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Cited by 1,000Nutritional Studies and DietCardiovascular Health and Risk FactorsAlcohol Consumption and Health Effects

Mediterranean Diet, Lifestyle Factors, and 10-Year Mortality in Elderly European Men and Women: The HALE Project

Knoops, Kim T. B., de Groot, Lisette C. P. G. M., Kromhout, Daan, Perrin, Anne-Elisabeth, Moreiras-Varela, Olga, Menotti, Alessandro, van Staveren, Wija A.·2004·JAMA
DOI 10.1001/jama.292.12.1433
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Abstract

ContextDietary patterns and lifestyle factors are associated with mortality from all causes, coronary heart disease, cardiovascular diseases, and cancer, but few studies have investigated these factors in combination.ObjectiveTo investigate the single and combined effect of Mediterranean diet, being physically active, moderate alcohol use, and nonsmoking on all-cause and cause-specific mortality in European elderly individuals.Design, Setting, and ParticipantsThe Healthy Ageing: a Longitudinal study in Europe (HALE) population, comprising individuals enrolled in the Survey in Europe on Nutrition and the Elderly: a Concerned Action (SENECA) and the Finland, Italy, the Netherlands, Elderly (FINE) studies, includes 1507 apparently healthy men and 832 women, aged 70 to 90 years in 11 European countries. This cohort study was conducted between 1988 and 2000.Main Outcome MeasuresTen-year mortality from all causes, coronary heart disease, cardiovascular diseases, and cancer.ResultsDuring follow-up, 935 participants died: 371 from cardiovascular diseases, 233 from cancer, and 145 from other causes; for 186, the cause of death was unknown. Adhering to a Mediterranean diet (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.68-0.88), moderate alcohol use (HR, 0.78; 95% CI, 0.67-0.91), physical activity (HR, 0.63; 95% CI, 0.55-0.72), and nonsmoking (HR, 0.65; 95% CI, 0.57-0.75) were associated with a lower risk of all-cause mortality (HRs controlled for age, sex, years of education, body mass index, study, and other factors). Similar results were observed for mortality from coronary heart disease, cardiovascular diseases, and cancer. The combination of 4 low risk factors lowered the all-cause mortality rate to 0.35 (95% CI, 0.28-0.44). In total, lack of adherence to this low-risk pattern was associated with a population attributable risk of 60% of all deaths, 64% of deaths from coronary heart disease, 61% from cardiovascular diseases, and 60% from cancer.ConclusionAmong individuals aged 70 to 90 years, adherence to a Mediterranean diet and healthful lifestyle is associated with a more than 50% lower rate of all-causes and cause-specific mortality.

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Authors
Knoops, K. T. B., de Groot, L. C. P. G. M., Kromhout, D., Perrin, A.-E., Moreiras-Varela, O., Menotti, A., & van Staveren, W. A.
Affiliations
Wageningen University & Research (NL)
ORCID
Menotti, Alessandro
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2004-09-22
Volume
292
Issue
12
Pages
1433
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.292.12.1433
OpenAlex
W84376058
Cited by
146
References
31
Citations by year
2021: 3 · 2019: 1 · 2018: 4 · 2017: 1 · 2016: 7 · 2015: 7 · 2014: 6 · 2013: 15 · 2012: 14
FWCI
12.79
Type
journal article
Language
en
Open access
closed
Locations
JAMA (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
Mediterranean diet, physical activity, moderate drinking, lifestyle factors, all-cause mortality, coronary artery disease, cardiovascular mortality, cancer mortality, older adults, healthy aging, population attributable risk, dietary habits, Seneca, European older adults, sex differences, educational attainment, body mass index, cardiovascular risk factors, cancer risk factors

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