title: The association of the Mediterranean Adequacy Index with fatal coronary events in an Italian middle-aged male population followed for 40 years.
abstract: OBJECTIVE
  The dietary habits defined as the Mediterranean diet have shown to be protective for coronary heart disease (CHD) and other morbid conditions. The present analysis aims to test the Mediterranean Adequacy Index (MAI), a dietary index derived from the Mediterranean habits, versus the occurrence of fatal CHD events in an Italian male population followed for 40 years.
  
  
  RESULTS
  In 1965, at the time of the 5-year follow-up examination of the Italian Rural Areas of the Seven Countries Study, the diet was assessed by the dietary-history method in 1139 men aged 45-64 years, free from previous coronary events, in the rural communities of Crevalcore (Northern Italy) and Montegiorgio (Central Italy). MAI has been computed and its natural log (lnMAI) used for the analysis. Mortality data were collected and coded for the subsequent 40 years. The lnMAI was inversely associated with CHD mortality at 20 and 40 years when entered alone in the Cox proportional hazards model and when adjusted for age, cigarette smoking, systolic blood pressure, serum cholesterol, physical activity and body mass index. The hazard ratio for 1 unit of lnMAI (roughly corresponding to 2.7 units of MAI) was associated with a CHD mortality reduction of 26% in 20 years and 21% in 40 years of follow-up, when adjusted for the covariates.
  
  
  CONCLUSIONS
  In an Italian middle-aged male population, MAI showed the protective effect of a healthy Mediterranean Diet pattern versus the occurrence of fatal CHD events at 20 and 40 years.
authors.affiliation: VP Association for Cardiac Research - Associazione per la Ricerca Cardiologica, Via Latina 49, 00179 Rome, Italy. menottia@tin.it
authors.forename: A
authors.initials: A
authors.lastname: Menotti
authors.forename: A
authors.initials: A
authors.lastname: Alberti-Fidanza
authors.forename: F
authors.initials: F
authors.lastname: Fidanza
mesh_terms: D000328:Adult; D003327:Coronary Disease / Q000401:mortality* / Q000517:prevention & control; D038441:Diet, Mediterranean; D005247:Feeding Behavior; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models