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Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study.
BMJ. 2009 Jun 23; 338:b2337.BMJ

Abstract

OBJECTIVE

To investigate the relative importance of the individual components of the Mediterranean diet in generating the inverse association of increased adherence to this diet and overall mortality.

DESIGN

Prospective cohort study.

SETTING

Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC).

PARTICIPANTS

23 349 men and women, not previously diagnosed with cancer, coronary heart disease, or diabetes, with documented survival status until June 2008 and complete information on nutritional variables and important covariates at enrolment.

MAIN OUTCOME MEASURE

All cause mortality.

RESULTS

After a mean follow-up of 8.5 years, 652 deaths from any cause had occurred among 12 694 participants with Mediterranean diet scores 0-4 and 423 among 10 655 participants with scores of 5 or more. Controlling for potential confounders, higher adherence to a Mediterranean diet was associated with a statistically significant reduction in total mortality (adjusted mortality ratio per two unit increase in score 0.864, 95% confidence interval 0.802 to 0.932). The contributions of the individual components of the Mediterranean diet to this association were moderate ethanol consumption 23.5%, low consumption of meat and meat products 16.6%, high vegetable consumption 16.2%, high fruit and nut consumption 11.2%, high monounsaturated to saturated lipid ratio 10.6%, and high legume consumption 9.7%. The contributions of high cereal consumption and low dairy consumption were minimal, whereas high fish and seafood consumption was associated with a non-significant increase in mortality ratio.

CONCLUSION

The dominant components of the Mediterranean diet score as a predictor of lower mortality are moderate consumption of ethanol, low consumption of meat and meat products, and high consumption of vegetables, fruits and nuts, olive oil, and legumes. Minimal contributions were found for cereals and dairy products, possibly because they are heterogeneous categories of foods with differential health effects, and for fish and seafood, the intake of which is low in this population.

Authors+Show Affiliations

Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, 115 27 Athens, Greece. dtrichop@hsph.harvard.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19549997

Citation

Trichopoulou, Antonia, et al. "Anatomy of Health Effects of Mediterranean Diet: Greek EPIC Prospective Cohort Study." BMJ (Clinical Research Ed.), vol. 338, 2009, pp. b2337.
Trichopoulou A, Bamia C, Trichopoulos D. Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. BMJ. 2009;338:b2337.
Trichopoulou, A., Bamia, C., & Trichopoulos, D. (2009). Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. BMJ (Clinical Research Ed.), 338, b2337. https://doi.org/10.1136/bmj.b2337
Trichopoulou A, Bamia C, Trichopoulos D. Anatomy of Health Effects of Mediterranean Diet: Greek EPIC Prospective Cohort Study. BMJ. 2009 Jun 23;338:b2337. PubMed PMID: 19549997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. AU - Trichopoulou,Antonia, AU - Bamia,Christina, AU - Trichopoulos,Dimitrios, Y1 - 2009/06/23/ PY - 2009/6/25/entrez PY - 2009/6/25/pubmed PY - 2009/7/25/medline SP - b2337 EP - b2337 JF - BMJ (Clinical research ed.) JO - BMJ VL - 338 N2 - OBJECTIVE: To investigate the relative importance of the individual components of the Mediterranean diet in generating the inverse association of increased adherence to this diet and overall mortality. DESIGN: Prospective cohort study. SETTING: Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC). PARTICIPANTS: 23 349 men and women, not previously diagnosed with cancer, coronary heart disease, or diabetes, with documented survival status until June 2008 and complete information on nutritional variables and important covariates at enrolment. MAIN OUTCOME MEASURE: All cause mortality. RESULTS: After a mean follow-up of 8.5 years, 652 deaths from any cause had occurred among 12 694 participants with Mediterranean diet scores 0-4 and 423 among 10 655 participants with scores of 5 or more. Controlling for potential confounders, higher adherence to a Mediterranean diet was associated with a statistically significant reduction in total mortality (adjusted mortality ratio per two unit increase in score 0.864, 95% confidence interval 0.802 to 0.932). The contributions of the individual components of the Mediterranean diet to this association were moderate ethanol consumption 23.5%, low consumption of meat and meat products 16.6%, high vegetable consumption 16.2%, high fruit and nut consumption 11.2%, high monounsaturated to saturated lipid ratio 10.6%, and high legume consumption 9.7%. The contributions of high cereal consumption and low dairy consumption were minimal, whereas high fish and seafood consumption was associated with a non-significant increase in mortality ratio. CONCLUSION: The dominant components of the Mediterranean diet score as a predictor of lower mortality are moderate consumption of ethanol, low consumption of meat and meat products, and high consumption of vegetables, fruits and nuts, olive oil, and legumes. Minimal contributions were found for cereals and dairy products, possibly because they are heterogeneous categories of foods with differential health effects, and for fish and seafood, the intake of which is low in this population. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/19549997/Anatomy_of_health_effects_of_Mediterranean_diet:_Greek_EPIC_prospective_cohort_study_ L2 - https://www.bmj.com/lookup/pmidlookup?view=long&pmid=19549997 DB - PRIME DP - Unbound Medicine ER -