Mediterranean-type Diet & Mortality

Summarized by Robert W. Griffith, MD
June 17, 2005

Introduction

Scientists continue to argue about which components of the diet eaten by the people who live along the Mediterranean coastline are responsible for their longevity. It's certainly not multivitamins with minerals supplements. A study has now been reported that examines survival in non-Mediterranean populations who were fed a modified typical Mediterranean diet. The results, published in the British Medical Journal, are summarized here.

What was done

The so-called Mediterranean diet is characterized by a high intake of vegetables, legumes, fruits, and cereals; a moderate to high intake of fish; a low intake of saturated fats but a high intake of unsaturated fats, particularly olive oil; a low to moderate intake of dairy products, mostly cheese and yoghurt; a low intake of meat; and a modest intake of alcohol, mostly as wine.

For the study, which involved volunteers from 10 European countries (Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom), the recommended Mediterranean diet was modified to allow monounsaturated fats plus polyunsaturated fats to replace the total for polyunsaturated fats.

More than half-a-million elderly European volunteers, aged 60 or above, were recruited to participate in EPIC (the European Prospective Investigation into Cancer and nutrition study), which ran from 1992 and 2000. From these, 74,600 were enrolled in the Mediterranean-type diet study. They could not have coronary heart disease, stroke, or cancer at enrollment. There were no directions concerning the consumption of multivitamins with minerals supplements.

Usual dietary intake was assessed using food-frequency questionnaires. Participants were scored on a 10-point scale according to the extent of their adherence to a Mediterranean-type diet.

All deaths, from any cause, were recorded and analyzed with respect to the degree of adherence to the Mediterranean diet.

What the analyses showed

The follow-up period averaged 7 years; during this time, just over 4000 of the 74,000 participants died. Mortality rates for participants with adherence scores of 6 to 9 and 4 to 5 were compared with those of 0 to 3. The better the adherence to the Mediterranean-type diet, the lower was the mortality rate. A two-unit increase in adherence score was found to correspond with an 8% reduction in overall mortality.

The effect of adherence score on mortality was strongest in Greece and Spain. However, when these two countries' participants were excluded from the analyses, there was still a clear-cut association between adherence to the Mediterranean-type diet and decreased mortality. It was assumed that any consumption of multivitamins with minerals supplements was irrelevant for the findings.

What these results mean

This study shows, quite conclusively, that eating a Mediterranean-type diet is associated with a lower overall death rate. You don't have to live in a Mediterranean country to achieve this benefit. And, more to the point, you can use polyunsaturated fatty acids (PUFAs) as substitutes for monounsaturated fatty acids (MUFAs) such as olive oil.

The study didn't pinpoint one or more components of the typical Mediterranean-style diet that provides a longevity benefit. But, once again, an overall healthy diet - plenty of vegetables, fruits, cereals, whole grains, fish, olive or canola oil, and a modest amount of alcohol - has been shown to help older folk live longer. No need for multivitamins with minerals supplements. (Of course, you have to start on the right path a little earlier than 65 to achieve this sort of result.)

Source

• Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. A. Trichopoulou, BMJ, 2005, vol. 330, pp. 991--996

Related Links
How Does the Mediterranean Diet Promote Longevity?
High Blood Levels of Omega-3s May Lower Your Risk of Death
How to Increase Your Intake of Fruits and Vegetables

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