Purpose: To investigate whether lifetime adherence to an MD pattern (i.e., from adolescence to adulthood) is associated with arterial stiffness in adults.

Methods: Longitudinal data on dietary intake (2–8 repeated measures; ages 13–36) were retrieved for 373 subjects in whom carotid stiffness was assessed by means of ultrasonography at age 36. An MD_score [range: 0 to 9 (higher values indicate better adherence)] was calculated based on values < or > the sex-specific medians or pre-defined cut-off values of vegetables, legumes, fruits/nuts, whole grains, fish, meat/poultry, dairy products, alcohol and the ratio of mono-unsaturated to saturated lipids intake. Adherence to an MD pattern (yes/no) was defined based on values > or < median of the MD_score. We used generalized estimating equations to compare, throughout the 24-yr longitudinal period, the MD_score between subjects with increasing levels [i.e., tertiles (T)] of the inversed distensiblity (DC⁻¹) and compliance coefficients, and Young’s elastic modulus.

Results: After adjustment for height, energy intake, physical activity, smoking and mean arterial pressure, and as compared to subjects with ‘stiffer’ arteries (i.e., in T3), those with ‘less stiff’ arteries (T1) had a higher lifetime mean MD_score [e.g., +0.44 (95%CI: 0.20–0.69), when considering the DC⁻¹ levels - Figure]. Subjects with ‘less stiff’ arteries were also more likely to have had adhered to an MD pattern throughout the longitudinal period than those with ‘stiffer’ arteries [OR=1.68 (1.22–2.31)].

Discussion: Promoting adherence to the MD throughout the course of young life might offer an important means to prevent accelerated arterial stiffening later in life.