Macro partitioning
Higher adherence to a Mediterranean diet, as measured by a 14-item screener, is inversely associated with abdominal obesity (waist-to-height ratio) and general obesity in high-risk adults, independent of total caloric intake.
To reduce abdominal fat, prioritize a Mediterranean dietary pattern over simple calorie restriction. Focus on increasing intake of nuts, olive oil, vegetables, and fish, while reducing sweetened beverages and red/processed meats. Use the waist-to-height ratio as a more accurate health indicator than BMI alone. This approach is particularly effective for individuals with existing cardiovascular risk factors.
Strong inverse linear associations between the 14-item tool and all adiposity indexes were found... High consumption of nuts and low consumption of sweetened/carbonated beverages presented the strongest inverse associations with abdominal obesity.
Why this rating
Large sample size (n=7,447), rigorous statistical adjustment, but cross-sectional design limits causal inference.
Source
A 14-Item Mediterranean Diet Assessment Tool and Obesity Indexes among High-Risk Subjects: The PREDIMED Trial
Miguel Ángel Martínez‐González et al. · PLoS ONE · 2012
DOI 10.1371/journal.pone.0043134
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