Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study.
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.


METHODS
Multicentre, prospective cohort study.


METHODS
Nine European countries (Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden, United Kingdom).


METHODS
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.


METHODS
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%).


CONCLUSIONS
The Mediterranean diet, modified so as to apply across Europe, was associated with increased survival among older people.
Trichopoulou
Antonia
A
Department of Hygiene and Epidemiology, University of Athens Medical School, Athens 11527, Greece. antonia@nut.uoa.gr
Orfanos
Philippos
P
Norat
Teresa
T
Bueno-de-Mesquita
Bas
B
Ocké
Marga C
MC
Peeters
Petra H M
PH
van der Schouw
Yvonne T
YT
Boeing
Heiner
H
Hoffmann
Kurt
K
Boffetta
Paolo
P
Nagel
Gabriele
G
Masala
Giovanna
G
Krogh
Vittorio
V
Panico
Salvatore
S
Tumino
Rosario
R
Vineis
Paolo
P
Bamia
Christina
C
Naska
Androniki
A
Benetou
Vassiliki
V
Ferrari
Pietro
P
Slimani
Nadia
N
Pera
Guillem
G
Martinez-Garcia
Carmen
C
Navarro
Carmen
C
Rodriguez-Barranco
Miguel
M
Dorronsoro
Miren
M
Spencer
Elizabeth A
EA
Key
Timothy J
TJ
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Kesse
Emmanuelle
E
Clavel-Chapelon
Francoise
F
Boutron-Ruault
Marie-Christine
MC
Berglund
Goran
G
Wirfalt
Elisabet
E
Hallmans
Goran
G
Johansson
Ingegerd
I
Tjonneland
Anne
A
Olsen
Anja
A
Overvad
Kim
K
Hundborg
Heidi H
HH
Riboli
Elio
E
Trichopoulos
Dimitrios
D
D000368:Aged; D015331:Cohort Studies; D038441:Diet, Mediterranean; D005060:Europe; D005260:Female; D006801:Humans; D008019:Life Style; D008136:Longevity; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D017678:Sex Distribution; D016019:Survival Analysis