Adherence to a Mediterranean diet is associated with the presence and extension of atherosclerotic plaques in middle-aged asymptomatic adults: The Aragon Workers' Health Study.

•This is the first study of MEDiterranean (MeDi) and atherosclerosis in different territories.•MeDi adherence is directly correlated to presence of plaque mainly in femoral.•MeDi induces the highest protection against plaque presence in smokers.•Mediterranean diet adherence was dose dependently related to number of plaques.•Protective effect of diet on atherosclerosis was independent of risk factors.