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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 Ferrari
  • Nadia 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
  • National and Kapodistrian University of Athens
  • International Agency for Research on Cancer
  • National Institute of Public Health and the Environment
  • Utrecht University
  • German Institute of Human Nutrition Potsdam-Rehbruecke
  • German Cancer Research Center
  • Centro Per Lo Studio E La Prevenzione Oncologica
  • IRCCS Fondazione Istituto Nazionale per lo studio e la cura dei tumori - Milano
  • University of Naples Federico II
  • Azienda Ospedaliera Civile M.P. Arezzo
  • Imperial College London
  • Parc Taulí Hospital Universitari
  • Escuela Andaluza de Salud Publica
  • IMIB-Arrixaca
  • Department of Public Health of Guipuzcoa
  • University of Oxford
  • MRC Mitochondrial Biology Unit
  • University of Cambridge
  • Institut national de la santé et de la recherche médicale
  • Lund University
  • Umeå University
  • Danish Cancer Society
  • Aalborg University
  • Harvard University

Research output: Contribution to journalArticlepeer-review

688 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 (Clinical research ed.)
Volume330
Issue number7498
DOIs
StatePublished - Apr 30 2005

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