ORIGINAL CONTRIBUTION Mediterranean Diet, Lifestyle Factors, and 10-Year Mortality in Elderly European Men and Women The HALE Project

THE NUMBER OF OLDER PEOPLE IS growing rapidly worldwide. More than 580 million people are older than 60 years, and the number is projected to rise to 1000 million by 2020. With the increase in life expectancy, the leading causes of death have shifted dramatically from infectious diseases to noncommunicable diseases and from younger to older individuals. In industrialized countries, about 75% of deaths in persons older than the age of 65 are now from cardiovascular diseases and cancer. Regardless of predisposing factors, diet and lifestyle influence morbidity and mortality during the course of life. Because of the cumulative effect of adverse factors throughout life, it is particularly important for older persons to adopt diet and lifestyle practices that minimize their risk of death from morbidity and maximize their prospects for healthful aging. Dietary patterns and other modifiable lifestyle factors are associated with mortality from all causes, coronary heart disease (CHD), cardiovascular diseases (CVD), and cancer. As yet, few studies have investigated the combined effect of diet and other lifestyle factors. In the current study, we investigated the association of individual and combined dietary patterns and lifestyle factors (alcohol use, smoking staAuthor Affiliations: Division of Human Nutrition, Wageningen University, the Netherlands (Drs de Groot, Kromhout, and van Staveren, and Ms Knoops); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (Dr Kromhout); Université Louis Pasteur, France (Dr Perrin); Universidad Complutense de Madrid, Spain (Dr MoreirasVarela); Associazione per la Ricerca Cardiologica, Roma, Italy (Dr Menotti). Corresponding Author: Kim T. B. Knoops, MSc, Wageningen University, Human Nutrition, PO Box 8129, 6700 EV Wageningen, the Netherlands (Kim.Knoops @wur.nl). Context Dietary patterns and lifestyle factors are associated with mortality from all causes, coronary heart disease, cardiovascular diseases, and cancer, but few studies have investigated these factors in combination.