Public Health Nutrition

Research Paper

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

Marta Rossia1 c1, Eva Negria1, Cristina Bosettia1, Luigino Dal Masoa2, Renato Talaminia2, Attilio Giacosaa3, Maurizio Montellaa4, Silvia Franceschia5 and Carlo La Vecchiaa1a6

a1 Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via La Masa 19, I-20156 Milan, Italy

a2 Unità di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, Pordenone, Italy

a3 Policlinico di Monza, Monza, Italy

a4 Istituto Tumori ‘Fondazione Pascale’ Cappella dei Cangiani, Naples, Italy

a5 International Agency for Research on Cancer, Lyon, France

a6 Istituto di Statistica Medica e Biometria, ‘G. A. Maccacaro’ University of Milan, Milan, Italy


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.

(Received March 14 2007)

(Accepted June 22 2007)


c1 Corresponding author: Email