London, UK - In the largest analysis of its kind, a new study assessing the effects of a Mediterranean style diet in men and women over age 60 has shown that a diet rich in plant foods and unsaturated fats is "particularly appropriate" in the elderly. Using data from nine European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, investigators found that people with the highest scores—reflecting high adherence to the diet—lived longer than people with lower scores.

The study, led by Dr Antonia Trichopoulou (University of Athens Medical School, Greece), appears in the April 7, 2005 issue of the BMJ.[1]

In total, 74 607 people age 60 or older from Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden, and the UK were enrolled in the original EPIC trial, providing complete information on their usual dietary intake. A previously validated scale (0-10) indicating adherence to a traditional Mediterranean diet was used to categorize people who had either high or low consumption of "beneficial components," namely vegetables, legumes, fruits, unrefined cereals, fish, and unsaturated fats. "Detrimental components" were principally meat and dairy products, with a much higher proportion of saturated fats.

Over a median period of 89 months, 4047 people died, predominantly in Sweden, Denmark, and the UK, where the cohorts were larger and older at the start of the EPIC study. When the authors looked at specific foods and survival rates, they found that overall mortality increased with lower intake of vegetables, fruits, cereals, and a lower ratio of unsaturated to saturated fats. When using the diet scores, which the authors say capture a broader picture of overall nutrition and preempt confounding, Trichopoulou et al found mortality to be inversely associated with Mediterranean-diet adherence. For example, three- or four-point increment increases in diet score—"realistically achievable changes"—were associated with a reduction of total mortality by 11% or 14%, respectively. Of note, no significant heterogeneity was seen between countries, although the association appeared to be strongest in Greece and Spain, where the "modified Mediterranean diet is genuinely a Mediterranean diet." In Italy, most of the deaths occurred in the north of the country, where the diet is not considered Mediterranean.

The authors conclude that their findings add further support to the adoption of a Mediterranean-style diet as a means of living longer and more healthily. The applicability of the Mediterranean diet to older adults is particularly relevant, given that elderly people represent a rapidly increasing proportion of the population in Europe and elsewhere, they say.