Mediterranean and European populations are more likely to be less racially and ethnically heterogeneous, have lower rates of obesity and overweight, be more physically active, have larger social networks, and set a higher emphasis on sleep compared to other populations. Yet, research on adherence to the Mediterranean dietary pattern and chronic disease risk in U.S. populations is limited and  remains important to assess whether potential benefits of a Mediterranean diet are translatable to other heterogeneous populations. In a middle-aged U.S. adults population, as part of the Atherosclerosis Risk in Communities (ARIC) study, a Mediterranean-style eating pattern, relatively high in healthy fats, such as olive oil, and plant-based foods, was associated with a lower risk of diabetes after a median follow-up of 22 years.