Dietary patterns and survival of older Europeans: the EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition).
OBJECTIVE
To investigate the association of a posteriori dietary patterns with overall survival of older Europeans.


METHODS
This is a multi-centre cohort study. Cox regression analysis was used to investigate the association of the prevailing, a posteriori-derived, plant-based dietary pattern with all-cause mortality in a population of subjects who were 60 years or older at recruitment to the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort). Analyses controlled for all known potential risk factors.


METHODS
In total, 74,607 men and women, 60 years or older at enrolment and without previous coronary heart disease, stroke or cancer, with complete information about dietary intakes and potentially confounding variables, and with known survival status as of December 2003, were included in the analysis.


RESULTS
An increase in the score which measures the adherence to the plant-based diet was associated with a lower overall mortality, a one standard deviation increment corresponding to a statistically significant reduction of 14% (95% confidence interval 5-23%). In country-specific analyses the apparent association was stronger in Greece, Spain, Denmark and The Netherlands, and absent in the UK and Germany.


CONCLUSIONS
Greater adherence to the plant-based diet that was defined a posteriori in this population of European elders is associated with lower all-cause mortality. This dietary score is moderately positively correlated with the Modified Mediterranean Diet Score that has been constructed a priori and was also shown to be beneficial for the survival of the same EPIC-Elderly cohort.
Bamia
Christina
C
Department of Hygiene and Epidemiology, University of Athens, Medical School, 75 Mikras Asias Street, 115 27 Athens, Greece.
Trichopoulos
Dimitrios
D
Ferrari
Pietro
P
Overvad
Kim
K
Bjerregaard
Lone
L
Tjønneland
Anne
A
Halkjaer
Jytte
J
Clavel-Chapelon
Françoise
F
Kesse
Emmanuelle
E
Boutron-Ruault
Marie-Christine
MC
Boffetta
Paolo
P
Nagel
Gabriele
G
Linseisen
Jacob
J
Boeing
Heiner
H
Hoffmann
Kurt
K
Kasapa
Christina
C
Orfanou
Anastasia
A
Travezea
Chrysoula
C
Slimani
Nadia
N
Norat
Teresa
T
Palli
Domenico
D
Pala
Valeria
V
Panico
Salvatore
S
Tumino
Rosario
R
Sacerdote
Carlotta
C
Bueno-de-Mesquita
H Bas
HB
Waijers
Patricia M C M
PM
Peeters
Petra H M
PH
van der Schouw
Yvonne T
YT
Berenguer
Antonio
A
Martinez-Garcia
Carmen
C
Navarro
Carmen
C
Barricarte
Aurelio
A
Dorronsoro
Miren
M
Berglund
Göran
G
Wirfält
Elisabet
E
Johansson
Ingegerd
I
Johansson
Gerd
G
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Spencer
Elizabeth A
EA
Key
Tim
T
Riboli
Elio
E
Trichopoulou
Antonia
A
D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D004032:Diet / Q000592:standards*; D038441:Diet, Mediterranean; D005060:Europe; D005260:Female; D006801:Humans; D008136:Longevity; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016019:Survival Analysis; D014675:Vegetables