scholarly journals The Mediterranean diet and physical activity: better together than apart for the prevention of premature mortality

2021 ◽  
pp. 1-12
Author(s):  
Maria Soledad Hershey ◽  
Miguel Ángel Martínez-González ◽  
Ismael Álvarez-Álvarez ◽  
José Alfredo Martínez Hernández ◽  
Miguel Ruiz-Canela
Keyword(s):  
Physical Activity ◽  
Mediterranean Diet ◽  
Premature Mortality ◽  
Lifestyle Factors ◽  
Individual Risk ◽  
Additive Interaction ◽  
Increased Risk ◽  
Diet And Physical Activity ◽  
All Cause Mortality ◽  
The Mediterranean

Abstract Diet and physical activity (PA) have been studied extensively in epidemiology as single or combined lifestyle factors; however, their interaction has not been studied thoroughly. Studying potential synergisms between lifestyle components with a comprehensive interaction analysis, including additive measures of interaction, provides key insights into the nature of their joint effect and helps target interventions more effectively. First, a comprehensive review was conducted to assess the potential research gap regarding reported interaction analyses conducted in studies assessing the Mediterranean diet (MedDiet) in combination with PA on all-cause mortality. Thereafter, we prospectively assessed the joint association of the MedDiet with PA on all-cause mortality in the Seguimiento Universidad de Navarra (SUN) cohort, followed by both multiplicative and additive interaction analyses. The conjoint effect of low adherence to the MedDiet and low PA observed an increased risk greater than the individual risk factors, suggesting a potential additive interaction or synergism between both exposures, with relative risk due to interaction (RERI) and (95 % confidence interval (95 % CI)) = 0·46 (–0·83 to 1·75) and attributable proportion (95 % CI) due to interaction of 36 % (–0·62, 1·34). No multiplicative interaction was detected. Studying interactions between lifestyle factors, such as the MedDiet and PA, is particularly relevant given the current research gaps in studying the complexities of combined aspects of lifestyle in comparison with isolated behaviours. Our findings underline the important public health message of adhering to both the MedDiet and PA for the prevention of premature mortality.

scholarly journals Population Impact of Adhering to the Mediterranean Diet and Physical Activity on All-cause Mortality: The Seguimiento Universidad De Navarra (SUN) Cohort (P18-018-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Maria Hershey ◽  
Ismael Álvarez Álvarez ◽  
Clara Gómez-Donoso ◽  
Alfredo Gea ◽  
Alfredo Martínez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mediterranean Diet ◽  
Population Attributable Risk ◽  
Total Mortality ◽  
Joint Effect ◽  
Substantial Impact ◽  
Population Impact ◽  
Increased Risk ◽  
All Cause Mortality ◽  
The Mediterranean

Abstract Objectives We assessed the population impact of the joint effect of the Mediterranean Diet (MedDiet) and physical activity (PA) in a Spanish cohort. Methods We used data from the SUN (“Seguimiento Universidad de Navarra) study, a dynamic cohort of university graduates. We used a MedDiet score (MDS) of 0–9 points and PA score of 0–8 points. Adjusted multivariable Cox regression models were used to study the individual and joint effects of the MedDiet and PA on all-cause mortality. To assess adherence to MDS, PA, or the combination of both, the highest tertiles of each served as references. P-values for interaction were calculated for the Relative Risk due to Interaction (RERI) and the attributable proportion due to interaction. We calculated the population attributable risk (PAR) and the rate advancement period (RAP) as the aging effect attributable to the lowest combination of MDS and PA score. Results We recruited 20,127 participants, 61.5% female and 37 years-old mean age. After a mean follow-up of 10.9 months, 347 deaths were confirmed. The lowest adherence to PA was associated with a 69% increased risk of all-cause mortality compared with the highest tertile (95%CI;1.32–2.17). MDS, as a continuous variable, was also inversely significantly associated with total mortality. The joint effect showed a trend towards an increased risk for all-cause mortality. Using the highest MedDiet and PA as reference, the HR for death in participants with lowest adherence to both was 2.08 (1.28–3.37). We observed a positive but non-significant additive interaction between MedDiet and PA (RERI for the lowest MedDiet and PA = 0.54, (95% CI;0.64–1.72, P = 0.367). We estimated that 48% (95%CI; −0.33–1.30) of the joint effect was attributable to the interaction between MedDiet and PA. The RAP for participants with the lowest tertiles of both MedDiet and PA was 10 years (95% CI: 2.97–17.13). An estimated 28% (95% CI: 11%–43%) of all premature deaths may have been prevented if all participants exhibited high MedDiet and PA levels. Conclusions A combination of poor MedDiet adherence and low PA levels account for almost 30% of all-cause mortality. Public health interventions combining both diet and PA could have a substantial impact at the population level. Funding Sources Spanish Government-Instituto de Salud Carlos III, European Fund for Regional & Economic Development, CIBER-OBN, Navarra Government. Supporting Tables, Images and/or Graphs

scholarly journals Sustained adherence to a Mediterranean diet and physical activity on all-cause mortality in the Melbourne Collaborative Cohort Study: application of the g-formula

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Elizabeth J. Williamson ◽  
Julia Polak ◽  
Julie A. Simpson ◽  
Graham G. Giles ◽  
Dallas R. English ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Mediterranean Diet ◽  
Dietary Patterns ◽  
Relative Importance ◽  
High Physical Activity ◽  
Diet And Physical Activity ◽  
All Cause Mortality ◽  
Melbourne Collaborative Cohort Study ◽  
Over Time

Abstract Background Adherence to a traditional Mediterranean diet has been associated with lower mortality and cardiovascular disease risk. The relative importance of diet compared to other lifestyle factors and effects of dietary patterns over time remains unknown. Methods We used the parametric G-formula to account for time-dependent confounding, in order to assess the relative importance of diet compared to other lifestyle factors and effects of dietary patterns over time. We included healthy Melbourne Collaborative Cohort Study participants attending a visit during 1995–1999. Questionnaires assessed diet and physical activity at each of three study waves. Deaths were identified by linkage to national registries. We estimated mortality risk over approximately 14 years (1995–2011). Results Of 22,213 participants, 2163 (9.7%) died during 13.6 years median follow-up. Sustained high physical activity and adherence to a Mediterranean-style diet resulted in an estimated reduction in all-cause mortality of 1.82 per 100 people (95% confidence interval (CI): 0.03, 3.6). The population attributable fraction was 13% (95% CI: 4, 23%) for sustained high physical activity, 7% (95% CI: − 3, 17%) for sustained adherence to a Mediterranean-style diet and 18% (95% CI: 0, 36%) for their combination. Conclusions A small reduction in mortality may be achieved by sustained elevated physical activity levels in healthy middle-aged adults, but there may be comparatively little gain from increasing adherence to a Mediterranean-style diet.

Multiple approaches to associations of physical activity and adherence to the Mediterranean diet with all-cause mortality in older adults: the PREvención con DIeta MEDiterránea study

2018 ◽  
Vol 58 (4) ◽  
pp. 1569-1578 ◽  
Author(s):  
Gabriela Cárdenas-Fuentes ◽  
Isaac Subirana ◽  
Miguel A. Martinez-Gonzalez ◽  
Jordi Salas-Salvadó ◽  
Dolores Corella ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mediterranean Diet ◽  
All Cause Mortality ◽  
The Mediterranean ◽  
Dieta Mediterranea ◽  
Dieta Mediterránea

scholarly journals Adherence to Mediterranean Diet, Physical Activity and Survival after Prostate Cancer Diagnosis

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 243
Author(s):  
Matteo Di Maso ◽  
Livia S. A. Augustin ◽  
Federica Toffolutti ◽  
Carmen Stocco ◽  
Luigino Dal Maso ◽  
...  
Keyword(s):  
Physical Activity ◽  
Prostate Cancer ◽  
Overall Survival ◽  
Mediterranean Diet ◽  
Cancer Survival ◽  
Cox Model ◽  
Moderate Physical Activity ◽  
High Physical Activity ◽  
Diet And Physical Activity ◽  
The Mediterranean

Despite the considerable number of studies investigating the Mediterranean diet in prostate cancer (PCa) etiology, very few focused on cancer survival. We assessed the pre-diagnostic diet and physical activity in a cohort of 777 men with PCa diagnosed between 1995 and 2002 in north-eastern Italy; adherence to the Mediterranean diet was evaluated through the Mediterranean Diet Score (MDS). Hazard ratios (HR) of death with confidence intervals (CI) were estimated using the Cox model, adjusting for potential confounders. During 10 years of follow-up, 208 patients (26.8%) died, 75 (9.7%) due to PCa. Patients reporting MDS ≥ 5 showed a higher overall survival than those with MDS < 5 (HR = 0.74; 95% CI: 0.56–0.99). Although high physical activity was not significantly associated with overall survival (HR = 0.79; 95% CI: 0.59–1.07), the HR for all-cause death was the lowest (HR = 0.58; 95% CI: 0.38–0.90) for men reporting MDS ≥ 5 and high physical activity compared to those reporting MDS < 5 and low/moderate physical activity. No association emerged for PCa specific survival. Study findings support the beneficial impact of pre-diagnostic adherence to the Mediterranean diet and physical activity on overall survival; they are mainly driven by risk reduction in non-prostate cancer mortality, which however accounts for about 80% of death in men with PCa.

scholarly journals Mediterranean Diet and physical activity in Romanian and Spanish university students - a comparative study

2018 ◽  
Vol 23 (4) ◽  
pp. 172-178
Author(s):  
G. Badicu ◽  
C.R. Chacón ◽  
F. Zurita-Ortega ◽  
M. Castro-Sanchez ◽  
L. Balint
Keyword(s):  
Physical Activity ◽  
Standard Deviation ◽  
Mediterranean Diet ◽  
Poor Adherence ◽  
Chi Square ◽  
Arithmetic Average ◽  
Diet And Physical Activity ◽  
Chi Square Test ◽  
The Mediterranean ◽  
Student’S T

Purpose: The main purpose of this research was to show if there are differences between the Mediterranean diet and physical activity in students from Romania and Spain. Material: The study was carried out on a sample of 567 participants, 149 of which (24.69%) are from Romania (Transilvania University of Braşov) and 427 (75.31%) are students from Spain (University of Granada ). To evaluate adherence to the Mediterranean diet we used The Mediterranean Diet Quality Index (KIDMED), and for the assessment of the level of physical activity, we used the Physical Activity Questionnaire for Adolescents (PAQ-A). The reliability of the KIDMED was good (Cronbach’s α = 0.83) and for PAQ-A is 0.874. Statistical analyses were done through program IBM SPSS Statistics 22. The statistical indicators used in this study, were the following: standard deviation (SD), arithmetic average (X), chi-square test, Student’s T-test (t), percent%, Levene’s test, ANOVA One-Way. Results: The results of the variance analysis showed that there is no statistically significant relationship between the adherence to the Mediterranean diet and physical activity in Romanian students (F=0.517; p=0.598), or in Spanish students (F=0.255; p=0.775). Also, the results regarding adherence to the MD and PA was: poor adherence , n=31, (mean=29.06; standard deviation=3.723), average adherence , n=275, (mean=28.62; standard deviation=3.386), and high adherence, n=261 (mean=28.50; standard deviation=3.779). Conclusions: This study highlighted the fact that there are no significant differences regarding the adherence to the Mediterranean diet and the level of physical activity between the two countries (Romania and Spain). Unlike Spanish students, we found that Romanian students have a poor adherence to the MD.

scholarly journals Physical Activity and Adherence to the Mediterranean Diet among Spanish Employees in a Health-Promotion Program before and during the COVID-19 Pandemic: The Sanitas-Healthy Cities Challenge

2021 ◽  
Vol 18 (5) ◽  
pp. 2735
Author(s):  
Evelia Franco ◽  
Jesús Urosa ◽  
Rubén Barakat ◽  
Ignacio Refoyo
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Mediterranean Diet ◽  
Short Form ◽  
Health Promotion Program ◽  
Noncommunicable Diseases ◽  
Healthy Cities ◽  
Sedentary Behaviors ◽  
Promotion Program ◽  
The Mediterranean

Physical activity and a healthy diet are key factors for avoiding major noncommunicable diseases. The aim of the present study was to analyze how physical activity (PA) and adherence to the Mediterranean diet among employees participating in the Healthy Cities program have been affected during confinement due to the COVID-19 pandemic. The sample was composed of 297 employees from 40 leading companies based in Spain, who participated in the 5th edition of the Sanitas “Healthy Cities” challenge. The participants (148 women and 149 men), aged between 24 and 63 years old (M = 42.76; SD = 7.79) completed the short form of the International Physical Activity Questionnaire (IPAQ) and the PREDIMED (Prevención con Dieta Mediterránea) questionnaire to measure adherence to the Mediterranean diet before and during the pandemic. Pearson χ2 tests revealed that workers were more likely to show sedentary behaviors during the pandemic than before (83.5% vs. 66.7%). Additionally, they were more likely to reach high levels of PA (51.2% vs. 64%), and Wilcoxon tests revealed that energy expenditure measured in Metabolic Equivalent of Task (MET) was higher during the pandemic (4199.03 METs) than before (3735.32 METs), due to an increase in moderate PA. Lastly, a higher adherence to a Mediterranean diet during the pandemic (76.4%) than before (54.5%) was reported. The findings of this investigation suggest a positive effect of working from home for employees involved in a health-promotion program, and highlight the relevance of this kind of action among this population.

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