MEDITERRANEAN DIET and LONGEVITY

Dr. George C. SPATHARAKIS Clinical Director

Geriatrician - GerontologistPublic Primary Health Care

Center Itea, Phokida, Greece

INTRODUCTION

Although most people believe that the Mediterranean diet is just a unique one, reality shows that this consists of a series of diets, related to different cultures and people around the Mediterranean Sea that share common nutritional characteristics

MEDITERRANEAN DIETS’ SYNTHESIS

On the nutritional level these findings are mostly correlated to higher consumption of:

wholegrain cereals foods rich in polyunsaturated fatty

acids OLIVE OIL high antioxidant content and a limited amount of alcohol

MEDITERANEAN DIET PYRAMID

FIRST PROOFS

The first proofs of a beneficial effect of these diets on the health outcomes came in the early sixties with the “Seven Countries’ Study” conducted by the American nutritionnist Ancel Keys

ANCEL KEYSAmerican Nutritionist

LOW CARDIOVASCULAR

MORTALITY

FOLLOW - UP

Since then, multiple observational -mostly- studies has relied Mediterranean diet to longevity, although the adherence of each people to it seems to differ importantly

LOW CARDIOVASCULAR

MORTALITY

This influence is mostly due to a significant decrease of mortality due to cardiovascular dissease but also to a decline of cancer mortality

CVD RISK PROFILESeven Countries Study

LOWER CANCER PREVALENCE

Itsiopoulos C et al.: Can the Mediterranean diet prevent prostate cancer? Mol Nutr Food Res. 2009 Feb

Compared with many Western countries Greece has lower prostate cancer mortality and Greek migrant men in Australia have retained their low risk for prostate cancer. Consumption of a traditional Mediterranean diet, rich in bioactive nutrients, may confer protection to Greek migrant men, and this dietary pattern offers a palatable alternative for prevention of this disease

OTHER BENEFITS

Perez-Lopez FR et al., Spain, MATURITAS, 2009 Oct

There is some evidence of the benefits of the Mediterranean Diet in relation to bone metabolism, rheumatoid arthritis, and neurodegenerative age-related diseases (cognitive deficit, Alzheimer's disease, Parkinson's disease)

OVERALL SURVIVAL

Bamia C, Trichopoulos D. et al., Greece, PUBLIC HEALTH NUTR, 2007 June

In total, 74,607 men and women, 60 years or older at enrolment and without previous coronary heart disease, stroke or cancer, with complete information about dietary intakes and potentially confounding variables, and with known survival status as of December 2003, were included in the analysis

OVERALL SURVIVAL

Bamia C, Trichopoulos D. et al., Greece, PUBLIC HEALTH NUTR, 2007 June

An increase in the score which measures the adherence to the plant-based diet was associated with a lower overall mortality

A one standard deviation increment corresponding to a statistically significant reduction of 14% (95% confidence interval 5-23%)

In country-specific analyses the apparent association was stronger in Greece, Spain, Denmark and The Netherlands, and absent in the UK and Germany

BIOLOGICAL PATHWAYS

ZINCAGE Study These beneficial effects seem to be related

to different biological factors and pathways, most noticeable of which are: the fall of different inflammation markers, especially the IL-8, a reduced oxidative stress and increased insulin sensitivity and all these some times although the presence of obesity and / or a sedentary way of life

Dedoussis GV et al., GREECE, Clin Chem Lab Med. 2008

BIOLOGICAL PATHWAYS

A significant difference between groups at 2 years for insulin (P = .04), 8-iso-PGF2α (P = .037), glucose (P = .04), and adiponectin (P = .01)

Esposito K. et al., Italy, CARDIO RES PRACT, 2010 Dec

SEVEN COUNTRIES STUDY

MEDITERANEAN WAY of LIFE Vs DIET

The observed effects of longevity, however, should not only be attributed to the diet itself but to other concomitants like low smoking habit (smoking cessation at the advanced age), mid-day naps (siestas), active social and family life and possibly religion

MEDITERANEAN WAY of LIFE Vs DIET

OTHER STUDIES Tourlouki E.: The ‘secrets’ of the long livers in

Mediterranean islands: the MEDIS study Eur J Public Health (2010 Dec) 20(6): 659-664

During 2005-7, 1190 elderly (aged > 65) men and women (from Cyprus, Mitilini, Samothraki, Cephalonia, Crete, Lemnos, Corfu and Zakynthos) were randomly enrolled

From all islands, the proportion of males aged 65-80, 80-90 and > 90 years was 71.8, 24.8 and 3.4%, respectively. The proportion of women, for the same age categories, was 80.4, 17.9 and 1.7%, respectively

Dietary characteristics of The Mediterranean Islands Study (MEDIS) sample display a favourable adherence to dietary recommendations (Mediterranean diet)

OTHER STUDIES

Walking and other activities significantly declined with age (P < 0.001)

However, nearly one in five participants over the age of 90 years remained physically active

Current smoking significantly declined in males as age increased (P < 0.001)

All participants above the age of 90 years reported sleeping at noon

The proportion of participants living alone differs significantly (P < 0.001) across the three age groups. However, considerably more women live alone (men vs. women living alone: aged 65-80 years 12 vs. 37%; 80-90 years 16 vs. 55%; > 90 years 52 vs. 55%)