Abstract
Weight loss maintenance is crucial for obesity management, yet optimal dietary patterns for this period are not established. We aimed to explore the relationship between adherence to the Mediterranean diet and weight loss maintenance. Sample includes 565 adults (62 % women) of the MedWeight study. Eligible volunteers were those reporting intentional weight loss of ≥10 %, starting from a BMI ≥ 25 kg/m2, over 12 months prior to enrolment. Based on current weight, participants were characterised as maintainers (≤90 % maximum weight) or regainers (>95 % maximum weight). Socio-demographics and weight history were recorded. Dietary intake was assessed by two non-consecutive 24-h recalls within 10 d and analysed in energy, macronutrient and food group intakes. Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Score (MedDietScore) (range 0–55, greater scores showing higher adherence). Protein intake was higher in maintainers than in regainers (P < 0·001). When MedDietScore quartiles were considered, a linear trend for weight loss maintenance was revealed (P < 0·05). After adjustment for basic demographic characteristics, being in the third or fourth quartile of the MedDietScore (v. first) was associated with 2·30 (95 % CI 1·29, 4·09) and 1·88 (95% CI 1·10, 3·22) increased odds of maintenance. Regarding individual MedDietScore components, only fruit intake is associated with increased odds for maintenance (1·03 (95% CI 1·01, 1·06)). The leave-one-out approach revealed that at least six MedDietScore components were essential for the observed relationship. Higher adherence to the Mediterranean diet was associated with 2-fold increased likelihood of weight loss maintenance. Future studies should replicate these findings in non-Mediterranean populations as well.
Highlights
The term Mediterranean diet is used to describe the traditional dietary pattern of the people residing in the Mediterranean basin, characterised by abundance of plant foods such as fruits, vegetables, either as main or side dish, cereals, including bread, legumes, nuts and seeds
The leave-one-out approach showed that the MedDietScore was not associated with weight loss maintenance in six of the eleven altered MedDietScore models. These were the scores that were calculated without the respective loadings from potatoes (OR 1·62) without the respective loadings from potatoes, fruit (OR 1·70), legumes (OR 1·38), olive oil (OR 1·66), red meat (OR 1·74) and alcohol (OR 1·52) weekly consumption. This is one of the first studies exploring the relationship between adherence to the Mediterranean diet and long-term weight loss maintenance
Our results suggest that high adherence to the Mediterranean diet is associated with a 2-fold increased likelihood of weight loss maintenance in this large cohort of maintainers and regainers
Summary
The term Mediterranean diet is used to describe the traditional dietary pattern of the people residing in the Mediterranean basin, characterised by abundance of plant foods such as fruits, vegetables, either as main or side dish, cereals, including bread, legumes, nuts and seeds. Two interventional weight loss studies with 6 months of follow-up suggest that adhering to the Mediterranean diet after weight loss may favour maintenance outcomes[16,17]. Our hypothesis was that higher adherence to the Mediterranean dietary pattern in the post-dieting period is associated with favourable outcomes for the maintenance of reduced body weight. To address this hypothesis, we explored the relationship between adherence to the Mediterranean diet and long-term weight loss maintenance in the MedWeight study[18], a large cohort of weight loss maintainers and regainers, reporting lifestyle data for at least 12 months after initial weight loss
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
