Mediterranean dietary pattern is inversely related to visceral adipose tissue in subjects with impaired fasting glucose and excess weight

Excessive visceral adipose tissue (VAT) is related to waist circumference (Wc) and impaired fasting glucose concentration (IFG) in the metabolic syndrome (MS). The relationship of Mediterranean dietary pattern (MDp) to fat distribution and risk factors of MS is not yet clear. We measured Mdp by a validated 14-items questionnaire (MEDsc≥9 points) with anthropometry, VAT and subcutaneous fat (SAT) by ultrasonography and the parameters of the MS in 1957 subjects seeking weight loss treatment at this institution. We evaluated the determinants of VAT including MEDsc. We also extracted a sample of 406 couples of IFG+ and IFG- subjects accurately matched for sex age and BMI to evaluate the independent relationship of MEDsc to VAT according to glycemic status. We found by multivariate analysis that VAT was the most important nutritional predictor of p-glucose in the whole sample with age, sex and BMI. In the sample matched for the latter factors, VAT and Wc were increased in IFG+ whereas MEDsc was similar. Exploring the determinants of VAT in the matched sample by multivariate analysis with age, sex, BMI and smoke as covariates, MEDsc resulted negatively related to VAT only in IFG+ (p=0,02) and not in IFG-. The results were confirmed in the whole sample. We conclude that VAT is a strong determinant of p-glucose independent by BMI and subcutaneous fat; in the subjects with IFG the fat distribution is sensitive to MDp, suggesting that it may protect subjects at-risk for diabetes and cardiovascular diseases.