Abstract

BACKGROUND
The Mediterranean diet has been associated with reduced mortality; few studies have investigated the combined impact of the Mediterranean diet with other modifiable lifestyle factors.
OBJECTIVES
The objectives were to investigate the association between adherence to the Mediterranean diet and total mortality and to estimate the overall impact of a combined healthy lifestyle on premature death.
DESIGN
In 1986 a cohort of 120,852 men and women aged 55-69 y provided information on dietary and other lifestyle habits. A mortality follow-up until 1996 was established by linkage to the Dutch Central Bureau of Genealogy. A combined lifestyle score was constructed by allocating one point per the following healthy lifestyle factors: adhering to the Mediterranean diet, nonsmoking, normal weight [BMI (in kg/m(2)): 18.5 to <25], and regular physical activity. The lifestyle score ranged from 0 to 4 points (least healthy to healthiest). The multivariate case-cohort analysis was based on 9691 deaths and 3576 subcohort members.
RESULTS
Adherence to the Mediterranean diet was significantly related to lower mortality in women but not significantly in men. The healthy lifestyle score was strongly inversely related to mortality in women and men. When the least-healthy to the healthiest lifestyle scores were compared, HRs of 4.07 (95% CI: 2.59, 6.40; P-trend <0.001) and 2.61 (95% CI: 1.79, 3.80; P-trend <0.001) were shown in women and men, respectively. For the same comparison, the mortality rate advancement period ("aging effect") was 15.1 y (95% CI: 9.9, 20.2 y) in women and 8.4 y (95% CI: 5.0, 11.8 y) in men.
CONCLUSION
This study suggests that adherence to 4 modifiable healthy lifestyle factors can substantially reduce premature mortality in women and men.

Links

Publisher Full Text

Authors

van den Brandt PA

Institution

Department of Epidemiology, Schools for Oncology and Developmental Biology and Public Health and Primary Care, Maastricht University Medical Centre, Netherlands. pa.vandenbrandt@maastrichtuniversity.nl

Source

The American journal of clinical nutrition 94:3 2011 Sep pg 913-20

MeSH

Aged
Aging
Body Mass Index
Body Weight
Diet, Mediterranean
Exercise
Female
Health Behavior
Humans
Life Style
Male
Middle Aged
Mortality
Proportional Hazards Models
Reference Values
Sex Factors
Smoking

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21795445