Mediterranean dietary pattern and prediction of all-cause mortality in a US population: results from the NIH-AARP Diet and Health Study.
BACKGROUND
The Mediterranean diet has been suggested to play a beneficial role for health and longevity. However, to our knowledge, no prospective US study has investigated the Mediterranean dietary pattern in relation to mortality.


METHODS
Study participants included 214,284 men and 166,012 women in the National Institutes of Health (NIH)-AARP (formerly known as the American Association of Retired Persons) Diet and Health Study. During follow-up for all-cause mortality (1995-2005), 27,799 deaths were documented. In the first 5 years of follow-up, 5,985 cancer deaths and 3,451 cardiovascular disease (CVD) deaths were reported. We used a 9-point score to assess conformity with the Mediterranean dietary pattern (components included vegetables, legumes, fruits, nuts, whole grains, fish, monounsaturated fat-saturated fat ratio, alcohol, and meat). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using age- and multivariate-adjusted Cox models.


RESULTS
The Mediterranean diet was associated with reduced all-cause and cause-specific mortality. In men, the multivariate HRs comparing high to low conformity for all-cause, CVD, and cancer mortality were 0.79 (95% CI, 0.76-0.83), 0.78 (95% CI, 0.69-0.87), and 0.83 (95% CI, 0.76-0.91), respectively. In women, an inverse association was seen with high conformity with this pattern: decreased risks that ranged from 12% for cancer mortality to 20% for all-cause mortality (P = .04 and P < .001, respectively, for the trend). When we restricted our analyses to never smokers, associations were virtually unchanged.


CONCLUSIONS
These results provide strong evidence for a beneficial effect of higher conformity with the Mediterranean dietary pattern on risk of death from all causes, including deaths due to CVD and cancer, in a US population.
Mitrou
Panagiota N
PN
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. pm277@medschl.cam.ac.uk
Kipnis
Victor
V
Thiébaut
Anne C M
AC
Reedy
Jill
J
Subar
Amy F
AF
Wirfält
Elisabet
E
Flood
Andrew
A
Mouw
Traci
T
Hollenbeck
Albert R
AR
Leitzmann
Michael F
MF
Schatzkin
Arthur
A
D000368:Aged; D002318:Cardiovascular Diseases / Q000178:diet therapy* / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D038441:Diet, Mediterranean; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009315:National Institute of Mental Health (U.S.); D009369:Neoplasms / Q000178:diet therapy* / Q000401:mortality*; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology