[Background]: There has been growing interest in the last years in assessing the relationship between diet and disease through the study of whole dietary patterris and not only focusing on single nutrients or foods. Though several studies have assessed the relationship between a posteriori dietary patterns and different health outcomes, there is little evidence on post hoc dietary patterns and all cause mortality in Southern European populations.[Objective]: To identify the association between a posteriori defined major dietary patterns and total mortality in the PREDIMED study. Methods We followed-up 7,340 participants (57.5 percent women, mean age: 67 years) during a median follow-up time of 4.8 years. To assess dietary exposures, a validated 137-item semi-quantitative food- frequency questionnaire was administered. Dietary patterns were ascertained through a factor analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to dietary pattern scores at baseline. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) for mortality. Deaths were confirmed by review of medical records and consultation of the National Death Index.[Results]: We identified two major dietary patterns: the “Western” dietary pattern and “Mediterranean” dietary pattern. During follow- up, 337 participants died. Among deceased participants, the median age of death was 70 (6.5). After controlling for potential confounders including the intervention group, higher baseline adherence to a “Mediterranean” dietary pattern was associated with lower risk of all- cause mortality (adjusted HR for third tertile vs. first textile: 0.68; 95 la CI: 0.49—0.95) (p for trend 0.028).
[Conclusion]: Higher adherence to a Mediterranean-type diet may reduce the risk of all-cause mortality in elderly people at high cardiovascular risk
