Nutrition, metabolism, and cardiovascular diseases : NMCD · 2022
Dietary habits, cardiovascular and other causes of death in a practically extinct cohort of middle-aged men followed-up for 61 years.
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Menotti Alessandro, Puddu Paolo E, Catasta Giovina
Аннотация
BACKGROUND AND AIM: To test a dietary score produced from individual data of middle-aged-men enrolled in 1960 based on an a-posteriori approach and to study its association with some specific causes of death during 61 years until their practical extinction.
METHODS AND RESULTS: In 1960 the Italian Rural Areas of the Seven Countries of Cardiovascular Diseases were enrolled and 1712 men aged 40-59 were examined with measurement of several risk factors and the collection of dietary history. Using 18 food groups a factor score was obtained from a Principal Component Analysis, that was divided into three classes, arbitrarily called non-Mediterranean, Intermediate and Mediterranean diets. Follow-up for mortality was extended for 61 years and dietary habits were related to several causes of death. There were 1708 deaths (99.8%) and Cox proportional hazards models, adjusted for five major risk factors, showed a significant protective effect of Mediterranean diet for coronary heart disease [Hazard Ratio (HR) = 0.67], cancer other than lung (0.74) and other causes, as from an operational definition (0.71), covering overall about 60% of all deaths. HR for all-cause mortality was of 0.85. In parallel, Kaplan-Meier curves provided significant p of log rank test for the same end-points (<0.0001, 0.0002, 0.0002 and < 0.0001, respectively). On the other hand, stroke, heart diseases of uncertain etiology, lung cancer, chronic bronchitis, unknown causes were not associated to dietary habits.
CONCLUSION: In a 61-year follow-up of middle-aged men, the Mediterranean diet was beneficial for a large part of the causes of death and for total mortality.
METHODS AND RESULTS: In 1960 the Italian Rural Areas of the Seven Countries of Cardiovascular Diseases were enrolled and 1712 men aged 40-59 were examined with measurement of several risk factors and the collection of dietary history. Using 18 food groups a factor score was obtained from a Principal Component Analysis, that was divided into three classes, arbitrarily called non-Mediterranean, Intermediate and Mediterranean diets. Follow-up for mortality was extended for 61 years and dietary habits were related to several causes of death. There were 1708 deaths (99.8%) and Cox proportional hazards models, adjusted for five major risk factors, showed a significant protective effect of Mediterranean diet for coronary heart disease [Hazard Ratio (HR) = 0.67], cancer other than lung (0.74) and other causes, as from an operational definition (0.71), covering overall about 60% of all deaths. HR for all-cause mortality was of 0.85. In parallel, Kaplan-Meier curves provided significant p of log rank test for the same end-points (<0.0001, 0.0002, 0.0002 and < 0.0001, respectively). On the other hand, stroke, heart diseases of uncertain etiology, lung cancer, chronic bronchitis, unknown causes were not associated to dietary habits.
CONCLUSION: In a 61-year follow-up of middle-aged men, the Mediterranean diet was beneficial for a large part of the causes of death and for total mortality.