Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population

Background/Objectives: A higher adherence to the Mediterranean diet (MedDiet) has been associated with a lower risk of death in different populations, but this association has been insufficiently investigated in the elderly Spanish population. In this study, we assess the association between adheren...

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Autores: Ojeda-Belokon, C, González-Palacios, S, Compañ-Gabucio, LM, Oncina-Cánovas, A, Garcia-de-la-Hera, M, Vioque, J, Torres-Collado, L
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p11392
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones11392
https://doi.org/10.3390/nu17182956
Access Level:acceso abierto
Palabra clave:Mediterranean diet
dietary indexes
all-cause mortality
cardiovascular disease
cancer
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spelling Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean PopulationOjeda-Belokon, CGonzález-Palacios, SCompañ-Gabucio, LMOncina-Cánovas, AGarcia-de-la-Hera, MVioque, JTorres-Collado, LMediterranean dietdietary indexesall-cause mortalitycardiovascular diseasecancerBackground/Objectives: A higher adherence to the Mediterranean diet (MedDiet) has been associated with a lower risk of death in different populations, but this association has been insufficiently investigated in the elderly Spanish population. In this study, we assess the association between adherence to three MedDiet indexes and all-cause, cardiovascular disease (CVD), and cancer mortality in a population aged 65 years and older in Spain. Methods: The population included 903 participants from two population-based surveys. Diet was assessed at baseline by using validated food-frequency questionnaires (FFQ). We calculated scores of adherence to the MedDiet for three indexes: alternate Mediterranean Diet Score (aMED), relative Mediterranean Diet Score (rMED) and 17-item energy-restricted Mediterranean Diet Adherence Screener (erMEDAS). Deaths were ascertained through the National Death Index of Spain and the Mortality Registry in the Valencian Region during a 12 year follow-up period. Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI), adjusting for relevant confounders. Results: During the 12 years of follow-up, 403 deaths occurred: 160 due to CVD and 90 to cancer. Compared to participants in the lowest tertile of adherence to aMED, those in the highest tertile showed a 30% lower risk of all-cause mortality, HR = 0.70 (95% CI 0.51-0.96). In addition, per two-point increase in aMED, we observed a 17% lower risk of all-cause mortality, HR = 0.83 (95% CI 0.73-0.95), and a 21% lower risk of CVD mortality, HR = 0.79 (95% CI 0.64-0.99). A 9% lower risk of all-cause mortality was also observed per two-point increase in the rMED score, HR = 0.91 (95% CI 0.84-0.99). Compared to participants in the lowest tertile of adherence to rMED, those in the highest tertile showed evidence of a marginally significant, lower risk of cancer mortality, HR = 0.55 (95% CI 0.29-1.04). No association was observed between the erMEDAS index and mortality for any cause. Conclusions: High adherence to the MedDiet, as measured by aMED and rMED indexes, was associated with lower all-cause, CVD, and cancer mortality in an older Mediterranean population after 12 years of follow-up.MDPI2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones11392https://doi.org/10.3390/nu17182956NutrientsISSN: 20726643reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p113922026-06-12T10:20:37Z
dc.title.none.fl_str_mv Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population
title Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population
spellingShingle Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population
Ojeda-Belokon, C
Mediterranean diet
dietary indexes
all-cause mortality
cardiovascular disease
cancer
title_short Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population
title_full Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population
title_fullStr Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population
title_full_unstemmed Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population
title_sort Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population
dc.creator.none.fl_str_mv Ojeda-Belokon, C
González-Palacios, S
Compañ-Gabucio, LM
Oncina-Cánovas, A
Garcia-de-la-Hera, M
Vioque, J
Torres-Collado, L
author Ojeda-Belokon, C
author_facet Ojeda-Belokon, C
González-Palacios, S
Compañ-Gabucio, LM
Oncina-Cánovas, A
Garcia-de-la-Hera, M
Vioque, J
Torres-Collado, L
author_role author
author2 González-Palacios, S
Compañ-Gabucio, LM
Oncina-Cánovas, A
Garcia-de-la-Hera, M
Vioque, J
Torres-Collado, L
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Mediterranean diet
dietary indexes
all-cause mortality
cardiovascular disease
cancer
topic Mediterranean diet
dietary indexes
all-cause mortality
cardiovascular disease
cancer
description Background/Objectives: A higher adherence to the Mediterranean diet (MedDiet) has been associated with a lower risk of death in different populations, but this association has been insufficiently investigated in the elderly Spanish population. In this study, we assess the association between adherence to three MedDiet indexes and all-cause, cardiovascular disease (CVD), and cancer mortality in a population aged 65 years and older in Spain. Methods: The population included 903 participants from two population-based surveys. Diet was assessed at baseline by using validated food-frequency questionnaires (FFQ). We calculated scores of adherence to the MedDiet for three indexes: alternate Mediterranean Diet Score (aMED), relative Mediterranean Diet Score (rMED) and 17-item energy-restricted Mediterranean Diet Adherence Screener (erMEDAS). Deaths were ascertained through the National Death Index of Spain and the Mortality Registry in the Valencian Region during a 12 year follow-up period. Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI), adjusting for relevant confounders. Results: During the 12 years of follow-up, 403 deaths occurred: 160 due to CVD and 90 to cancer. Compared to participants in the lowest tertile of adherence to aMED, those in the highest tertile showed a 30% lower risk of all-cause mortality, HR = 0.70 (95% CI 0.51-0.96). In addition, per two-point increase in aMED, we observed a 17% lower risk of all-cause mortality, HR = 0.83 (95% CI 0.73-0.95), and a 21% lower risk of CVD mortality, HR = 0.79 (95% CI 0.64-0.99). A 9% lower risk of all-cause mortality was also observed per two-point increase in the rMED score, HR = 0.91 (95% CI 0.84-0.99). Compared to participants in the lowest tertile of adherence to rMED, those in the highest tertile showed evidence of a marginally significant, lower risk of cancer mortality, HR = 0.55 (95% CI 0.29-1.04). No association was observed between the erMEDAS index and mortality for any cause. Conclusions: High adherence to the MedDiet, as measured by aMED and rMED indexes, was associated with lower all-cause, CVD, and cancer mortality in an older Mediterranean population after 12 years of follow-up.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones11392
https://doi.org/10.3390/nu17182956
url https://isabial.portalinvestigacion.com/publicaciones11392
https://doi.org/10.3390/nu17182956
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Nutrients
ISSN: 20726643
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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