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Cross-sectional study on the relationship between the Mediterranean Diet Score and blood lipids

Evelien Mertens1*, Patrick Mullie123, Benedicte Deforche1, Johan Lefevre4, Ruben Charlier4, Inge Huybrechts56 and Peter Clarys12

Author Affiliations

1 Department of Human Biometrics and Biomechanics, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium

2 Erasmus University College, Laerbeeklaan 121, 1090 Brussels, Belgium

3 International Prevention Research Institute (iPRI), 15 chemin du Saquin, Ecully, Lyon, France

4 Department of Kinesiology, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium

5 Department of public health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium

6 International Agency for Research on Cancer (IARC), Dietary Exposure Assessment Group (DEX), 150 Cours Albert Thomas, 69372 Lyon, France

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Nutrition Journal 2014, 13:88  doi:10.1186/1475-2891-13-88

Published: 4 September 2014



Blood lipids are cardiovascular health indicators. High LDL cholesterol values and/or high total cholesterol (TC)/HDL cholesterol ratios are positively related with cardiovascular mortality. Evidence suggests that a Mediterranean diet can reduce the incidence of cardiovascular diseases. Adherence to the Mediterranean diet is often measured by the Mediterranean Diet Score (MDS). However, the association between the Mediterranean diet and blood lipid profiles seems still inconclusive. The aim of this study was to investigate the relationship between the MDS, its different components and blood lipid profiles.


A sample of 506 women and 707 men (aged 18–75 years) was recruited. Three-day diet records were used to calculate the MDS. Blood samples were analyzed for serum TC, LDL and HDL cholesterol. ANOVA was used to analyze blood lipids across the MDS tertiles. A multivariate linear regression analysis was performed to investigate the associations between the MDS, its components and blood lipids, adjusted for several confounders. All analyses were stratified by gender.


Few gender-specific associations were found between the MDS, its components and blood lipids. Only in men, the total MDS was negatively related with LDL cholesterol and the ratio TC/HDL cholesterol while positively with HDL cholesterol. In women, respectively two (MUFA/SFA and cereals) and in men three (fruits & nuts, meat and alcohol) of the nine MDS components were related with blood lipids.


Analyses investigating the relationship between the MDS, its components and blood lipid profiles indicate only limited influence of the Mediterranean diet on blood lipids. More associations were detected in men compared to women.

Mediterranean diet score; Blood cholesterol; Cardiovascular disease; Dietary pattern analysis