Abstract
Background/Objectives: The decrease in estrogen levels during menopause is associated with an increase in visceral fat accumulation, which can contribute to the development of metabolic syndrome (MetS). While some studies have suggested a link between the Mediterranean diet (MedDiet) and the reduced incidence of MetS and its components in the general population, these findings have not been confirmed among postmenopausal women. Therefore, this study investigated the association between the adherence to the MedDiet and the odds of having MetS, and established the food groups responsible for this effect in postmenopausal women. Methods: This cross-sectional study involved 312 postmenopausal women who underwent anthropometric measurements and blood parameter assessment. Adherence to the MedDiet was assessed using the Alternate Mediterranean Diet score (the aMED score), and MetS was defined based on the updated 2022 criteria. Results: After adjusting for potential confounders, adherence to the MedDiet was inversely associated with central obesity and hypertension. For each one-point increase in the aMED score (indicating a better adherence to the MedDet), the odds of central obesity and hypertension were significantly reduced by 33% (OR = 0.669, 95% CI: 0.518; 0.866, p = 0.002) and by 18% (OR = 0.817, 95% CI: 0.689; 0.969, p = 0.020), respectively. A greater consumption of nuts and fish was associated with lower odds of central obesity (OR = 0.972, 95% CI: 0.950; 0.995; p = 0.016) and (OR = 0.989, 95%CI: 0.979; 1.000; p = 0.043), respectively, whereas high processed red meat consumption was associated with hypertension (OR = 1.004, 95% CI: 1.000; 1.008, p = 0.048). Conclusions: A greater adherence to the MedDiet was associated with lower odds of central obesity and hypertension among postmenopausal women; however, it did not translate to a reduced likelihood of having MetS. A higher consumption of nuts and fish was associated with lower odds of central obesity, whereas a higher consumption of red, processed meats was associated with higher odds of hypertension. Longitudinal studies are needed to determine the causality of these relationships.