Comparison of cardiovascular disease and cancer prevalence between Mediterranean and north European middle-aged populations (The Cilento on Ageing Outcomes Study and The Malmö Offspring Study)

Abstract

Mediterranean diet protects from both cardiovascular disease (CVD) and cancer. In the 1960s, Ancel Keys defined the concept of Mediterranean diet in the South Italian region of Cilento and proposed it as a key factor for healthy ageing in the region. The aim of the current study was to compare the prevalence of CVD and cancer between a middle-aged population from Cilento and those of a Northern European population from Malmö, Sweden. We clinically characterized two middle-aged (50–67 years of age) population-based samples from Cilento (n = 809) and Malmö (n = 1025), Sweden, respectively. Logistic regression was used to calculate odds ratios (95% confidence interval) for disease prevalence in Malmö versus Cilento inhabitants adjusted for age and sex (model 1) and adjusted for all cardiometabolic risk factors (model 2). The prevalence of hypertension, current smoking, diabetes mellitus and levels of body mass index and triglycerides were lower, whereas HDL-cholesterol was higher in Malmö than in Cilento. LDL-cholesterol was higher and estimated glomerular filtration rate was lower in Malmö than in Cilento. The odds ratio for cardiovascular disease in Malmö versus Cilento inhabitants was 1.13 (0.69–1.87) (P = 0.62) in model 1, whereas it was significantly elevated in model 2 [2.03 (1.14–3.60) (P = 0.016)]. Moreover, the odds ratio for cancer in Malmö versus Cilento was 2.78 (1.81–4.27) (P < 0.001) in model 1 and 3.11 (1.97–4.92) (P < 0.001) in model 2. The higher odds of CVD and cancer in Malmö versus Cilento, when risk factors were accounted for, suggests the existence of unknown protective factors in Cilento.

Metabolome-Defined Obesity and the Risk of Future Type 2 Diabetes and Mortality

“…CIAO is a population-based cohort from the area of Cilento in the Campania region of South Italy. A random sample of middle-aged (50-67 years old) individuals from Cilento were invited through their local primary health care providers (20). A total of 935 individuals had overnight-fasted EDTA plasma sam-ples available, and metabolomic analysis was performed on 821 samples after application of exclusion criteria.…”

Metabolome-defined obesity and the risk of future diabetes and mortality

“…CIAO is a population-based cohort, based in the area of Cilento in the Campania region in South Italy. A random sample of middle-age (50-67 years) individuals from Cilento were invited via the local primary health care 20 , with a participation rate of 55 %. A total of 821 individuals had over-night fasted EDTA plasma samples available for metabolite analysis.…”

A Narrative Review Exploring the Similarities between Cilento and the Already Defined “Blue Zones” in Terms of Environment, Nutrition, and Lifestyle: Can Cilento Be Considered an Undefined “Blue Zone”?

“…These recipes are composed of macro- and micronutrients associated with the Mediterranean diet and represent a model of “healthy eating” [ 43 , 58 ]. Several studies have confirmed that people who follow a Mediterranean diet have a lower risk of cardiovascular disease, metabolic syndrome, obesity, and cancer; lower rates of diabetes; and less cognitive dysfunction [ 59 , 60 ]. It should also be remembered that in the 1960s, the American cardiovascular scientist Ancel Keys defined the concept of the Mediterranean diet in Cilento and proposed it as a key factor of healthy aging in the region [ 60 ].…”