Angelo Campanella1,2,3, Giovanni Misciagna4, Antonella Mirizzi1,3, Maria Gabriella Caruso2,5, Caterina Bonfiglio1,3, Laura R Aballay6, Liciana Vas de Arruda Silveira7, Antonella Bianco1,3, Isabella Franco1,3, Paolo Sorino3, Claudia Buongiorno1,3, Anna Maria Cisternino2, Maria Notarnicola1, Vito M B Guerra1,3, Alberto R Osella1,3. 1. Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy. 2. Clinical Nutrition Outpatients Clinic, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy. 3. Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy. 4. Scientific and Ethical Committee Polyclinic Hospital, University of Bari, Italy. 5. Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana Grotte, (BA), Italy. 6. Human Nutrition Research Center (CenINH), School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba, Argentina. 7. Department of Biostatistics, Bioscience Institute (UNESP), Botucatu, Brazil.
Abstract
BACKGROUND: The Mediterranean diet (MedDiet) is associated with good health. We aimed to estimate the effect of levels of adherence to the MedDiet on lifespan by performing treatment effects survival analysis. METHODS: A sample of 5250 subjects aged ≥18 years were randomly selected from the electoral list of Castellana Grotte and Putignano (Apulian Region, Italy). Cohorts were enrolled in 2005-06 and followed-up until December 2018. The adherence to the MedDiet was measured by the relative Mediterranean score (rMED) and categorized as high, medium and low. Time-to-death (all-causes) as estimated by average treatment effect on the treated (ATET), potential outcome mean (POM) and relative efficiency of exposure were the outcomes. RESULTS: A total of 4896 subjects were included. The median follow-up time was 12.82 (inter quartile range (IQR) 12.22-13.05), 12.91 (IQR 12.21-13.27) and 12.84 (IQR 12.19-13.03) years for high, medium and low rMED subjects respectively. By December 2018, 453 (9.25%) had died. There was a strong effect of medium and low rMED {ATET, -5.10 [95% confidence interval (CI) -9.39, -0.80] and -8.91 (95%CI -13.37, -4.45), respectively}. High rMED has an important effect on mean age at death [POM 90.16 (95% CI 86.06, 94.25)]. The relative effect size for medium and low rMED subjects was a lower lifespan of 5.62% (95% CI 1.01, 10.3) and 9.90% (95% CI 5.30, 5.30), respectively. CONCLUSIONS: We observed an important benefit in additional years of survival from adherence to MedDiet in this southern Italian cohort. Further investigation corroborating our findings in other population groups in other geographic regions will be an important contribution to promoting health and longevity.
BACKGROUND: The Mediterranean diet (MedDiet) is associated with good health. We aimed to estimate the effect of levels of adherence to the MedDiet on lifespan by performing treatment effects survival analysis. METHODS: A sample of 5250 subjects aged ≥18 years were randomly selected from the electoral list of Castellana Grotte and Putignano (Apulian Region, Italy). Cohorts were enrolled in 2005-06 and followed-up until December 2018. The adherence to the MedDiet was measured by the relative Mediterranean score (rMED) and categorized as high, medium and low. Time-to-death (all-causes) as estimated by average treatment effect on the treated (ATET), potential outcome mean (POM) and relative efficiency of exposure were the outcomes. RESULTS: A total of 4896 subjects were included. The median follow-up time was 12.82 (inter quartile range (IQR) 12.22-13.05), 12.91 (IQR 12.21-13.27) and 12.84 (IQR 12.19-13.03) years for high, medium and low rMED subjects respectively. By December 2018, 453 (9.25%) had died. There was a strong effect of medium and low rMED {ATET, -5.10 [95% confidence interval (CI) -9.39, -0.80] and -8.91 (95%CI -13.37, -4.45), respectively}. High rMED has an important effect on mean age at death [POM 90.16 (95% CI 86.06, 94.25)]. The relative effect size for medium and low rMED subjects was a lower lifespan of 5.62% (95% CI 1.01, 10.3) and 9.90% (95% CI 5.30, 5.30), respectively. CONCLUSIONS: We observed an important benefit in additional years of survival from adherence to MedDiet in this southern Italian cohort. Further investigation corroborating our findings in other population groups in other geographic regions will be an important contribution to promoting health and longevity.
Authors: Antonella Mirizzi; Laura R Aballay; Giovanni Misciagna; Maria G Caruso; Caterina Bonfiglio; Paolo Sorino; Antonella Bianco; Angelo Campanella; Isabella Franco; Ritanna Curci; Filippo Procino; Anna M Cisternino; Maria Notarnicola; Pierina F D'Aprile; Alberto R Osella Journal: Nutrients Date: 2021-11-10 Impact factor: 5.717