August 29, 2023
3 min read
Disclosures: Sotos-Prieto and colleagues report no relevant financial disclosures.
Key takeaways:
- Higher adherence to the Mediterranean lifestyle was linked to a 29% lower risk for all-cause mortality and a 28% lower risk for cancer mortality.
- The lifestyle includes diet, social life, exercise and more.
Higher adherence to the Mediterranean lifestyle was associated with a nearly 30% lower risk for all-cause and cancer mortality, according to researchers.
Mercedes Sotos-Prieto, PhD, a nutrition epidemiologist at the University Autonomous of Madrid in Spain and adjunct professor at the Harvard T.H Chan School of Public Health, told Healio that “the Mediterranean lifestyle represents a traditional and cultural healthy way of living” based on the Mediterranean diet — a plant-based diet that is rich in vegetables, fruit, whole grains, healthy oils, nuts, legumes, moderate in fish and dairy and very low in red and processed meats. However, the Mediterranean lifestyle does not just focus on diet; it also includes social habits and exercise characteristics.
“Physical activity is important in the context of the community life, and adequate rest including the typical short mid[day] nap or ‘siesta,’” Sotos-Prieto said. “All those items have shown to be related to cardiovascular disease; however, this study assesses the association of all of them in an all-inclusive Mediterranean lifestyle index as a better way to evaluate the synergy among all of them and a way of living.”
Sotos-Prieto and colleagues conducted a prospective study to evaluate connections between the Mediterranean lifestyle and cancer, CVD and all-cause mortality. The findings were recently published in Mayo Clinic Proceedings.
The researchers included data from 110,799 people in the U.K. Biobank cohort who were aged 40 to 75 years between 2009 and 2012 and followed to 2021. They evaluated adherence to the Mediterranean lifestyle with the Mediterranean Lifestyle (MEDLIFE) index, which was divided into three areas: Mediterranean food consumption; dietary habits; and social habits, rest, physical activity and conviviality.
Sotos-Prieto and colleagues found that adhering to the Mediterranean lifestyle was connected with lower risks for all-cause and cancer mortality in a dose-response manner.
All of the MEDLIFE index blocks were independently linked to lower risks for all-cause and cancer mortality, and block 3 was linked to lower CVD mortality.
When compared with the first quartile of the MEDLIFE index, the researchers observed increasing quartiles had HRs of 0.89 (95% CI, 0.81-0.97), 0.81 (95% CI, 0.74-0.89) and 0.71 (95% CI, 0.65-0.78) for all-cause mortality. For cancer mortality, the quartiles had HRs of 0.9 (95% CI, 0.8-1.01), 0.83 (95% CI, 0.74-0.93) and 0.72 (95% CI, 0.64-0.82).
In other words, Sotos-Prieto said that higher adherence to the Mediterranean lifestyle was associated with a 28% lower risk for cancer mortality and a 29% lower risk for all-cause mortality compared with the lowest adherence.
“This study adds to the literature that beyond diet, other components of the Mediterranean lifestyle can play a combined and stronger role in the risk for mortality, cancer and CVD death, not only in Mediterranean countries but in non-Mediterranean,” she said. “Our study makes an important addition to the literature by showing that adherence to the Mediterranean diet based on locally available products was associated with lower all-cause and cancer mortality and, furthermore, that the overall Mediterranean way of life was also strongly protective of such outcomes.”
Sotos-Prieto added that primary care can be “one of the best places for the prevention of chronic disease,” and “a wonderful setting to start the communication between the health provider and the patient.”
“That can be as simple as recommending a Mediterranean style diet, adequate rest, physical activity, and socializing with friends or family. Setting goals, like improving two items that the patient recognizes [and] could achieve, could be something doable that can be sustained over time,” she said. “Small changes make a big difference.”
For example, walking to work, using the stairs rather than an elevator, reducing intake of sugar and sweetened beverages and increasing legume consumption up to three servings per week can all represent achievable interventions, Sotos-Prieto said.
Perspective
The study explored the correlation between adhering to a Mediterranean lifestyle, as assessed by the MEDLIFE index, and mortality outcomes among middle-aged and elderly individuals in the U.K. Biobank study. Embracing this lifestyle was associated with reduced risks of all-cause and cancer-related mortalities. Elements of the MEDLIFE index, such as physical activity, rest, positive social habits and interactions, were independently linked to lower cardiovascular disease mortality.
In essence, adopting a Mediterranean lifestyle, including dietary habits, yielded health benefits for non-Mediterranean populations, highlighting its potential advantages across cultures. These benefits, particularly improvements in cardiovascular health, suggest that people can achieve positive health outcomes by collectively incorporating elements like diet, physical activity, rest and social interactions into their lives, even if they don’t reside in the Mediterranean region themselves.
Farzaneh Daghigh, PhD
Professor of biochemistry
Director of culinary medicine course
Philadelphia College of Osteopathic Medicine
Disclosures: Daghigh reports no relevant financial disclosures.
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