Spatharakis 2
- 1. MEDITERRANEAN DIET and LONGEVITY Dr. George C. SPATHARAKIS Clinical Director Geriatrician - Gerontologist Public Primary Health Care Center Itea, Phokida, Greece
- 2. INTRODUCTION Although most people believe that the Mediterranean diet is just a unique one, reality shows that this consists of a series of diets, related to different cultures and people around the Mediterranean Sea that share common nutritional characteristics
- 4. MEDITERRANEAN DIETS’ SYNTHESIS On the nutritional level these findings are mostly correlated to higher consumption of: wholegrain cereals foods rich in polyunsaturated fatty acids OLIVE OIL high antioxidant content and a limited amount of alcohol
- 5. MEDITERANEAN DIET PYRAMID
- 6. FIRST PROOFS The first proofs of a beneficial effect of these diets on the health outcomes came in the early sixties with the “Seven Countries’ Study” conducted by the American nutritionnist Ancel Keys
- 7. ANCEL KEYS American Nutritionist
- 8. LOW CARDIOVASCULAR MORTALITY
- 9. FOLLOW - UP Since then, multiple observational -mostly- studies has relied Mediterranean diet to longevity, although the adherence of each people to it seems to differ importantly
- 10. LOW CARDIOVASCULAR MORTALITY This influence is mostly due to a significant decrease of mortality due to cardiovascular dissease but also to a decline of cancer mortality
- 11. CVD RISK PROFILE Seven Countries Study
- 12. LOWER CANCER PREVALENCE Itsiopoulos C et al.: Can the Mediterranean diet prevent prostate cancer? Mol Nutr Food Res. 2009 Feb Compared with many Western countries Greece has lower prostate cancer mortality and Greek migrant men in Australia have retained their low risk for prostate cancer. Consumption of a traditional Mediterranean diet, rich in bioactive nutrients, may confer protection to Greek migrant men, and this dietary pattern offers a palatable alternative for prevention of this disease
- 13. OTHER BENEFITS Perez-Lopez FR et al., Spain, MATURITAS, 2009 Oct There is some evidence of the benefits of the M editerranean D iet in relation to bone metabolism, rheumatoid arthritis, and neurodegenerative age-related diseases (cognitive deficit, Alzheimer's disease, Parkinson's disease)
- 14. OVERALL SURVIVAL Bamia C, Trichopoulos D. et al., Greece, PUBLIC HEALTH NUTR, 2007 June In total, 74,607 men and women, 60 years or older at enrolment and without previous coronary heart disease, stroke or cancer, with complete information about dietary intakes and potentially confounding variables, and with known survival status as of December 2003, were included in the analysis
- 15. OVERALL SURVIVAL Bamia C, Trichopoulos D. et al., Greece, PUBLIC HEALTH NUTR, 2007 June An increase in the score which measures the adherence to the plant-based diet was associated with a lower overall mortality A one standard deviation increment corresponding to a statistically significant reduction of 14% (95% confidence interval 5-23%) In country-specific analyses the apparent association was stronger in Greece, Spain, Denmark and The Netherlands, and absent in the UK and Germany
- 16. BIOLOGICAL PATHWAYS ZINCAGE Study These beneficial effects seem to be related to different biological factors and pathways, most noticeable of which are: the fall of different inflammation markers, especially the IL-8, a reduced oxidative stress and increased insulin sensitivity and all these some times although the presence of obesity and / or a sedentary way of life Dedoussis GV et al., GREECE, Clin Chem Lab Med. 2008
- 17. BIOLOGICAL PATHWAYS A significant difference between groups at 2 years for insulin (P = .04), 8-iso-PGF2α (P = .037), glucose (P = .04), and adiponectin (P = .01) Esposito K. et al., Italy, CARDIO RES PRACT, 2010 Dec
- 18. SEVEN COUNTRIES STUDY
- 19. MEDITERANEAN WAY of LIFE Vs DIET The observed effects of longevity, however, should not only be attributed to the diet itself but to other concomitants like low smoking habit (smoking cessation at the advanced age), mid-day naps (siestas), active social and family life and possibly religion
- 20. MEDITERANEAN WAY of LIFE Vs DIET
- 21. OTHER STUDIES Tourlouki E.: The ‘secrets’ of the long livers in Mediterranean islands: the MEDIS study Eur J Public Health (2010 Dec ) 20(6): 659-664 During 2005-7, 1190 elderly (aged > 65) men and women (from Cyprus, Mitilini, Samothraki, Cephalonia, Crete, Lemnos, Corfu and Zakynthos) were randomly enrolled From all islands, the proportion of males aged 65-80, 80-90 and > 90 years was 71.8, 24.8 and 3.4%, respectively. The proportion of women, for the same age categories, was 80.4, 17.9 and 1.7%, respectively Dietary characteristics of The Mediterranean Islands Study (MEDIS) sample display a favourable adherence to dietary recommendations (Mediterranean diet)
- 22. OTHER STUDIES Walking and other activities significantly declined with age (P < 0.001) H owever, nearly one in five participants over the age of 90 years remained physically active Current smoking significantly declined in males as age increased (P < 0.001) All participants above the age of 90 years reported sleeping at noon The proportion of participants living alone differs significantly (P < 0.001) across the three age groups. However, considerably more women live alone (men vs. women living alone: aged 65-80 years 12 vs. 37%; 80-90 years 16 vs. 55%; > 90 years 52 vs. 55%)