Skip to main content
Top
Published in: European Journal of Nutrition 4/2019

01-06-2019 | Original Contribution

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

Authors: Gabriela Cárdenas-Fuentes, Isaac Subirana, Miguel A. Martinez-Gonzalez, Jordi Salas-Salvadó, Dolores Corella, Ramon Estruch, Montserrat Fíto, Carlos Muñoz-Bravo, Miguel Fiol, José Lapetra, Fernando Aros, Luis Serra-Majem, Josep A. Tur, Xavier Pinto, Emilio Ros, Oscar Coltell, Andres Díaz-López, Miguel Ruiz-Canela, Helmut Schröder

Published in: European Journal of Nutrition | Issue 4/2019

Login to get access

Abstract

Purpose

Although evidence indicates that both physical activity and adherence to the Mediterranean diet (MedDiet) reduce the risk of all-cause mortality, a little is known about optimal intensities of physical activity and their combined effect with MedDiet in older adults. We assessed the separate and combined associations of leisure-time physical activity (LTPA) and MedDiet adherence with all-cause mortality.

Methods

We prospectively studied 7356 older adults (67 ± 6.2 years) at high vascular risk from the PREvención con DIeta MEDiterránea study. At baseline and yearly thereafter, adherence to the MedDiet and LTPA were measured using validated questionnaires.

Results

After 6.8 years of follow-up, we documented 498 deaths. Adherence to the MedDiet and total, light, and moderate-to-vigorous LTPA were inversely associated with all-cause mortality (p < 0.01 for all) in multiple adjusted Cox regression models. The adjusted hazard of all-cause mortality was 73% lower (hazard ratio 0.27, 95% confidence interval 0.19–0.38, p < 0.001) for the combined category of highest adherence to the MedDiet (3rd tertile) and highest total LTPA (3rd tertile) compared to lowest adherence to the MedDiet (1st tertile) and lowest total LTPA (1st tertile). Reductions in mortality risk did not meaningfully differ between total, light intensity, and moderate-to-vigorous LTPA.

Conclusions

We found that higher levels of LTPA, regardless of intensity (total, light and moderate-to-vigorous), and greater adherence to the MedDiet were associated separately and jointly with lower all-cause mortality. The finding that light LTPA was inversely associated with mortality is relevant because this level of intensity is a feasible option for older adults.
Appendix
Available only for authorised users
Literature
6.
go back to reference Onvani S, Haghighatdoost F, Surkan PJ et al (2017) Adherence to the Healthy Eating Index and Alternative Healthy Eating Index dietary patterns and mortality from all causes, cardiovascular disease and cancer: a meta-analysis of observational studies. J Hum Nutr Diet 30:216–226. https://doi.org/10.1111/jhn.12415 CrossRefPubMed Onvani S, Haghighatdoost F, Surkan PJ et al (2017) Adherence to the Healthy Eating Index and Alternative Healthy Eating Index dietary patterns and mortality from all causes, cardiovascular disease and cancer: a meta-analysis of observational studies. J Hum Nutr Diet 30:216–226. https://​doi.​org/​10.​1111/​jhn.​12415 CrossRefPubMed
25.
go back to reference Elosua R, Marrugat J, Molina L et al (1994) Validation of the Minnesota Leisure Time Physical Activity Questionnaire in Spanish men. The MARATHOM Investigators. Am J Epidemiol 139:1197–1209CrossRefPubMed Elosua R, Marrugat J, Molina L et al (1994) Validation of the Minnesota Leisure Time Physical Activity Questionnaire in Spanish men. The MARATHOM Investigators. Am J Epidemiol 139:1197–1209CrossRefPubMed
26.
go back to reference Elosua R, Garcia M, Aguilar A et al (2000) Validation of the Minnesota Leisure Time Physical Activity Questionnaire in Spanish Women. Med Sci Sport Exerc 32:1431–1437CrossRef Elosua R, Garcia M, Aguilar A et al (2000) Validation of the Minnesota Leisure Time Physical Activity Questionnaire in Spanish Women. Med Sci Sport Exerc 32:1431–1437CrossRef
Metadata
Title
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
Authors
Gabriela Cárdenas-Fuentes
Isaac Subirana
Miguel A. Martinez-Gonzalez
Jordi Salas-Salvadó
Dolores Corella
Ramon Estruch
Montserrat Fíto
Carlos Muñoz-Bravo
Miguel Fiol
José Lapetra
Fernando Aros
Luis Serra-Majem
Josep A. Tur
Xavier Pinto
Emilio Ros
Oscar Coltell
Andres Díaz-López
Miguel Ruiz-Canela
Helmut Schröder
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nutrition / Issue 4/2019
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-018-1689-y

Other articles of this Issue 4/2019

European Journal of Nutrition 4/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.