Is diet an independent risk factor for mortality? 20 year mortality in the Italian rural cohorts of the Seven Countries Study.

The relation of diet to mortality is examined using the data of the Italian rural cohorts of the Seven Countries Study, a prospective investigation of factors related to cardiovascular disease. The present analysis includes 1536 men aged 45-64 years, whose dietary habits and food consumption, including alcoholic beverages, were measured in 1965. Of the 1536, 668 (43.5%) died during a follow-up period of 20 years. Large differences in survival probabilities were observed for different dietary patterns (i.e. for different intakes of energy and nutrients). The dietary pattern that corresponded to the lowest mortality rate (27% after 20 years) was: more than 2800 kcal/d (11.7 MJ/d), with more than 41% of the calories coming from carbohydrates, more than 9% from proteins, between 16% and 23% from unsaturated lipids, and between 13% and 19% from alcohol. As the number of disagreements from the previous conditions increases, the mortality rate increases to reach 69% in 20 years in the worst case. Differences in mortality persisted after adjustment for confounders and some major established mortality risk factors.