Conclusions
T2D
The findings of the current study have demonstrated the utility of combining circulating carotenoids and fatty acids as a composite biomarker of the Mediterranean diet. The inverse association between a biomarker score of this dietary pattern and T2D was approximately 3-fold larger than for adherence to the Mediterranean diet estimated from dietary self-report, thus raising the possibility that adherence to the Mediterranean diet is likely to be more beneficial for the primary prevention of T2D than previously estimated from observational dietary studies. These results add to the evidence in favour of adopting a Mediterranean-type diet in Western European adults for the prevention of T2D.