossian, E H Yeung, S L Mumford, C Zhang, A J Gaskins, J Wactawski-Wende, E F Schisterman, BioCycle Study Group

Abstract

Background/objectives: Adherence to the Mediterranean diet (MD), high in fruits, vegetables and monounsaturated fats, has been associated with lower body mass index. Associations with measured body fat, including regional adiposity, have not been previously investigated. We examined the associations between the alternate Mediterranean diet score (aMED), anthropometry and measured adiposity by dual-energy x-ray absorptiometry (DXA).

Subjects/methods: This study included 248 healthy females, aged 18-44 years from the BioCycle Study. Each woman's aMED (range 0-9) was calculated from up to eight 24-h dietary recalls over 1-2 menstrual cycles (>97% had ≥ 7 recalls). Multiple linear regression was used to determine whether aMED and its specific components were associated with total and regional adiposity after adjusting for age, race, education, physical activity and energy intake.

Results: Participants had an average (s.d.) aMED of 4.2 (1.7) and percent body fat of 29.5 (6.0)%. Significant inverse associations were found between aMED and all the examined adiposity measures except waist-to-hip ratio. Among the DXA measures, a 1-unit increment in aMED was associated with a 0.06 (95% confidence interval (CI): -0.09, -0.02) lower trunk-to-leg fat ratio (T/L), a measure of upper to lower body fat. In an analysis examining T/L as an outcome with the separate components of the aMED, T/L was lower with increased legume consumption (β=-0.280, 95% CI: -0.550, -0.010) but was higher with increased consumption of red and processed meat (β=0.060, 95% CI: 0.002, 0.117).

Conclusions: Adherence to the aMED was associated with lower total and regional adiposity, adding to the mounting evidence of the health benefits of the MD.

Conflict of interest statement

CONFLICT OF INTEREST

The authors declare no conflict of interest.

References

    1. Centers for Disease Control and Prevention. Overweight and obesity. [cited 2012 Jun 18]
    1. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307:491–497.
    1. Pasquali R, Patton L, Gambineri A. Obesity and infertility. Curr Opin Endocrinol Diabetes Obes. 2007;14:482–487.
    1. Zera C, McGirr S, Oken E. Screening for obesity in reproductive-aged women. Prev Chronic Dis. 2011;8:A125.
    1. Jacques PF, Tucker KL. Are dietary patterns useful for understanding the role of diet in chronic disease? Am J Clin Nutr. 2001;73:1–2.
    1. Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011;14:2274–2284.
    1. Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E, et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995;61:1402S–1406S.
    1. Buckland G, Bach A, Serra-Majem L. Obesity and the Mediterranean diet: a systematic review of observational and intervention studies. Obes Rev. 2008;9:582–593.
    1. Branchtein L, Schmidt MI, Mengue SS, Reichelt AJ, Matos MC, Duncan BB. Waist circumference and waist-to-hip ratio are related to gestational glucose tolerance. Diabetes Care. 1997;20:509–511.
    1. Snijder MB, van Dam RM, Visser M, Seidell JC. What aspects of body fat are particularly hazardous and how do we measure them? Int J Epidemiol. 2006;35:83–92.
    1. Wactawski-Wende J, Schisterman EF, Hovey KM, Howards PP, Browne RW, Hediger M, et al. BioCycle study: design of the longitudinal study of the oxidative stress and hormone variation during the menstrual cycle. Paediatr Perinat Epidemiol. 2009;23:171–184.
    1. Posner BM, Smigelski C, Duggal A, Morgan JL, Cobb J, Cupples LA. Validation of two-dimensional models for estimation of portion size in nutrition research. J Am Diet Assoc. 1992;92:738–741.
    1. Fung TT, McCullough ML, Newby PK, Manson JE, Meigs JB, Rifai N, et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2005;82:163–173.
    1. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003;348:2599–2608.
    1. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–1395.
    1. Lumley T, Diehr P, Emerson S, Chen L. The importance of the normality assumption in large public health data sets. Annu Rev Public Health. 2002;23:151–169.
    1. Martinez-Gonzalez MA, de lF-A, Nunez-Cordoba JM, Basterra-Gortari FJ, Beunza JJ, Vazquez Z, et al. Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ. 2008;336:1348–1351.
    1. Romaguera D, Norat T, Mouw T, May AM, Bamia C, Slimani N, et al. Adherence to the Mediterranean diet is associated with lower abdominal adiposity in European men and women. J Nutr. 2009;139:1728–1737.
    1. Trichopoulou A, Naska A, Orfanos P, Trichopoulos D. Mediterranean diet in relation to body mass index and waist-to-hip ratio: the Greek European Prospective Investigation into Cancer and Nutrition Study. Am J Clin Nutr. 2005;82:935–940.
    1. Panagiotakos DB, Chrysohoou C, Pitsavos C, Stefanadis C. Association between the prevalence of obesity and adherence to the Mediterranean diet: the ATTICA study. Nutrition. 2006;22:449–456.
    1. Panagiotakos DB, Polystipioti A, Papairakleous N, Polychronopoulos E. Long-term adoption of a Mediterranean diet is associated with a better health status in elderly people; a cross-sectional survey in Cyprus. Asia Pac J Clin Nutr. 2007;16:331–337.
    1. Rossi M, Negri E, Bosetti C, Dal ML, Talamini R, Giacosa A, et al. Mediterranean diet in relation to body mass index and waist-to-hip ratio. Public Health Nutr. 2008;11:214–217.
    1. Schroder H, Marrugat J, Vila J, Covas MI, Elosua R. Adherence to the traditional mediterranean diet is inversely associated with body mass index and obesity in a spanish population. J Nutr. 2004;134:3355–3361.
    1. Schroder H, Mendez MA, Ribas-Barba L, Covas MI, Serra-Majem L. Mediterranean diet and waist circumference in a representative national sample of young Spaniards. Int J Pediatr Obes. 2010;5:516–519.
    1. Shubair MM, McColl RS, Hanning RM. Mediterranean dietary components and body mass index in adults: the peel nutrition and heart health survey. Chronic Dis Can. 2005;26:43–51.
    1. Beunza JJ, Toledo E, Hu FB, Bes-Rastrollo M, Serrano-Martinez M, Sanchez-Villegas A, et al. Adherence to the Mediterranean diet, long-term weight change, and incident overweight or obesity: the Seguimiento Universidad de Navarra (SUN) cohort. Am J Clin Nutr. 2010;92:1484–1493.
    1. Mendez MA, Popkin BM, Jakszyn P, Berenguer A, Tormo MJ, Sanchez MJ, et al. Adherence to a Mediterranean diet is associated with reduced 3-year incidence of obesity. J Nutr. 2006;136:2934–2938.
    1. Romaguera D, Norat T, Vergnaud AC, Mouw T, May AM, Agudo A, et al. Mediterranean dietary patterns and prospective weight change in participants of the EPIC-PANACEA project. Am J Clin Nutr. 2010;92:912–921.
    1. Sanchez-Villegas A, Bes-Rastrollo M, Martinez-Gonzalez MA, Serra-Majem L. Adherence to a Mediterranean dietary pattern and weight gain in a follow-up study: the SUN cohort. Int J Obes (Lond) 2006;30:350–358.
    1. Woo J, Cheung B, Ho S, Sham A, Lam TH. Influence of dietary pattern on the development of overweight in a Chinese population. Eur J Clin Nutr. 2008;62:480–487.
    1. Dai J, Jones DP, Goldberg J, Ziegler TR, Bostick RM, Wilson PW, et al. Association between adherence to the Mediterranean diet and oxidative stress. Am J Clin Nutr. 2008;88:1364–1370.
    1. Gaskins AJ, Rovner AJ, Mumford SL, Yeung E, Browne RW, Trevisan M, et al. Adherence to a Mediterranean diet and plasma concentrations of lipid peroxidation in premenopausal women. Am J Clin Nutr. 2010;92:1461–1467.
    1. Schroder H. Protective mechanisms of the Mediterranean diet in obesity and type 2 diabetes. J Nutr Biochem. 2007;18:149–160.
    1. Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB. The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol. 2011;57:1299–1313.
    1. Gunderson EP, Murtaugh MA, Lewis CE, Quesenberry CP, West DS, Sidney S. Excess gains in weight and waist circumference associated with childbearing: The Coronary Artery Risk Development in Young Adults Study (CARDIA) Int J Obes Relat Metab Disord. 2004;28:525–535.
    1. Gunderson EP, Sternfeld B, Wellons MF, Whitmer RA, Chiang V, Quesenberry CP, Jr, et al. Childbearing may increase visceral adipose tissue independent of overall increase in body fat. Obesity (Silver Spring) 2008;16:1078–1084.
    1. Smith DE, Lewis CE, Caveny JL, Perkins LL, Burke GL, Bild DE. Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study. JAMA. 1994;271:1747–1751.
    1. Piers LS, Walker KZ, Stoney RM, Soares MJ, O’Dea K. Substitution of saturated with monounsaturated fat in a 4-week diet affects body weight and composition of overweight and obese men. Br J Nutr. 2003;90:717–727.
    1. Fung TT, Schulze M, Manson JE, Willett WC, Hu FB. Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med. 2004;164:2235–2240.
    1. Zhang C, Schulze MB, Solomon CG, Hu FB. A prospective study of dietary patterns, meat intake and the risk of gestational diabetes mellitus. Diabetologia. 2006;49:2604–2613.

Source: PubMed

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