Entry #: 34
Date: 27 January 2018
Section: Mediterranean diet
Topic: Mediterranean diet and aging
Type: Human trial

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Aging and adherence to the Mediterranean diet: Relationship with cardiometabolic disorders and polypharmacy


Vicinanza et al

Citation / Year

(1) / 2018


Mediterranean diet, aging, cardiovascular disease, cardiometabolic disorders, polypharmacy


As indicated by the authors, the important large-scale PREDIMED study has highlighted the beneficial health effects associated with the Mediterranean diet. Amongst the numerous health benefits reported to date, significant reductions in the incidence of type 2 diabetes and metabolic syndrome, as well as decreased incidence of cardiovascular diseases, have been observed (2-4). The overall aim of this study was to investigate the effects of the Mediterranean diet with respect cardiometabolic disorders and polypharmacy associated with aging. Aging, which currently represents a little bit over 10% of the population and anticipated to increase to over 20% by 2050, is associated with progressive biological decline and increased risk of numerous chronic diseases (5-7). In the context of aging and cardiovascular diseases, shortened telomeres, oxidative stress and damage, and chronic inflammatory process are general features. Previous studies have highlighted that the Mediterranean is positively associated with these characteristics of aging (8-11). This study extends our understanding of the beneficial effects of the Mediterranean diet in reducing the incidence of cardiometabolic disorders, and the association with polypharmacy is a unique aspect of this work.

Key points and implications

A total of 508 people (219M, 289F) were recruited to this study (70.4±9.1 years), and adherence to the Mediterranean diet was assessed using a validated questionnaire. On the basis of the questionnaire (which can be considered semi-quantitative), people were stratified into two group the high scoring group (>8), corresponding to high adherence to the Mediterranean diet), and the medium to low scoring group (<8), corresponding to relatively low adherence to the Mediterranean diet. The findings indicated that compared to those with a high Mediterranean diet score, people with a medium-low score had increased: 1) body mass index, 2) arterial hypertension, 3) diabetes, 4) dyslipidemia, and 5) higher previous cardiovascular events. The well-accepted and World Health Organization definition of polypharmacy namely, five or more daily medications for chronic diseases, was adopted by the authors (12). The higher Mediterranean diet scores were associated with a decrease in the total number of medications in all age groups. Further, the findings indicated the medium-low adherence to the Mediterrenean diet was associated with polypharmacy. Overall, the findings from this important human clinical study reaffirm the beneficial effects of the Mediterranean diet in reducing the incidence of cardiometabolic disorders. Importantly, the findings point in the direction that the Mediterranean diet may have positive impacts on the aging process with a decrease in the requirement for multiple medications for chronic diseases.

Related publications

  1. R. Vicinanza et al., Aging and Adherence to the Mediterranean Diet: Relationship with Cardiometabolic Disorders and Polypharmacy. The journal of nutrition, health & aging 22, 73-81 (2018).
  2. R. Estruch et al., Primary prevention of cardiovascular disease with a Mediterranean diet. The New England journal of medicine 368, 1279-1290 (2013).
  3. J. Salas-Salvado et al., Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes care 34, 14-19 (2011).
  4. B. Roman, L. Carta, M. A. Martinez-Gonzalez, L. Serra-Majem, Effectiveness of the Mediterranean diet in the elderly. Clinical interventions in aging 3, 97-109 (2008).
  5. L. A. Lipsitz, Physiological complexity, aging, and the path to frailty. Science of aging knowledge environment : SAGE KE 2004, pe16 (2004).
  6. A. Marengoni, D. Rizzuto, H. X. Wang, B. Winblad, L. Fratiglioni, Patterns of chronic multimorbidity in the elderly population. Journal of the American Geriatrics Society 57, 225-230 (2009).
  7. J. L. Wolff, B. Starfield, G. Anderson, Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Archives of internal medicine 162, 2269-2276 (2002).
  8. S. Garcia-Calzon et al., Mediterranean diet and telomere length in high cardiovascular risk subjects from the PREDIMED-NAVARRA study. Clinical nutrition 35, 1399-1405 (2016).
  9. S. Garcia-Calzon et al., Dietary inflammatory index and telomere length in subjects with a high cardiovascular disease risk from the PREDIMED-NAVARRA study: cross-sectional and longitudinal analyses over 5 y. The American journal of clinical nutrition 102, 897-904 (2015).
  10. V. Boccardi et al., Mediterranean diet, telomere maintenance and health status among elderly. PloS one 8, e62781 (2013).
  11. D. Pastori et al., Does Mediterranean Diet Reduce Cardiovascular Events and Oxidative Stress in Atrial Fibrillation? Antioxidants & redox signaling 23, 682-687 (2015).
  12. A. Nobili et al., Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study. European journal of clinical pharmacology 67, 507-519 (2011).