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Mediterranean diet could prolong the life of seniors

The Mediterranean diet has been shown to reduce the risk of many diseases, including cardiovascular disease, and now it may be linked to prolonging the life of seniors.

In general, I’m unconvinced about fad diets, unless there is some really powerful published evidence in support. And those are rare. Now a published study shows that there is moderate evidence that the Mediterranean diet could add years to the life of seniors.

As I usually do, let’s take a look at the study and critically analyze it.

vegetable salad on ceramic plate
Photo by Foodie Factor on

What is the Mediterranean diet?

The Mediterranean diet is a diet that is common to the eating habits of people living in areas of the Mediterranean, including Greece, Southern Italy, and Spain. The diet generally includes proportionally higher amounts of olive oil, legumes, unrefined grains, nuts, fruits, and vegetables. It also includes moderate to high fish consumption, dairy products (generally, cheese and yogurt), moderate wine consumption, and low consumption of other meats.

Unfortunately, there is not a solid definition of this diet. In general, it is low in red meat, moderate in chicken and fish, and high in whole grains, fruits, vegetables, tree nuts, and legumes. But, it does vary from region to region around the Mediterranean.

During the 1940s and 50s, scientists observed that people who consumed the Mediterranean diet seemed to be objectively healthier (broadly defined) and suffered from lower rates of obesity than other populations that ate other types of diets that included refined grains and non-fish meats.

There seems to be some moderate- to high-quality evidence that the Mediterranean diet is linked to improving numerous health outcomes, including type 2 diabetes, cancer, and Alzheimer’s disease.

© 2009 Oldways Preservation and Exchange Trust

Mediterranean diet and seniors

In a study published on 30 August 2018 in the British Journal of Nutrition, Marialaura Bonnacio, Ph.D., Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy, and colleagues developed a prospective cohort study to examine the health and diet of 5200 seniors aged 65 and over from the Molise region of Italy. These individuals were recruited as part of a larger study between 2005 and 2010. They were followed until 2015.

Participants completed a food survey that inquired about their diet during the year prior to enrolling in the study. Each survey was scored on how close the seniors adhered to a Mediterranean diet (from a low score of 0 to a high of 9). One of the weaknesses of a cohort study is the reliance upon surveys and questionnaires, which can vary in quality depending on the participant. However, larger numbers of participants can mitigate the quality of the surveys.

Here are some of the key results:

  • Seniors who stuck most closely to the “ideal” Mediterranean diet were also more likely to undertake more physical activity in their free time. Of course, this alone could have a large influence on health outcomes.
  • When confounding factors such as age, sex, activity levels, socioeconomic status, smoking, and BMI were taken into account, individuals with high adherence to the diet (scoring 7-9 on the scale mentioned above) had a 25% lower risk of any cause of death than those who only scored 0-3.
  • In fact, a one-point increase in adherence to the diet was linked to about a 6% drop in the risk of death from any cause.
  • The researchers found no significant links to specific causes of death, such as cancer or cardiovascular disease. There was a weak correlation between the diet and reduced risk of coronary artery or cerebrovascular disease mortality.
  • The researchers also attempted to determine if removing certain components of the Mediterranean diet were linked to increases or reductions in risk. Although the statistical quality was weak, increases in saturated fats (or a reduction in consumption of fish), reduction in a moderate amount of alcohol, and a reduction in cereals all appear to reduce the size of the benefit of the diet.

The authors concluded:

In conclusion, a prospective cohort study and a meta-analysis showed that closer adherence to the MD (Mediterranean Diet) was associated with prolonged survival in elderly individuals, suggesting the appropriateness for older persons to adopt/preserve the MD to maximise their prospects for survival.


There are some limitations to this study. First, cohort studies cannot establish a causal link between the Mediterranean diet and a reduction in mortality in seniors. Larger studies would be required to provide stronger evidence of causality.

Second, it is possible that those that are already healthier better adhere to diets like this one.

Lastly, as I mentioned above, self-reporting surveys, as used in this study, are prone to memory errors.

However, the researchers also included a meta-analysis of another six unrelated studies that also focused on the elderly. Those studies suggested a 5% reduction in mortality risk for every one-point better adherence to the Mediterranean diet.

Overall, this is a lot of moderate-quality evidence that adopting and adhering to a Mediterranean diet can reduce the rate of mortality for elderly individuals. It’s also possible that starting a healthy lifestyle, including this diet, at a young age would provide even greater benefits.

Again, there are some weaknesses to this type of study, and it cannot establish a causal effect between this diet and lowered mortality risk for the elderly. However, this study, along with several others, is strongly suggestive of the benefit of the Mediterranean diet for individuals.


Michael Simpson

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