Mediterranean diet and other lifestyle factors in relation to 20-year all-cause mortality: a cohort study in an Italian population.
The aim of the present analysis was to evaluate the association of the Mediterranean diet (MeDi), smoking habits and physical activity with all-cause mortality in an Italian population during a 20-year follow-up study. A total of 1693 subjects aged 40-74 who enrolled in the study in 1991-5 were asked about dietary and other lifestyle information at baseline. Adherence to the MeDi was evaluated by the Mediterranean dietary score (MedDietScore). A healthy lifestyle score was computed by assigning 1 point each for a medium or high adherence to the MedDietScore, non-smoking and physical activity. Cox models were used to assess the associations between lifestyle factors and healthy lifestyle scores and all-cause mortality, adjusting for potential confounders. The final sample included 974 subjects with complete data and without chronic disease at baseline. During a median of 17·4 years of follow-up, 193 people died. Subjects with high adherence to the MedDietScore (hazard ratio (HR) 0·62, 95 % CI 0·43, 0·89)), non-smokers (HR 0·71, 95 % CI 0·51, 0·98) and physically active subjects (HR 0·55, 95 % CI 0·36, 0·82) were at low risk of death. Each point increase in the MedDietScore was associated with a significant 5 % reduction of death risk. Subjects with 1, 2 or 3 healthy lifestyle behaviours had a significantly 39, 56, and 73 % reduced risk of death, respectively. A high adherence to MeDi, non-smoking and physical activity were strongly associated with a reduced risk of all-cause mortality in healthy subjects after long-term follow-up. This reduction was even stronger when the healthy lifestyle behaviours were combined.
Department of Environmental,Food and Nutritional Sciences, University of Milan,Via Celoria 2,20101Milan,Italy.
Federica
F
Prinelli
Department of Nutrition and Dietetics,Harokopio University,70 Eleftheriou Venizelou Avenue,176 71Athens,Greece.
Mary
M
Yannakoulia
Department of Nutrition and Dietetics,Harokopio University,70 Eleftheriou Venizelou Avenue,176 71Athens,Greece.
Costas A
CA
Anastasiou
Epidemiology and Biostatistics Unit, Institute of Biomedical Technology - National Research Council,Via Fratelli Cervi 93,Segrate Milan,Italy.
Fulvio
F
Adorni
Department of Neuroscience,Santa Lucia Foundation IRCCS,Via Ardeatina 306,00179Rome,Italy.
Simona G
SG
Di Santo
Epidemiology and Biostatistics Unit, Institute of Biomedical Technology - National Research Council,Via Fratelli Cervi 93,Segrate Milan,Italy.
Massimo
M
Musicco
Department of Neurology,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia University,622 West 168th Street, P and S #16,NY10032,USA.
Nikolaos
N
Scarmeas
Epidemiology and Biostatistics Unit, Institute of Biomedical Technology - National Research Council,Via Fratelli Cervi 93,Segrate Milan,Italy.
Maria L
ML
Correa Leite
D000328:Adult; D000368:Aged; D000375:Aging; D015331:Cohort Studies; D038441:Diet, Mediterranean; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009043:Motor Activity; D018673:Nutrition Policy; D010349:Patient Compliance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects; D000074606:Smoking Prevention
All-cause mortality