The Southern European Atlantic Diet and all-cause mortality in older adults

Adrián Carballo-Casla,Carla Lopes,Andreia Oliveira,Mercedes Sotos-Prieto,Esther García-Esquinas,Rosario Ortolá,Fernando Rodríguez-Artalejo,Esther Lopez-Garcia

doi:10.1186/s12916-021-01911-y

Abstract

BackgroundThe Southern European Atlantic Diet (SEAD) is the traditional diet of Northern Portugal and North-Western Spain. Higher adherence to the SEAD has been associated with lower levels of some cardiovascular risk factors and reduced risk for myocardial infarction, but whether this translates into lower all-cause mortality is uncertain. We hence examined the association between adherence to the SEAD and all-cause mortality in older adults.MethodsData were taken from the Seniors-ENRICA-1 cohort, which included 3165 individuals representative of the non-institutionalized population aged ≥ 60 years in Spain. Food consumption was assessed with a validated diet history, and adherence to the SEAD was measured with an index comprising 9 food components: fresh fish, cod, red meat and pork products, dairy products, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and wine. Vital status was ascertained with the National Death Index of Spain. Statistical analyses were performed with Cox regression models and adjusted for the main confounders.ResultsDuring a median follow-up of 10.9 years, 646 deaths occurred. Higher adherence to the SEAD was associated with lower all-cause mortality (fully adjusted hazard ratio [95% confidence interval] per 1-SD increment in the SEAD score 0.86 [0.79, 0.94]; p-trend < 0.001). Most food components of the SEAD showed some tendency to lower all-cause mortality, especially moderate wine consumption (hazard ratio [95% confidence interval] 0.71 [0.59, 0.86]). The results were robust in several sensitivity analyses. The protective association between SEAD and all-cause death was of similar magnitude to that found for the Mediterranean Diet Adherence Screener (hazard ratio [95% confidence interval] per 1-SD increment 0.89 [0.80, 0.98]) and the Alternate Healthy Eating Index (0.83 [0.76, 0.92]).ConclusionsAdherence to the SEAD is associated with a lower risk of all-cause death among older adults in Spain.

Highlights

The Southern European Atlantic Diet (SEAD) is the traditional diet of Northern Portugal and North-Western Spain
Some of the SEAD foundations are controversial, as high consumption of red meat and pork products has often been associated with cardiometabolic disease, cancer, and increased mortality [12,13,14], while consumption of potatoes might increase the risk of type 2 diabetes [15]
When we examined the individual food components comprising the SEAD and the Mediterranean Diet Adherence Screener (MEDAS), they were entered into the models as dichotomous variables

Summary

Introduction

The Southern European Atlantic Diet (SEAD) is the traditional diet of Northern Portugal and North-Western Spain. The Southern European Atlantic Diet (SEAD) is the traditional dietary pattern of North-Western Spain and Northern Portugal, where staple foods are fish (especially cod), red meat and pork products, dairy, vegetables and potatoes (often eaten as vegetable soup), whole-grain bread, and wine [1,2,3,4]. Some of the SEAD foundations are controversial, as high consumption of red meat and pork products has often been associated with cardiometabolic disease, cancer, and increased mortality [12,13,14], while consumption of potatoes might increase the risk of type 2 diabetes [15] These characteristics of the SEAD diverge from other healthy dietary patterns that have been consistently linked to a lower risk of chronic diseases and mortality, such as the Mediterranean Diet or the Alternate Healthy Eating Index [16, 17].

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