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Combination of Mediterranean Diet and Healthy Lifestyle Associated With Significant Reduction in Death Rate For Elderly

Chicago Individuals 70 to 90 years old who adhered to a Mediterranean-type diet and several healthy lifestyle habits had a more than 50 percent lower death rate than those who did not, according to a study in the September 22/29 issue of JAMA.

Because of the cumulative effect of adverse factors throughout life, it is particularly important for older persons to adopt diet and lifestyle practices that minimize their risk of death from illness and maximize their prospects for healthful aging, according to background information in the article. Dietary patterns and lifestyle factors are associated with death from all causes, coronary heart disease, cardiovascular diseases, and cancer, but few studies have investigated these factors in combination.

Kim Knoops, M.Sc., of Wageningen University, the Netherlands and colleagues investigated the single and combined effect of a Mediterranean diet (rich in plant foods and fish, low in meat and dairy products, and with a high ratio of monounsaturated fatty acids to polyunsaturated fatty acids), being physically active (approximately 30 minutes of activity per day or more), moderate alcohol use, and nonsmoking on all-cause and cause-specific death in European elderly individuals. The study, HALE (Healthy Ageing: a Longitudinal study in Europe), was conducted between 1988 and 2000 and was comprised of 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. It included 1,507 apparently healthy men and 832 women, aged 70 to 90 years in 11 European countries.

The researchers found that adhering to a Mediterranean diet was associated with a 23 percent lower risk of all-cause death; moderate alcohol use, a 22 percent lower risk; physical activity, a 37 percent lower risk; and nonsmoking, a 35 percent lower risk. Similar results were observed for death from coronary heart disease, cardiovascular diseases, and cancer. Having all four low risk factors lowered the all-cause death rate by 65 percent. In total, 60 percent of all deaths, 64 percent of deaths from coronary heart disease, 61 percent from cardiovascular diseases, and 60 percent from cancer were associated with lack of adherence to this low-risk pattern.

(JAMA. 2004; 292:1433-1439. Available at www.jama.com)

Editors note: This study, based on the HALE project, was supported by a grant from the European Union (to co-author Mr. Kromhout).

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Editorial: Diet, Lifestyle, and LongevityThe Next Steps?

In an accompanying editorial, Eric B. Rimm, Sc.D., and Meir J. Stampfer, M.D., Dr.P.H., of the Harvard School of Public Health, Boston, write that although understanding of the relation of lifestyle and health outcomes will continue to be refined, information available now is sufficient to take action.

Knoops et al have identified a simple set of lifestyle practices that can reduce the mortality rate among elderly individuals by nearly two-thirds. Esposito and colleagues provide evidence of the possible mechanisms for such effects. Both studies are supported by prior data. As a society, the United States spends billions on chronic disease treatments and interventions for risk factors. Although these are useful and important, a fraction of that investment to promote healthful lifestyles for primary prevention among individuals at all ages would yield greater benefit, the authors write.

(JAMA. 2004; 292:1490-1492. Available at www.jama.com)

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