The 'secrets' of the long livers in Mediterranean islands: the MEDIS study.

BACKGROUND: The aim of the present work was to evaluate various socio-demographic, clinical, lifestyle and psychological characteristics of elderly (> 65 years) and very elderly (> 90 years) individuals without known cardiovascular disease. METHODS: During 2005-7, 1190 elderly (aged > 65) men and women (from Cyprus, Mitilini, Samothraki, Cephalonia, Crete, Lemnos, Corfu and Zakynthos) were randomly enrolled. Socio-demographic, clinical, psychological and lifestyle factors were assessed using standard questionnaires and procedures. RESULTS: 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. Walking and other activities significantly declined with age (P < 0.001); however, 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%). Dietary characteristics of The Mediterranean Islands Study (MEDIS) sample display a favourable adherence to dietary recommendations (Mediterranean diet). CONCLUSION: A favourable adherence to the Mediterranean diet, mid-day naps and smoking cessation with an increase in age was characteristic of our elderly population. Future research should further evaluate whether the aforementioned characteristics are associated with longevity beyond the average life expectancy.

Associations of energy intake and type 2 diabetes with hypertryglyceridemia in older adults living in the Mediterranean islands: the MEDIS study.

The aim of the present work was to evaluate the associations of bio-clinical, dietary, and other lifestyle characteristics with the prevalence of hypertriglyceridemia among older individuals living in the Mediterranean islands. Information was collected for an extensive array of demographic, bio-clinical, and dietary characteristics, including serum lipids, body weight and height, and food group and nutrient information derived from a food frequency questionnaire. Serum lipid analyses showed that 37% and 35% of males and females, respectively, had elevated triglyceride (TG) levels. After adjustment for a variety of potential confounders, including age, gender, hypertension, physical activity, smoking, and energy consumption, individuals with type 2 diabetes (T2D) had a 112% higher likelihood of hypertriglyceridemia (95% CI 1.28-3.51). When reported energy intake was quantified in tertiles of consumption, those in the highest tertile (i.e., intakes > 1300 kcal) had a 156% higher (p < 0.01) likelihood of having hypertriglyceridemia compared to the lowest tertile (i.e., <1000 kcal). Analysis by gender showed that energy intake did not predict hypertriglyceridemia in females (p = 0.31) or in those who were normal weight (p = 0.16) or overweight (p = 0.96). However, in males (odds ratio per 1 kcal = 1.001, 95% CI 1.000-1.002) and obese participants (odds ratio per 1 kcal = 1.001, 95% CI 1.000-1.002), excess energy consumption was associated with elevated TG. In conclusion, we found that a considerable proportion of the older adults living in the Mediterranean islands and participating in this study had elevated TG levels. Furthermore, the energy intake and a finding of T2D were positively associated with occurrence of hypertriglyceridemia.

Lifestyle determinants of healthy ageing in a Mediterranean population: The multinational MEDIS study.

BACKGROUND: To evaluate modifiable, lifestyle risk factors of cardiovascular disease (CVD) among older adults, across ageing, in the Mediterranean area. METHODS: During 2005-2017, 3131 individuals from 26 Mediterranean islands of 5 countries, ≥65 years of age, were voluntarily enrolled. Anthropometrical, clinical and socio-demographic characteristics, dietary habits, lifestyle parameters were measured through standard procedures. Analyses were performed by year and across consecutive age groups of the participants. RESULTS: A decrease in the prevalence of current smoking (p < 0.001), engagement in physical activities (p = 0.001) and participation in social events (p = 0.001) for every year increase in age was found. Moderate alcohol drinking increased through ageing (p = 0.008), whereas adherence to Mediterranean diet remained stable, but adequate (p = 0.90). Trend analysis also revealed that a quadratic (U-shape) function better characterized the association between ageing and total cardiometabolic risk factors burden (p for trend <0.001). CONCLUSIONS: The gaps in the understanding of factors affecting longevity and healthy ageing remain; public health authorities and stakeholders should focus on the lifestyle determinants of healthy ageing, that seems to be an effective mean for improving older peoples' health.

Mediterranean diet and depression among older individuals: The multinational MEDIS study.

BACKGROUND: Depression has been linked to a large and growing economic and societal burden worldwide. In Europe, depression is one of the most frequent mental disorders across all age groups, but particularly in people aged 65 years and over, and higher depressive symptoms have been reported among individuals with chronic diseases (e.g., diabetes and heart disease). AIM: To evaluate the role of adherence to the Mediterranean diet (MedDiet) in depression in a sample of older people living in the Mediterranean basin. METHODS: Standard procedures were used to determine socio-demographic, lifestyle, and clinical characteristics of the participants, as well as their dietary habits, and depressive symptoms were evaluated using the Geriatric Depression Scale (GDS). Multi-adjusted logistic and linear regression analyses were carried out to evaluate the associations between participants' characteristics and depression. RESULTS: Participants classified as having mild or severe depression were less educated and physically active, and more diabetic, and they reported less adherence to the MedDiet. Adherence to the MedDiet was associated with the absence of depression [(OR, 95% CI): 0.65, 0.50-0.85]. In addition, daily tea drinking was also related to the absence of depression [(OR, 95% CI): 0.51, 0.40-0.65]. CONCLUSIONS: Greater adherence to the MedDiet and daily tea drinking seem to have a beneficial effect on depressive symptoms in older adults.

Diet, lifestyle factors and hypercholesterolemia in elderly men and women from Cyprus.

BACKGROUND: We sought to investigate the single and combined effect of Mediterranean diet, being physically active, moderate alcohol use, and non-smoking on clinical status of 150 elderly people from Cyprus. METHODS: The study comprises individuals enrolled in surveys from Greece and Cyprus. This work includes 53 apparently men and 97 women, aged 65 to 100 years, from various areas of Cyprus. The cohort study was conducted between 2004 and 2005. A diet score that assesses the inherent characteristics of the Mediterranean diet was developed (range 0-55) and then a healthy index was calculated that evaluated four lifestyle habits (range 0-4), i.e. non-smoking, alcohol intake, physical activity and adherence to the Mediterranean diet (i.e. above the median of the score). RESULTS: 65% participants had hypercholesterolemia (total serum cholesterol > 200 mg/dl or use of lipid lowering agents). Moreover, 32% of the participants reported physically active, 5% reported smoking habits and 4% that they have stopped smoking during the past decade, while 8% reported alcohol drinking. A positive association was observed between prevalence of hypercholesterolemia and smoking habits (odds ratio = 4.3, p = 0.03), while an inverse association was observed between hypercholesterolemia, alcohol drinking (odds ratio = 0.3, p = 0.04) and adherence to a Mediterranean diet (odds ratio = 0.77, p = 0.02), controlled for age, sex, and other factors. CONCLUSION: Adherence to a Mediterranean diet and healthful lifestyle is associated with reduced odds of having hypercholesterolemia among elderly people.

Long-term adoption of a Mediterranean diet is associated with a better health status in elderly people; a cross-sectional survey in Cyprus.

BACKGROUND: There is increasing evidence that there are protective health effects from diets which are high in fruits, vegetables, legumes, and whole grains, and which include fish, nuts, and low-fat dairy products. We sought to investigate the association of Mediterranean diet on clinical status of 150 elderly men and women. METHODS: During 2004 - 2005, we studied 53 men and 97 women, aged 65 to 100 years, from various areas of Cyprus. A diet score that assesses the inherent characteristics of the Mediterranean diet was developed for each individual (range 0-55). Adoption of the Mediterranean diet was evaluated against the presence of cardiovascular risk factors like hypertension, diabetes, hypercholesterolemia and obesity. RESULTS: 26% of men and 18% of women had diabetes, 60% of men and 58% of women had hypertension, 60% of men and 68% of women had hypercholesterolemia, and 34% of men and 52% of women were obese. More than 90% of the participants reported consistency in their dietary habits for at least the past 3-4 decades. A significant inverse correlation was observed between diet score and the number of the investigated risk factors (rho= -0.26, p< 0.001). When we took into account age, sex, smoking habits, and physical activity status, we observed that a 10-unit increase in the diet score was associated with 21% lower odds of having one additional risk factor in women (p< 0.001) and with 14% lower odds in men (p = 0.05). CONCLUSION: Adherence to a Mediterranean diet is associated with reduced odds of having hypercholesterolemia, hypertension, diabetes and obesity among elderly people.