Adiponectin is thought to exert anti-inflammatory actions. The aim of the present work was to evaluate the association of long-term adherence to the Mediterranean diet with adiponectin levels, in a sample of cardiovascular disease-free adults. In a random sub-sample of "ATTICA" study, 532 men and women, serum adiponectin was measured. Among several sociodemographic, clinical and biological factors, adherence to the Mediterranean diet was assessed by a special diet score (MedDietSCore) that incorporated the inherent characteristics of this traditional diet. Unadjusted analysis revealed that participants who were in the highest tertile of the diet score had an average 41% higher adiponectin levels, as compared to those who were in the lowest tertile (P<.001). Multiadjusted data analysis showed that compared to the highest tertile of diet score, participants in the middle or the lowest one had an average 0.99+/-0.22 (P=.001) and 1.05+/-0.27 microg/ml (P=.001) lower adiponectin levels after adjusting for age, sex and various bioclinical factors. Adherence to the Mediterranean diet was associated with an increase on adiponectin levels. This finding may partially explain beneficial effects of this traditional healthy diet on the cardiovascular system.