Dietary Patterns and Total Mortality in a Mediterranean Cohort: The SUN Project |
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| Institution: | 1. University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, 31008, Pamplona, Spain;2. IdiSNA, Navarra Institute for Health Research, 31008, Pamplona, Spain;3. University of Navarra, Department of Nutrition and Food Sciences and Physiology, School of Pharmacy and Nutrition, 31008, Pamplona, Spain;4. Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), 28029, Madrid, Spain;5. Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA;1. Department of Obstetrics and Gynecology, Center for Integrated Oncology, University of Bonn, Sigmund-Freud-St 25, 53105 Bonn, Germany;2. Department of Radiology, Center for Integrated Oncology, University of Bonn, Bonn, Germany;1. NYU Clinical Cancer Center, New York, New York;2. Emory University Hospital, Atlanta, Georgia;3. University of Cincinnati, Cincinnati, Ohio;4. Imagimed, LLC, Rockville, Maryland;5. American College of Surgeons, Chicago, Illinois;6. Invision Sally Jobe, Englewood, Colorado;7. Ohio State University, Columbus, Ohio;8. University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, New Brunswick, New Jersey;9. University of Virginia Medical Center, Charlottesville, Virginia;10. Memorial Regional Hospital, Hollywood, Florida;11. Rush University Medical Center, Chicago, Illinois;12. Rhode Island Hospital, Providence, Rhode Island;13. University of Pennsylvania, Philadelphia, Pennsylvania;14. Society of Nuclear Medicine, Reston, Virginia;15. Radiology Inc., Mishawaka, Indiana;p. University of Miami, Miami, Florida;1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia;2. Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia;3. Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Public Health, University of Melbourne, Australia |
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| Abstract: | BackgroundDifferent dietary patterns have been associated with several health outcomes, including morbidity and mortality. There is little evidence on the association between empirically derived dietary patterns and all-cause mortality in Southern European populations.ObjectiveThe aim of our study was to prospectively evaluate the association between an empirically derived dietary pattern and all-cause mortality.DesignThe Seguimiento Universidad de Navarra (SUN) Project is an ongoing, multipurpose, prospective and dynamic Spanish cohort.Participants/settingParticipants were a prospective cohort of 16,008 middle-aged Spanish adults. All of them were university graduates (alumni) (59.6% women, mean age 38 years). Usual diet was assessed at baseline with a validated semiquantitative food frequency questionnaire.Main outcome measuresDeaths were confirmed by review of medical records and of the National Death Index.Statistical analysisDietary patterns were ascertained through a factor (principal component) analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to the three main dietary patterns identified with factor analysis. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios and 95% CIs for mortality.ResultsThree major dietary patterns were identified. They were labelled Western dietary pattern (rich in red and processed meat, potatoes, and fast food), Mediterranean dietary pattern (rich in vegetables, fish and seafood, fruits, and olive oil), and alcoholic beverages dietary pattern. During follow-up, 148 deaths were reported (mean age at death 54.5 years). After adjustment for potential confounders, the lowest risk of all-cause mortality was found in the tertile of highest adherence to the Mediterranean dietary pattern (adjusted hazard ratio for third vs first tertile 0.53, 95% CI 0.34 to 0.84) (P for trend <0.01). The Western dietary pattern and alcoholic beverages dietary pattern showed no significant association with mortality.ConclusionsGreater adherence to an empirically derived dietary pattern approaching the traditional Mediterranean diet was associated with a reduction in the risk of all-cause mortality among middle-aged Mediterranean adults. |
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| Keywords: | Mortality Mediterranean cohort Dietary pattern Post hoc |
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