title: EMAS position statement: Diet and health in midlife and beyond.
abstract: BACKGROUND
  There is increasing evidence that life-style factors, such as nutrition, physical activity, smoking and alcohol consumption have a profound modifying effect on the epidemiology of most major chronic conditions affecting midlife health.
  
  
  OBJECTIVE
  To provide guidance concerning the effect of diet on morbidity and mortality of the most frequent diseases prevalent in midlife and beyond.
  
  
  METHODS
  Literature review and consensus of expert opinion.
  
  
  CONCLUSIONS
  A healthy diet is essential for the prevention of all major chronic non-communicable diseases in midlife and beyond, both directly, through the effect of individual macro- and micronutrients and indirectly, through the control of body weight. Type 2 diabetes mellitus is best prevented or managed by restricting the total amount of carbohydrate in the diet and by deriving carbohydrate energy from whole-grain cereals, fruits and vegetables. The substitution of saturated and trans-fatty acids by mono-unsaturated and omega-3 fatty acids is the most important dietary intervention for the prevention of cardiovascular disease. Obesity is also a risk factor for a variety of cancers. Obese elderly persons should be encouraged to lose weight. Diet plans can follow the current recommendations for weight management but intake of protein should be increased to conserve muscle mass. The consumption of red or processed meat is associated with an increase of colorectal cancer. Adequate protein, calcium and vitamin D intake should be ensured for the prevention of osteoporotic fractures. Surveillance is needed for possible vitamin D deficiency in high risk populations. A diet rich in vitamin E, folate, B12 and omega-3 fatty acids may be protective against cognitive decline. With increasing longevity ensuring a healthy diet is a growing public health issue.
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, GR-11528 Athens, Greece. ilambrinoudaki@aretaieio.uoa.gr
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
authors.forename: Iuliana
authors.initials: I
authors.lastname: Ceasu
authors.forename: Herman
authors.initials: H
authors.lastname: Depypere
authors.forename: Tamer
authors.initials: T
authors.lastname: Erel
authors.forename: Margaret
authors.initials: M
authors.lastname: Rees
authors.forename: Karin
authors.initials: K
authors.lastname: Schenck-Gustafsson
authors.forename: Tommaso
authors.initials: T
authors.lastname: Simoncini
authors.forename: Florence
authors.initials: F
authors.lastname: Tremollieres
authors.forename: Yvonne T
authors.initials: YT
authors.lastname: van der Schouw
authors.forename: Faustino R
authors.initials: FR
authors.lastname: Pérez-López
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003071:Cognition; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D004032:Diet; D005247:Feeding Behavior; D006304:Health Status; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control; D009751:Nutritional Requirements; D009765:Obesity / Q000517:prevention & control