Unhealthy lifestyle and inadequate diet could influence the development of future cardiometabolic disease. The main aim of this study was to determine the association between aerobic fitness and cardiometabolic risk factors in adults, whether this relation is depends of adherence to Mediterranean diet (MD). A secondary aim was to study the combined effect of aerobic capacity and adherence to MD on global cardiometabolic risk score (CMRS). A total of 79 adults (38% women) enrolled between 18-40 year from Cádiz. We measured adiposity indicators, blood pressure, triglycerides, glucose and inflammatory profile (interleukin-6 and tumor necrosis factor) and was computed (CMRS). Aerobic fitness was measured by maximal oxygen comsuption through an incremental stress test by cycleergometer. The MD patterns was measured using the questionnaire of adherence to MD. The association between aerobic fitness and cardiometabolic risk factors was examined using a lineal regression and it was adjusted for different confounders. CMRS on the lifestyle was analyzed using the ANOVA test, with statistical significance level of P<0.05 in Bonferroni. Linear regression showed inverse association between aerobic fitness and cardiometabolic risk factors (all P≤0.05) in the model without adjustment. Blood pressure and triglycerides lost the association after adjust model for sex, age, and adherence to MD. Participants with high aerobic fitness and high adherence to MD show a lowest CMRS (-1.083±2.325 vs. 2.802±1.759). Aerobic fitness was inversely associated with fatness risk factors, that relationship is independent to adherence to MD. A high adherence to MD could modulate blood pressure. A combination of high aerobic capacity and high adherence to MD could reduce the adverse consecuence of a low adherencie to MD. Copyright © 2019 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.