Similar prediction of decreased total mortality, diabetes incidence or cardiovascular events using relative- and absolute-component Mediterranean diet score: The SUN cohort.

Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, via F. Scaduto 6/c, 90144 Palermo, Italy.
Nutrition, metabolism, and cardiovascular diseases: NMCD (Impact Factor: 3.52). 03/2012; DOI: 10.1016/j.numecd.2011.10.009
Source: PubMed

ABSTRACT BACKGROUND AND AIM: Accumulated evidence supports the effectiveness of Mediterranean-type diets (MeDiet) in reducing mortality and preventing several chronic diseases. Widely used scores to assess adherence to MeDiet are based on specific sample characteristics; alternatively, they might be built according to absolute/normative cut-off points for the consumption of specific food groups (pre-defined servings/day or/week). The aim of this study was to compare sample-specific MeDiet adherence scores (MDS) versus absolute-normative scores (Mediterranean Diet Adherence Screener - MEDAS) on their association with macronutrient intake, total mortality and incidence of chronic diseases. Design: SUN (Seguimiento Universidad de Navarra) dynamic prospective cohort study (60.5% women; mean age 38.4 years). METHODS AND RESULTS: In cross-sectional analyses (n=20,155) we evaluated macronutrient distribution according to MDS (based on 136-item FFQ), MEDAS (based on 13 questions), and variants of both. In prospective analyses (n=9109; mean follow-up: 6.2 years), we evaluated disease incidence or mortality. Adherence to MeDiet increased with age and, as expected, was associated with higher fiber intake, lower total fat intake but higher monounsaturated/saturated fat ratio, using all scores. Among subjects initially free of cancer, diabetes, and cardiovascular disease (CVD), adherence to MeDiet appraised with an absolute-normative score (MEDAS) similarly predicted macronutrient distribution and disease incidence or mortality (diabetes incidence, CVD or all-cause mortality), when compared to a sample-specific score based on 136-item FFQ (MDS). CONCLUSIONS: Adherence to MeDiet was associated with a decreased incidence of a composite outcome including diabetes incidence, cardiovascular events incidence or all-cause mortality.

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    American Journal of Clinical Nutrition 05/2014; 100(Supplement_1). · 6.50 Impact Factor
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    Current Atherosclerosis Reports 10/2014; 16(10):446. · 3.06 Impact Factor
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    ABSTRACT: Background and Objective Low intake of certain micronutrients and protein has been associated with higher risk of frailty. However, very few studies have assessed the effect of global dietary patterns on frailty. This study examined the association between adherence to the Mediterranean diet (MD) and the risk of frailty in older adults. Design, Setting, and Participants Prospective cohort study with 1815 community-dwelling individuals aged ≥60 years recruited in 2008–2010 in Spain. Measurements At baseline, the degree of MD adherence was measured with the Mediterranean Diet Adherence Screener (MEDAS) score and the Mediterranean Diet Score, also known as the Trichopoulou index. In 2012, individuals were reassessed to detect incident frailty, defined as having at least 3 of the following criteria: exhaustion, muscle weakness, low physical activity, slow walking speed, and weight loss. The study associations were summarized with odds ratios (OR) and their 95% confidence interval (CI) obtained from logistic regression, with adjustment for the main confounders. Results Over a mean follow-up of 3.5 years, 137 persons with incident frailty were identified. Compared with individuals in the lowest tertile of the MEDAS score (lowest MD adherence), the OR (95% CI) of frailty was 0.85 (0.54–1.36) in those in the second tertile, and 0.65 (0.40–1.04; P for trend = .07) in the third tertile. Corresponding figures for the Mediterranean Diet Score were 0.59 (0.37–0.95) and 0.48 (0.30–0.77; P for trend = .002). Being in the highest tertile of MEDAS was associated with reduced risk of slow walking (OR 0.53; 95% CI 0.35–0.79) and of weight loss (OR 0.53; 95% CI 0.36–0.80). Lastly, the risk of frailty was inversely associated with consumption of fish (OR 0.66; 95% CI 0.45–0.97) and fruit (OR 0.59; 95% CI 0.39–0.91). Conclusions Among community-dwelling older adults, an increasing adherence to the MD was associated with decreasing risk of frailty.
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