title: Adherence to the Mediterranean diet reduces mortality in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain).
abstract: Epidemiological studies show that adherence to a Mediterranean diet (MD) increases longevity; however, few studies are restricted to Mediterranean populations or explore the effect of a MD pattern that directly incorporates olive oil. Therefore the relationship between adherence to the MD and mortality was studied within the the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The EPIC-Spain analysis included 40 622 participants (37·7 % males) aged 29-69 years who were recruited from five Spanish regions in 1992-1996. During a mean follow-up of 13·4 years, 1855 deaths were documented: 913 from cancer, 399 from CVD, 425 from other causes and 118 from unknown causes of death. Risk of all-cause and cause-specific mortality was assessed according to the level of adherence to a relative MD (rMED) score, measured using an 18-unit scale incorporating nine selected dietary components. A high compared with a low rMED score was associated with a significant reduction in mortality from all causes (hazard ratio (HR) 0·79; 95 % CI 0·69, 0·91), from CVD (HR 0·66; 95 % CI 0·49, 0·89), but not from overall cancer (HR 0·92; 95 % CI 0·75, 1·12). A 2-unit increase in rMED score was associated with a 6 % (P < 0·001) decreased risk of all-cause mortality. A high olive oil intake and moderate alcohol consumption contributed most to this association. In this Spanish cohort, following an olive oil-rich MD was related to a significant reduction in all-cause mortality, and reduced the risk of mortality from CVD. These results support the important role that the MD pattern has on reducing mortality in Mediterranean countries.
authors: Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. gbuckland@iconcologia.net
authors: Genevieve
authors: G
authors: Buckland
authors: Antonio
authors: A
authors: Agudo
authors: Noemie
authors: N
authors: Travier
authors: José María
authors: JM
authors: Huerta
authors: Lluís
authors: L
authors: Cirera
authors: María-José
authors: MJ
authors: Tormo
authors: Carmen
authors: C
authors: Navarro
authors: María Dolores
authors: MD
authors: Chirlaque
authors: Conchi
authors: C
authors: Moreno-Iribas
authors: Eva
authors: E
authors: Ardanaz
authors: Aurelio
authors: A
authors: Barricarte
authors: Jaione
authors: J
authors: Etxeberria
authors: Pilar
authors: P
authors: Marin
authors: J Ramón
authors: JR
authors: Quirós
authors: María-Luisa
authors: ML
authors: Redondo
authors: Nerea
authors: N
authors: Larrañaga
authors: Pilar
authors: P
authors: Amiano
authors: Miren
authors: M
authors: Dorronsoro
authors: Larraitz
authors: L
authors: Arriola
authors: Mikel
authors: M
authors: Basterretxea
authors: María-José
authors: MJ
authors: Sanchez
authors: Esther
authors: E
authors: Molina
authors: Carlos A
authors: CA
authors: González
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D038441:Diet, Mediterranean; D019983:Guideline Adherence; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009026:Mortality; D013030:Spain / Q000453:epidemiology