Journal Name:
The New England Journal of Medicine
Article Title:
Adherence to a Mediterranean Diet and Survival in a Greek Population
Date Written:
2003
Volume:
348
Number:
26
Page:
2599
Author(s):
Trichopoulou, A.; Costacou, T.; Barnia, C.; Trichopoulos, D.
Article:
Several studies have investigated the effect of the traditional Mediterranean diet on prevalence of chronic diseases. The Mediterranean diet is characterized by a high intake of vegetables, legumes, fruits and nuts, cereals, and olive oil (rich in monounsaturated fat), moderate to high intakes of fish, low to moderate intakes of dairy products, and low intakes of meat, poultry, and diary products. A nine-point scale (Mediterranean-diet score) has previously been developed, and has been used in a number of studies to quantify adherence to this dietary pattern. The objective of the present study was to investigate the relationship between Mediterranean dietary pattern/Mediterranean-diet score and overall mortality in a large sample of the general Greek population.
Data for this study was obtained from the Greek component of the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which took place between 1994 and 1999. Dietary intake for 22,043 participants (20-86 years of age) was assessed via a semi-quantitative food-frequency at baseline. Adherence to the traditional Mediterranean diet was assessed by a 10-point Mediterranean-diet scale that incorporated the 9-points of the originally designed scale, with the addition of a tenth point to account for fish intake. The 10 points, or food categories, investigated included vegetables, legumes, fruits and nuts, dairy products, cereals, meat, fish, olive oil, potatoes, and eggs. A value of 0 or 1 was assigned to each category with the use of the sex specific median as the cutoff. Consumption of foods within each food group that was below the median was assigned a value of zero, while consumption above the median was assigned a value of 1. For foods presumed to be detrimental (meat, poultry, dairy), consumption below the median value was assigned a value of 1, while consumption above the median was assigned a value of 0.
During a median of 44-months of follow-up, 275 deaths occurred. A higher degree of adherence to the Mediterranean diet was associated with a reduction in total mortality. An inverse association was observed between a high adherence to this diet and death due to both coronary heart disease and cancer. Worth noting is that a 2-point increment in the score corresponded to a 25% reduction in total mortality. The reduction in mortality was observed for deaths due to both CHD and cancer. Finally, no significant association between individual food groups and total mortality was observed.
Results from this study are consistent with previous studies that have reported a beneficial effect of consuming a traditional Mediterranean diet on longevity. The observed magnitude of reduced mortality associated with greater adherence to the Mediterranean diet is compatible with the reported survival advantage of the Mediterranean population compared to North American and northern European populations., , , , ,
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