People who adhere to a Mediterranean lifestyle - which includes a diet rich in fruits, vegetables, and whole grains; healthy eating habits like limiting added salts and sugars; and habits promoting adequate rest, physical activity, and socialization - have a lower risk of all-cause and cancer mortality, according to a new study led by La Universidad Autónoma de Madrid and Harvard T.H. Chan School of Public Health. People who adhered to the lifestyle’s emphasis on rest, exercise, and socializing with friends had a lower risk of cardiovascular disease mortality.

The study will be published on Wednesday, August 16, in Mayo Clinic Proceedings.

While many studies have established the health benefits of a Mediterranean diet and lifestyle, little research has been conducted on the diet outside of its region of origin. "This study suggests that it’s possible for non-Mediterranean populations to adopt the Mediterranean diet using locally available products and to adopt the overall Mediterranean lifestyle within their own cultural contexts," said lead author Mercedes Sotos Prieto, Ramon y Cajal research fellow at La Universidad Autónoma de Madrid and adjunct assistant professor of environmental health at Harvard Chan School. "We're seeing the transferability of the lifestyle and its positive effects on health."

The researchers analyzed the habits of 110,799 members of the UK Biobank cohort, a population-based study across England, Wales, and Scotland using the Mediterranean Lifestyle (MEDLIFE) index, which is derived from a lifestyle questionnaire and diet assessments. Participants, who were between the ages of 40 and 75, provided information about their lifestyle according to the three categories the index measures: "Mediterranean food consumption" (intake of foods part of the Mediterranean diet such as fruits and whole grains); "Mediterranean dietary habits" (adherence to habits and practices around meals, including limiting salt and drinking healthy beverages); and "physical activity, rest, and social habits and conviviality" (adherence to lifestyle habits including taking regular naps, exercising, and spending time with friends). Each item within the three categories was then scored, with higher total scores indicating higher adherence to the Mediterranean lifestyle.

The researchers followed up nine years later to examine participants' health outcomes. Among the study population, 4,247 died from all causes; 2,401 from cancer; and 731 from cardiovascular disease. Analyzing these results alongside MEDLIFE scores, the researchers observed an inverse association between adherence to the Mediterranean lifestyle and risk of mortality. Participants with higher MEDLIFE scores were found to have a 29% lower risk of all-cause mortality and a 28% lower risk of cancer mortality compared to those with lower MEDLIFE scores. Adherence to each MEDLIFE category independently was associated with lower all-cause and cancer mortality risk. The "physical activity, rest, and social habits and conviviality" category was most strongly associated with these lowered risks, and additionally was associated with a lower risk of cardiovascular disease mortality.

Other Harvard Chan co-authors included Stefanos Kales.

Funding for the study came from the Carlos III Health Institute; the Secretary of R+D+I; the European Regional Development Fund/European Social Fund; the National Plan on Drugs; Fundación Soria Melguizo; Ministry of Science, Innovation and Universities; Universidad Autónoma de Madrid; Cancer Research UK Population Research Fellowship; and World Cancer Research Fund.

Maroto-Rodriguez J, Delgado-Velandia M, Ortolá R, Perez-Cornago A, Kales SN, Rodríguez-Artalejo F, Sotos-Prieto M.
Association of a Mediterranean Lifestyle With All-Cause and Cause-Specific Mortality: A Prospective Study from the UK Biobank.
Mayo Clin Proc. 2023 Aug 8:S0025-6196(23)00305-1. doi: 10.1016/j.mayocp.2023.05.031