Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study

Antonia Trichopoulou, Philippos Orfanos, Teresa Norat, Bas Bueno-de-Mesquita, Marga C. Ocké, Petra H.M. Peeters, Yvonne T. van der Schouw, Heiner Boeing, Kurt Hoffmann, Paolo Boffetta, Gabriele Nagel, Giovanna Masala, Vittorio Krogh, Salvatore Panico, Rosario Tumino, Paolo Vineis, Christina Bamia, Androniki Naska, Vassiliki Benetou, Pietro FerrariNadia Slimani, Guillem Pera, Carmen Martinez-Garcia, Carmen Navarro, Miguel Rodriguez-Barranco, Miren Dorronsoro, Elizabeth A. Spencer, Timothy J. Key, Sheila Bingham, Kay Tee Khaw, Emmanuelle Kesse, Francoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Goran Berglund, Elisabet Wirfalt, Goran Hallmans, Ingegerd Johansson, Anne Tjonneland, Anja Olsen, Kim Overvad, Heidi H. Hundborg, Elio Riboli, Dimitrios Trichopoulos

Research output: Contribution to journalArticlepeer-review

644 Scopus citations

Abstract

Objective: To examine whether adherence to the modified Mediterranean diet, in which unsaturates were substituted for monounsaturates, is associated with longer life expectancy among elderly Europeans. Design: Multicentre, prospective cohort study. Setting: Nine European countries (Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden, United Kingdom). Participants: 74 607 men and women, aged 60 or more, without coronary heart disease, stroke, or cancer at enrolment and with complete information about dietary intake and potentially confounding variables. Main outcome measures: Extent of adherence to a modified Mediterranean diet using a scoring system on a 10 point scale, and death from any cause by time of occurrence, modelled through Cox regression. Results: An increase in the modified Mediterranean diet score was associated with lower overall mortality, a two unit increment corresponding to a statistically significant reduction of 8% (95% confidence interval 3% to 12%). No statistically significant evidence of heterogeneity was found among countries in the association of the score with overall mortality even though the association was stronger in Greece and Spain. When dietary exposures were calibrated across countries, the reduction in mortality was 7% (1% to 12%). Conclusion: The Mediterranean diet, modified so as to apply across Europe, was associated with increased survival among older people.

Original languageEnglish
Pages (from-to)991-995
Number of pages5
JournalBMJ
Volume330
Issue number7498
DOIs
StatePublished - 30 Apr 2005
Externally publishedYes

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