title: Does a Mediterranean diet reduce the mortality risk associated with diabetes: evidence from the Melbourne Collaborative Cohort Study.
abstract: OBJECTIVE
  Diabetes is a risk factor for cardiovascular disease (CVD), yet southern European migrants to Australia with high rates of type 2 diabetes have relatively low CVD mortality. Our aim was to determine whether a Mediterranean style diet could reduce mortality in people with diabetes.
  
  
  RESULTS
  Participants included 16,610 males and 23,860 females from the Melbourne Collaborative Cohort Study; 25% were born in Greece or Italy, and 2150 had previously been diagnosed with diabetes or had elevated blood glucose at baseline (1990-94). Data on demographic, behavioral and physical risk factors were also collected. A personal Mediterranean Diet Score (MDS) was calculated using data from a validated 121-item food frequency questionnaire. Total and CVD mortality data were available up to 2003. Diabetes (new and known) at baseline, was associated with total mortality (men HR 1.43, 95%CI 1.26-1.62; women HR 1.86 95%CI 1.58-2.18), and CVD mortality (men HR 1.53, 95%CI 1.21-1.94; women HR 2.10 95%CI 1.48-2.97) in multivariate models. There was no evidence that glucose tolerance modified the associations between MDS and total or CVD mortality (p interaction all > 0.16). The HRs for total mortality per unit of MDS were 0.96 (95% CI 0.93-0.99) in men and 0.94 (95% CI 0.92-0.97) in women. The HRs for CVD mortality per unit of MDS were 0.94 (95% CI 0.89-0.99) in men and 0.94 (95% CI 0.87-1.01) in women.
  
  
  CONCLUSIONS
  Our results add to the evidence supporting the benefit of a Mediterranean style diet for people with type 2 diabetes.
authors.affiliation: University of Melbourne, Department of Medicine, St Vincent's Hospital, Fitzroy, VIC 3065, Australia. ahodge@medstv.unimelb.edu.au
authors.forename: A M
authors.initials: AM
authors.lastname: Hodge
authors.forename: D R
authors.initials: DR
authors.lastname: English
authors.forename: C
authors.initials: C
authors.lastname: Itsiopoulos
authors.forename: K
authors.initials: K
authors.lastname: O'Dea
authors.forename: G G
authors.initials: GG
authors.lastname: Giles
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000150:complications / Q000208:ethnology / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy* / Q000401:mortality*; D038441:Diet, Mediterranean; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000208:ethnology; D006801:Humans; D007558:Italy / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires