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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: Cárdenas-Fuentes, Gabriela
Subirana, Isaac
Martinez-Gonzalez, Miguel A.
Salas-Salvadó, Jordi
Corella, Dolores
Estruch, Ramon
Fíto, Montserrat
Muñoz-Bravo, Carlos
Fiol, Miguel
Lapetra, José
Aros, Fernando
Serra Majem, Luis 
Tur, Josep A.
Pinto, Xavier
Ros, Emilio
Coltell, Oscar
Díaz-López, Andres
Ruiz-Canela, Miguel
Schröder, Helmut
UNESCO Clasification: 32 Ciencias médicas
Keywords: Aged
Mediterranean Diet
Older Adults, et al
Issue Date: 2019
Journal: European Journal of Nutrition 
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.
ISSN: 1436-6207
DOI: 10.1007/s00394-018-1689-y
Source: European Journal of Nutrition [ISSN 1436-6207], v. 58 (4), p. 1569-1578
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