Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study

TLDR

The study aimed to determine whether adherence to a modified Mediterranean diet—substituting unsaturated for monounsaturated fats—extends life expectancy in elderly Europeans. Researchers conducted a multicentre prospective cohort study across nine European countries, enrolling 74,607 adults aged 60+ without major disease, assessing diet via a 10‑point Mediterranean score and modeling all‑cause mortality with Cox regression. Higher adherence to the modified Mediterranean diet was linked to an 8% reduction in all‑cause mortality per two‑point increase in the score (95% CI 3–12%), a benefit consistent across countries and amounting to a 7% reduction after cross‑country calibration.

Abstract

<h3>Abstract</h3> <b>Objective</b> To examine whether adherence to the modified Mediterranean diet, in which unsaturates were substituted for monounsaturates, is associated with longer life expectancy among elderly Europeans. <b>Design</b> Multicentre, prospective cohort study. <b>Setting</b> Nine European countries (Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden, United Kingdom). <b>Participants</b> 74 607 men and women, aged 60 or more, without coronary heart disease, stroke, or cancer at enrolment and with complete information about dietary intake and potentially confounding variables. <b>Main outcome measures</b> Extent of adherence to a modified Mediterranean diet using a scoring system on a 10 point scale, and death from any cause by time of occurrence, modelled through Cox regression. <b>Results</b> An increase in the modified Mediterranean diet score was associated with lower overall mortality, a two unit increment corresponding to a statistically significant reduction of 8% (95% confidence interval 3% to 12%). No statistically significant evidence of heterogeneity was found among countries in the association of the score with overall mortality even though the association was stronger in Greece and Spain. When dietary exposures were calibrated across countries, the reduction in mortality was 7% (1% to 12%). <b>Conclusion</b> The Mediterranean diet, modified so as to apply across Europe, was associated with increased survival among older people.