Abstract MP08: Association of a Mediterranean Lifestyle With All-Cause and Cause-Specific Mortality: A Prospective Cohort Study From UK Biobank

Abstract

Background: There is strong evidence that the Mediterranean diet protects from cardiovascular disease (CVD); however, beyond diet, the Mediterranean lifestyle may have synergistic effects through the combination of other health behaviors, such as adequate rest or sociability. While most evidence on this lifestyle pattern comes from Mediterranean countries, little is known about the health effects of a Mediterranean lifestyle in non-Mediterranean populations. Our aim was to examine the association between a Mediterranean lifestyle index (MEDLIFE) and all-cause, (CVD), and cancer mortality in a British population. Methods: We used data from 110,799 individuals free of CVD or cancer, aged 40-69 years, from the UK Biobank cohort, who were followed from 2006-2010 to 2020. The Mediterranean lifestyle was assessed through the validated 26-item MEDLIFE index derived from the lifestyle questionnaire and from 2 or more Oxford WebQ Online 24-hour diet recalls. MEDLIFE comprised three blocks: a) Block 1 (13 items): Mediterranean food consumption, b) Block 2 (7 items): Mediterranean dietary habits, c) Block 3 (6 items): Physical activity, rest, social habits, and conviviality. Mortality was obtained from the death register records. Multivariable-adjusted Cox proportional-hazards regression models were used to analyse associations between MEDLIFE and all-cause, CVD, and cancer mortality. Results: After a mean 9.4-year follow-up, 4,247 deaths were identified. Higher adherence to the MEDLIFE index was associated with lower all-cause and cancer mortality in a dose-response manner. Compared to the first quartile of adherence to the MEDLIFE, the increasingly higher quartiles had a HR (95% CI) of 0.89 (0.81 -0.97), 0.81 (0.74-0.89) and 0.71 (0.65-0.78), p-trend <0.001, for all-cause mortality; and 0.90 (0.80-1.01), 0.83 (0.74-0.93) and 0.72 (0.64-0.82), p -trend <0.001, for cancer mortality. All MEDLIFE blocks were independently associated with lower risk of all-cause and cancer death, and block 3 with lower CVD mortality. Conclusions: A Mediterranean lifestyle was associated to reduced all-cause and cancer-mortality in British middle-aged and older adults; this suggests that adopting a Mediterranean lifestyle adapted to the local characteristics of non-Mediterranean populations is possible and can be part of a healthy lifestyle.