People aged 65 or older who adhere to diet rich in fish, nuts and fresh vegetables have 25% lower risk of death, study finds

It’s been touted as the recipe for a healthy life, preventing all manner of ills. Now researchers say a Mediterranean diet still offers benefits in older age and could reduce the risk of death.

While somewhat nebulous in specific makeup, the diet is typically said to be rich in fish, nuts, fresh vegetables, olive oil and fruit.

“Because we are facing an ageing process all over the world, in particular in Europe, it is particularly important to see which kinds of tools we have today to face this ageing process,” said Marialaura Bonaccio, an epidemiologist at the Mediterranean Neurological Institute, IRCCS Neuromed, and first author of the study.

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“We all know that [the] Mediterranean diet is good for health, but there are few studies focusing on the elderly,” she added. Previous studies have suggested benefits linked to both heart disease and cancer.

Published in the British Journal of Nutrition, the study looked at the health and diet of 5,200 individuals aged 65 and over from the Molise region in Italy, who were recruited as part of a larger study between 2005 and 2010, and followed up until 2015, during which time 900 deaths occurred.

Quick guide The Mediterranean diet Show Hide The term “Mediterranean diet” rarely seems out of the headlines. It is usually linked to a range of health benefits, but the details of what it is composed of it are a little less clear, not least because it can vary between countries and regions. Even experts can differ in their exact definition. Generally, however, it is described as being a diet rich in vegetables, nuts, fish, fruit and oils and legumes like peas and lentils – a range of foods found in the south of Europe, and representative of the fare consumed in the early 1960s.

Participants completed a food questionnaire reflecting their diet in the year before signing up, and each was given a score for how close their diet was to the Mediterranean diet on a 0-9 scale.

The results reveal that those who stuck most closely to the Mediterranean diet were also more likely to undertake more physical activity in their free time.

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When factors including age, sex, activity levels, socioeconomic status, smoking and BMI were taken into account, those with a high adherence to the diet (scoring 7-9 on the scale) had a 25% lower risk of any cause of death than those who only scored 0-3. A one point increase in adherence to the diet was linked to about a 6% drop in the risk of death from any cause.

No clear links were seen for specific causes of death, such as cancer or cardiovascular mortality, although there were some signs of a reduction in risk of coronary artery disease or cerebrovascular mortality, and mortality from “other causes”.

The team also looked at whether particular components of the Mediterranean diet were more strongly linked to a reduction in mortality than others, by looking at changes to the reduction in risk of death associated with a two-point increase in adherence to the diet.

The results show that even when individual items are removed, the diet almost always remains beneficial but that a rise in saturated fats, or the loss of fish, loss of a moderate amount of alcohol or fewer cereals, appear to have some of the biggest effects in reducing the size of the benefit.

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The team note that the study cannot prove the Mediterranean diet is behind the effect; it only reveals a link. Also, self-reports of food intake can be prone to errors, and participants were only asked once about their diet and other areas of their life.

Nonetheless, the team say the findings suggest Mediterranean fare could help older individuals boost their prospects for a longer life.

They findings, they add, were backed up by an analysis that included another six studies focusing on older people which, taken together, suggested a 5% drop in risk of death from all causes with every one point better adherence to the Mediterranean diet.

“If you start a good healthy lifestyle when you are young, probably your benefit will be even greater,” said Bonaccio, “But even if you are old and you start having a healthy lifestyle including diet you can [live longer].”

Naveed Sattar, professor of metabolic medicine at the University of Glasgow who was not involved in the study, was cautious. “[The] study only suggests [the Mediterranean diet] might be good into older life but it does not prove it as all the data in this paper are from observations and not trials,” he said. “It may be people who keep well have better diets, as appetite can be altered by ill health.”

“I would say developing and maintaining healthier dietary habits is much more important earlier in life as once habits set in, they are usually maintained.”