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Dietary patterns and total mortality in a Mediterranean cohort: the SUN project.

Abstract

BACKGROUND

Different dietary patterns have been associated with several health outcomes, including morbidity and mortality. There is little evidence on the association between empirically derived dietary patterns and all-cause mortality in Southern European populations.

OBJECTIVE

The aim of our study was to prospectively evaluate the association between an empirically derived dietary pattern and all-cause mortality.

DESIGN

The Seguimiento Universidad de Navarra (SUN) Project is an ongoing, multipurpose, prospective and dynamic Spanish cohort.

PARTICIPANTS/SETTING

Participants were a prospective cohort of 16,008 middle-aged Spanish adults. All of them were university graduates (alumni) (59.6% women, mean age 38 years). Usual diet was assessed at baseline with a validated semiquantitative food frequency questionnaire.

MAIN OUTCOME MEASURES

Deaths were confirmed by review of medical records and of the National Death Index.

STATISTICAL ANALYSIS

Dietary patterns were ascertained through a factor (principal component) analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to the three main dietary patterns identified with factor analysis. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios and 95% CIs for mortality.

RESULTS

Three major dietary patterns were identified. They were labelled Western dietary pattern (rich in red and processed meat, potatoes, and fast food), Mediterranean dietary pattern (rich in vegetables, fish and seafood, fruits, and olive oil), and alcoholic beverages dietary pattern. During follow-up, 148 deaths were reported (mean age at death 54.5 years). After adjustment for potential confounders, the lowest risk of all-cause mortality was found in the tertile of highest adherence to the Mediterranean dietary pattern (adjusted hazard ratio for third vs first tertile 0.53, 95% CI 0.34 to 0.84) (P for trend <0.01). The Western dietary pattern and alcoholic beverages dietary pattern showed no significant association with mortality.

CONCLUSIONS

Greater adherence to an empirically derived dietary pattern approaching the traditional Mediterranean diet was associated with a reduction in the risk of all-cause mortality among middle-aged Mediterranean adults.

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    MeSH

    Adult
    Animals
    Body Mass Index
    Diet, Mediterranean
    Empirical Research
    European Continental Ancestry Group
    Factor Analysis, Statistical
    Feeding Behavior
    Female
    Fishes
    Follow-Up Studies
    Fruit
    Humans
    Life Style
    Male
    Meat Products
    Middle Aged
    Mortality
    Multivariate Analysis
    Nutrition Assessment
    Olive Oil
    Plant Oils
    Principal Component Analysis
    Proportional Hazards Models
    Prospective Studies
    Socioeconomic Factors
    Spain
    Surveys and Questionnaires
    Vegetables

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    24095621

    Citation

    Zazpe, Itziar, et al. "Dietary Patterns and Total Mortality in a Mediterranean Cohort: the SUN Project." Journal of the Academy of Nutrition and Dietetics, vol. 114, no. 1, 2014, pp. 37-47.
    Zazpe I, Sánchez-Tainta A, Toledo E, et al. Dietary patterns and total mortality in a Mediterranean cohort: the SUN project. J Acad Nutr Diet. 2014;114(1):37-47.
    Zazpe, I., Sánchez-Tainta, A., Toledo, E., Sánchez-Villegas, A., & Martínez-González, M. Á. (2014). Dietary patterns and total mortality in a Mediterranean cohort: the SUN project. Journal of the Academy of Nutrition and Dietetics, 114(1), pp. 37-47. doi:10.1016/j.jand.2013.07.024.
    Zazpe I, et al. Dietary Patterns and Total Mortality in a Mediterranean Cohort: the SUN Project. J Acad Nutr Diet. 2014;114(1):37-47. PubMed PMID: 24095621.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary patterns and total mortality in a Mediterranean cohort: the SUN project. AU - Zazpe,Itziar, AU - Sánchez-Tainta,Ana, AU - Toledo,Estefanía, AU - Sánchez-Villegas,Almudena, AU - Martínez-González,Miguel Ángel, Y1 - 2013/10/02/ PY - 2013/03/22/received PY - 2013/07/12/accepted PY - 2013/10/8/entrez PY - 2013/10/8/pubmed PY - 2014/2/11/medline KW - Dietary pattern KW - Mediterranean cohort KW - Mortality KW - Post hoc SP - 37 EP - 47 JF - Journal of the Academy of Nutrition and Dietetics JO - J Acad Nutr Diet VL - 114 IS - 1 N2 - BACKGROUND: Different dietary patterns have been associated with several health outcomes, including morbidity and mortality. There is little evidence on the association between empirically derived dietary patterns and all-cause mortality in Southern European populations. OBJECTIVE: The aim of our study was to prospectively evaluate the association between an empirically derived dietary pattern and all-cause mortality. DESIGN: The Seguimiento Universidad de Navarra (SUN) Project is an ongoing, multipurpose, prospective and dynamic Spanish cohort. PARTICIPANTS/SETTING: Participants were a prospective cohort of 16,008 middle-aged Spanish adults. All of them were university graduates (alumni) (59.6% women, mean age 38 years). Usual diet was assessed at baseline with a validated semiquantitative food frequency questionnaire. MAIN OUTCOME MEASURES: Deaths were confirmed by review of medical records and of the National Death Index. STATISTICAL ANALYSIS: Dietary patterns were ascertained through a factor (principal component) analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to the three main dietary patterns identified with factor analysis. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios and 95% CIs for mortality. RESULTS: Three major dietary patterns were identified. They were labelled Western dietary pattern (rich in red and processed meat, potatoes, and fast food), Mediterranean dietary pattern (rich in vegetables, fish and seafood, fruits, and olive oil), and alcoholic beverages dietary pattern. During follow-up, 148 deaths were reported (mean age at death 54.5 years). After adjustment for potential confounders, the lowest risk of all-cause mortality was found in the tertile of highest adherence to the Mediterranean dietary pattern (adjusted hazard ratio for third vs first tertile 0.53, 95% CI 0.34 to 0.84) (P for trend <0.01). The Western dietary pattern and alcoholic beverages dietary pattern showed no significant association with mortality. CONCLUSIONS: Greater adherence to an empirically derived dietary pattern approaching the traditional Mediterranean diet was associated with a reduction in the risk of all-cause mortality among middle-aged Mediterranean adults. SN - 2212-2672 UR - https://www.unboundmedicine.com/medline/citation/24095621/Dietary_patterns_and_total_mortality_in_a_Mediterranean_cohort:_the_SUN_project_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2212-2672(13)01180-5 DB - PRIME DP - Unbound Medicine ER -