Mediterranean and carbohydrate-restricted diets and mortality among elderly men: a cohort study in Sweden

Sjögren, Per; Becker, Wulf; Warensjö, Eva; Olsson, Eva; Byberg, Liisa; Gustafsson, Inga‐Britt; Karlström, Brita; Cederholm, Tommy

doi:10.3945/ajcn.2010.29345

Cited by 118 publications

(136 citation statements)

References 26 publications

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“…9,10 Saturated fat was the most important confounder in our study. However, other studies have reported a positive association between a carbohydrate-restricted diet and increased mortality after adjusting for saturated fat, 11 or with fat intake taken into account by other means.…”

Section: Discussionmentioning

confidence: 87%

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Low-carbohydrate, high-protein score and mortality in a northern Swedish population-based cohort

et al. 2012

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BACKGROUND/OBJECTIVE: Long-term effects of carbohydrate-restricted diets are unclear. We examined a low-carbohydrate, high-protein (LCHP) score in relation to mortality. SUBJECTS/METHODS: This is a population-based cohort study on adults in the northern Swedish county of Västerbotten. In 37 639 men (1460 deaths) and 39 680 women (923 deaths) from the population-based Västerbotten Intervention Program, deciles of energy-adjusted carbohydrate (descending) and protein (ascending) intake were added to create an LCHP score (2 --20 points). Sex-specific hazard ratios (HR) were calculated by Cox regression. RESULTS: Median intakes of carbohydrates, protein and fat in subjects with LCHP scores 2 --20 ranged from 61.0% to 38.6%, 11.3% to 19.2% and 26.6% to 41.5% of total energy intake, respectively. High LCHP score (14 --20 points) did not predict all-cause mortality compared with low LCHP score (2 --8 points), after accounting for saturated fat intake and established risk factors (men: HR for high vs low 1.03 (95% confidence interval (CI) 0.88 --1.20), P for continuous ¼ 0.721; women: HR for high vs low 1.10 (95% CI 0.91 --1.32), P for continuous ¼ 0.229). For cancer and cardiovascular disease, no clear associations were found. Carbohydrate intake was inversely associated with all-cause mortality, though only statistically significant in women (multivariate HR per decile increase 0.95 (95% CI 0.91 --0.99), P ¼ 0.010). CONCLUSION: Our results do not support a clear, general association between LCHP score and mortality. Studies encompassing a wider range of macronutrient consumption may be necessary to detect such an association.

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Section: Discussionmentioning

confidence: 87%

“…9,11,12 In one study, an increased mortality at high LCHP scores was found in subjects with coronary artery disease and diabetes. 10 The reduced CVD mortality at high LCHP scores in men with diabetes in our study is thus a novel finding.…”

Section: Discussionmentioning

confidence: 99%

Low-carbohydrate, high-protein score and mortality in a northern Swedish population-based cohort

et al. 2012

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“…The updated search from recent years resulted in the identification of eighteen additional prospective studies published up to June 2013 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) . Characteristics of these recent studies are displayed in Table 3.…”

Section: Updated Systematic Review and Meta-analysismentioning

confidence: 99%

“…Characteristics of these recent studies are displayed in Table 3. Of these, seven cohorts presented overall mortality as clinical outcome (7,8,10,11,(14)(15)(16) , eight incidence and/or mortality from cardio-and cerebrovascular diseases (7,9,10,12,(16)(17)(18)(19) , and eight incidence and/or mortality from neoplastic diseases (10,13,16,(20)(21)(22)(23)(24) . No updated studies for the incidence of neurodegenerative diseases have been found.…”

Section: Updated Systematic Review and Meta-analysismentioning

confidence: 99%

Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score

Sofi

Macchi

Abbate

et al. 2013

Public Health Nutr.

822

650

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Objective: To update previous meta-analyses of cohort studies that investigated the association between the Mediterranean diet and health status and to utilize data coming from all of the cohort studies for proposing a literature-based adherence score to the Mediterranean diet. Design: We conducted a comprehensive literature search through all electronic databases up to June 2013. Setting: Cohort prospective studies investigating adherence to the Mediterranean diet and health outcomes. Cut-off values of food groups used to compute the adherence score were obtained. Subjects: The updated search was performed in an overall population of 4 172 412 subjects, with eighteen recent studies that were not present in the previous meta-analyses. Results: A 2-point increase in adherence score to the Mediterranean diet was reported to determine an 8 % reduction of overall mortality (relative risk 5 0?92; 95 % CI 0?91, 0?93), a 10 % reduced risk of CVD (relative risk 5 0?90; 95 % CI 0?87, 0?92) and a 4 % reduction of neoplastic disease (relative risk 5 0?96; 95 % CI 0?95, 0?97). We utilized data coming from all cohort studies available in the literature for proposing a literature-based adherence score. Such a score ranges from 0 (minimal adherence) to 18 (maximal adherence) points and includes three different categories of consumption for each food group composing the Mediterranean diet. Conclusions: The Mediterranean diet was found to be a healthy dietary pattern in terms of morbidity and mortality. By using data from the cohort studies we proposed a literature-based adherence score that can represent an easy tool for the estimation of adherence to the Mediterranean diet also at the individual level.

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“…14 Such benefits have been observed both in Mediterranean 15 as well as in non-Mediterranean countries. 16 Adherence to a Mediterranean-like dietary pattern has often been evaluated based on scores. The most commonly applied Mediterranean diet score (MDS) used in studies on adults was developed by Trichopoulou et al 17 The score was subsequently modified to include fish 18,19 or calculated based on tertile rather than median intakes for application in large population studies.…”

Section: Introductionmentioning

confidence: 99%

Adherence to a Mediterranean-like dietary pattern in children from eight European countries. The IDEFICS study

et al. 2014

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on behalf of the IDEFICS consortium BACKGROUND: Despite documented benefits of a Mediterranean-like dietary pattern, there is a lack of knowledge about how children from different European countries compare with each other in relation to the adherence to this pattern. In response to this need, we calculated the Mediterranean diet score (MDS) in 2-9-year-old children from the Identification and prevention of dietary-and lifestyle-induced health effects in children and infants (IDEFICS) eight-country study. SUBJECTS AND METHODS:Using 24 h dietary recall data obtained during the IDEFICS study (n = 7940), an MDS score was calculated based on the age-and sex-specific population median intakes of six food groups (vegetables and legumes, fruit and nuts, cereal grains and potatoes, meat products and dairy products) and the ratio of unsaturated to saturated fats. For fish and seafood, which was consumed by 10% of the population, one point was given to consumers. The percentages of children with high MDS levels (43) were calculated and stratified by sex, age and by having at least one migrant parent or both native parents. Demographic (sex and age) and socioeconomic characteristics (parental education and income) of children showing high (43) vs low (⩽3) MDS levels were examined. RESULTS: The highest prevalence of children with MDS 43 was found among the Italian pre-school boys (55.9%) and the lowest among the Spanish school-aged girls (26.0%). Higher adherence to a Mediterranean-like dietary pattern was not associated with living in a Mediterranean country or in a highly educated or high-income family, although with some exceptions. Differences in adherence between boys and girls or age groups varied between countries without any general pattern. CONCLUSIONS: With the exception of Italian pre-schoolers, similar adherence levels to a Mediterranean-like dietary pattern have been observed among European children.

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Mediterranean and carbohydrate-restricted diets and mortality among elderly men: a cohort study in Sweden

Abstract: Adherence to a Mediterranean-like dietary pattern reduced mortality, whereas adherence to a CR dietary pattern appeared to increase mortality in elderly Swedish men, especially when only adequate dietary reporters were considered.

Cited by 118 publications

References 26 publications

Low-carbohydrate, high-protein score and mortality in a northern Swedish population-based cohort

Low-carbohydrate, high-protein score and mortality in a northern Swedish population-based cohort

Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score

Adherence to a Mediterranean-like dietary pattern in children from eight European countries. The IDEFICS study

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