Decomposition of Mediterranean Dietary Pattern on Successful Aging,Among Older Adults: A Combined Analysis of Two Epidemiological Studies

Abstract

Objective: To investigate the association of Mediterranean food group consumption with successful aging (SA), among people more than 50 years old. Method: Dietary habits, as well as several bio-clinical characteristics of the Greek participants enrolled in the ATTICA (n = 1,128 men and women from Athens metropolitan area) and the MEDIS (n = 2,221 men and women from selected Greek islands) cohort studies were investigated in relation to SA; SA was measured using a validated 10-scale index. Results: Multivariate discriminant food group analysis revealed that legumes consumption, followed by vegetables, cereals, and poultry were associated with higher levels of SA index (explained variability: 7.9%), mainly among islanders, but not among mainland participants. Further analysis revealed that alcohol consumption was positively associated with SA for mainlanders (ATTICA study) but inversely for islanders (MEDIS study; all p’s < .05). Conclusion: The differential and hierarchical effect of various foods on SA and the diet-environmental interaction revealed in the present work may help health professionals to better understand the role of diet on SA, and to prioritize the nutritional needs of older people for better quality of life.

Keywords

successful aging dietary habits food groups

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References

Arnold

C. G.

Sobal

(2000). Food practices and nutrition knowledge after graduation from the Expanded Food and Nutrition Education Program (EFNEP). Journal of Nutrition Education and Behavior, 32, 130-138.

Aschengrau

Seage

(2014). Essentials of epidemiology in public health (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Bountziouka

Polychronopoulos

Zeimbekis

Papavenetiou

Ladoukaki

Papairakleous

. . . Panagiotakos

(2009). Long-term fish intake is associated with less severe depressive symptoms among elderly men and women: The MEDIS (MEDiterranean ISlands Elderly) epidemiological study. Journal of Aging and Health, 21, 864-880.

Cosco

T. D.

Prina

A. M.

Perales

Stephan

B. C. M.

Brayne

(2014). Operational definitions of successful aging: A systematic review. International Psychogeriatrics, 26, 373-381.

Cosco

T. D.

Stephan

B. C. M.

Brayne

(2015). Validation of an a priori, index model of successful aging in a population-based cohort study: The successful aging index. International Psychogeriatrics, 27, 1971-1977.

Domènech-Abella

Perales

Lara

Moneta

M. V.

Izquierdo

Rico-Uribe

L. A.

. . . Haro

J. M.

(2017). Sociodemographic factors associated with changes in successful aging in Spain: A follow-up study. Journal of Aging and Health, 898264317714327. Advance online publication. doi:10.1177/0898264317714327

Driscoll

H. C.

Serody

Patrick

Maurer

Bensasi

Houck

P. R.

. . . Reynolds

C. F.

(2008). Sleeping well, aging well: A descriptive and cross-sectional study of sleep in “successful agers” 75 and older. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 16, 74-82.

Epel

E. S.

Lithgow

G. J.

(2014). Stress biology and aging mechanisms: Toward understanding the deep connection between adaptation to stress and longevity. The Journals of Gerontology: Series A, Biological Sciences & Medical Sciences, 69(Suppl. 1), S10-S16.

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Journal of the American Medical Association, 285, 2486-2497.

10.

Fountoulakis

K. N.

Tsolaki

Iacovides

Yesavage

O’ Hara

Kazis

Ierodiakonou

(1999). The validation of the short form of the Geriatric Depression Scale (GDS) in Greece. Aging, 11, 367-372.

11.

Hwalla

Koleilat

(2004). Dietetic practice: The past, present and future. Eastern Mediterranean Health Journal, 10, 716-730.

12.

Katsouyanni

Rimm

E. B.

Gnardellis

Trichopoulos

Polychronopoulos

Trichopoulou

(1997). Reproducibility and relative validity of an extensive semi-quantitative food frequency questionnaire using dietary records and biochemical markers among Greek schoolteachers. International Journal of Epidemiology, 26(Suppl. 1), S118-S127.

13.

Kołłajtis-Dołowy

Pietruszka

Kałuza

Pawlińiska-Chmara

Broczek

Mossakowska

(2007). The nutritional habits among centenarians living in Warsaw. Roczniki Panstwowego Zakladu Higieny, 58, 279-286.

14.

Martinez-Gonzalez

M. A.

Bes-Rastrollo

(2014). Dietary patterns, Mediterranean diet, and cardiovascular disease. Current Opinion in Lipidology, 25, 20-26.

15.

Milte

McNaughton

(2016). Dietary patterns and successful ageing: A systematic review. European Journal of Nutrition, 55, 423-450.

16.

Oikonomou

Tountas

(2011). Insufficient primary care services to the rural population of Greece. Rural and Remote Health, 11, 1661.

17.

Panagiotakos

D. B.

Georgousopoulou

E. N.

Pitsavos

Chrysohoou

Metaxa

Georgiopoulos

G. A.

. . . ATTICA Study Group. (2015). Ten-year (2002-2012) cardiovascular disease incidence and all-cause mortality, in urban Greek population: The ATTICA Study. International Journal of Cardiology, 180, 178-184.

18.

Panagiotakos

D. B.

Pitsavos

Stefanadis

(2006). Dietary patterns: A Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutrition, Metabolism, & Cardiovascular Diseases, 16, 559-568.

19.

Papathanasiou

Georgoudis

Papandreou

Spyropoulos

Georgakopoulos

Kalfakakou

Evangelou

(2009). Reliability measures of the short International Physical Activity Questionnaire (IPAQ) in Greek young adults. Hellenic Journal of Cardiology, 50, 283-294.

20.

Passarino

De Rango

Montesanto

(2016). Human longevity: Genetics or Lifestyle? It takes two to tango. Immunity & Aging, 13, Article 12.

21.

Price

J. L.

Lewis

Boissoneault

Frazier

I. R.

Nixon

S. J.

(2018). Effects of acute alcohol and driving complexity in older and younger adults. Psychopharmacology (Berl), 235, 887-896. doi:10.1007/s00213-017-4806-3

22.

Qato

D. M.

Manzoor

B. S.

Lee

T. A.

(2015). Drug-alcohol interactions in older U.S. adults. Journal of the American Geriatrics Society, 63, 2324-2331.

23.

Robson

(2002). Real world research: A resource for social scientists and practitioner-researchers (2nd ed.). Oxford, UK: Blackwell.

24.

Rockwood

M. R.

Mitnitski

(2010). Physiological redundancy in older adults in relation to the change with age in the slope of a frailty index. Journal of the American Geriatrics Society, 58, 318-323.

25.

Roman

Carta

Ángel

(2008). Effectiveness of the Mediterranean diet in the elderly. Clinical Interventions in Aging, 3, 97-109.

26.

Simopoulos

A. P.

(2001). The Mediterranean diets: What is so special about the diet of Greece? The scientific evidence. The Journal of Nutrition, 131(11 Suppl.), 3065S-3073S.

27.

Slavin

J. L.

Lloyd

(2012). Health benefits of fruits and vegetables. Advances in Nutrition, 3, 506-516.

28.

Tourlouki

Matalas

A. L.

Bountziouka

Tyrovolas

Zeimbekis

Gotsis

. . . Panagiotakos

D. B.

(2013). Are current dietary habits in Mediterranean islands a reflection of the past? Results from the MEDIS study. Ecology of Food and Nutrition, 52, 371-386.

29.

Trichopoulou

(2004). Traditional Mediterranean diet and longevity in the elderly: A review. Public Health Nutrition, 7, 943-947.

30.

Trichopoulou

Costacou

Bamia

Trichopoulos

(2003). Adherence to a Mediterranean diet and survival in a Greek population. The New England Journal of Medicine, 2003, 2599-2608.

31.

Tur

J. A.

Romaguera

Pons

(2004). Food consumption patterns in a Mediterranean region: Does the Mediterranean diet still exist? Annals of Nutrition & Metabolism, 48, 193-201.

32.

Tynjala

Kangastupa

Laatikainen

Aalto

Niemela

(2012). Effect of age and gender on the relationship between alcohol consumption and serum GGT: Time to recalibrate goals for normal ranges. Alcohol and Alcoholism, 47, 558-562.

33.

Tyrovolas

Chalkias

Morena

Tsiligianni

Zeimbekis

Gotsis

. . . Panagiotakos

(2011). Health care access and prevalence of the metabolic syndrome among elders living in high-altitude areas of the Mediterranean islands: The MEDIS study. The Review of Diabetic Studies, 8, 468-476.

34.

Tyrovolas

Haro

J. M.

Mariolis

Piscopo

Valacchi

Tsakountakis

. . . Panagiotakos

(2014). Successful aging, dietary habits and health status of elderly individuals: A k-dimensional approach within the multi-national MEDIS study. Experimental Gerontology, 60, 57-63.

35.

Tyrovolas

Pounis

Bountziouka

Polychronopoulos

Panagiotakos

D. B.

(2010). Repeatability and validation of a short, semi-quantitative food frequency questionnaire designed for older adults living in Mediterranean areas: The MEDIS-FFQ. Journal of Nutrition for the Elderly, 29, 311-324.

36.

Vasto

Scapagnini

Rizzo

Monastero

Marchese

Caruso

(2012). Mediterranean diet and longevity in Sicily: Survey in a Sicani Mountains population. Rejuvenation Research, 15, 184-188.

37.

Visioli

Strata

(2014). Milk, dairy products, and their functional effects in humans: A narrative review of recent evidence. Advances in Nutrition, 5, 131-143.

38.

Willett

W. C.

Sacks

Trichopoulou

Drescher

Ferro-Luzzi

Helsing

Trichopoulos

(1995). Mediterranean diet pyramid: A cultural model for healthy eating. The American Journal of Clinical Nutrition, 61(6 Suppl.), 1402S-1406S.

39.

World Health Organization. (1948). Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946. Geneva, Switzerland: World Health Organization.

40.

Yamori

(2006). Food factors for atherosclerosis prevention: Asian perspective derived from analyses of worldwide dietary biomarkers. Experimental & Clinical Cardiology, 11, 94-98.