Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
PhD Programme in Biomedicine, Department of Experimental and Health Sciences, Universidad Pompeu Fabra, Barcelona, Spain.
Eur J Nutr. 2019 Jun;58(4):1569-1578. doi: 10.1007/s00394-018-1689-y. Epub 2018 Apr 25.
Although evidence indicates that both physical activity and adherence to the Mediterranean diet (MedDiet) reduce the risk of all-cause mortality, a little is known about optimal intensities of physical activity and their combined effect with MedDiet in older adults. We assessed the separate and combined associations of leisure-time physical activity (LTPA) and MedDiet adherence with all-cause mortality.
We prospectively studied 7356 older adults (67 ± 6.2 years) at high vascular risk from the PREvención con DIeta MEDiterránea study. At baseline and yearly thereafter, adherence to the MedDiet and LTPA were measured using validated questionnaires.
After 6.8 years of follow-up, we documented 498 deaths. Adherence to the MedDiet and total, light, and moderate-to-vigorous LTPA were inversely associated with all-cause mortality (p < 0.01 for all) in multiple adjusted Cox regression models. The adjusted hazard of all-cause mortality was 73% lower (hazard ratio 0.27, 95% confidence interval 0.19-0.38, p < 0.001) for the combined category of highest adherence to the MedDiet (3rd tertile) and highest total LTPA (3rd tertile) compared to lowest adherence to the MedDiet (1st tertile) and lowest total LTPA (1st tertile). Reductions in mortality risk did not meaningfully differ between total, light intensity, and moderate-to-vigorous LTPA.
We found that higher levels of LTPA, regardless of intensity (total, light and moderate-to-vigorous), and greater adherence to the MedDiet were associated separately and jointly with lower all-cause mortality. The finding that light LTPA was inversely associated with mortality is relevant because this level of intensity is a feasible option for older adults.
尽管有证据表明，身体活动和遵循地中海饮食（MedDiet）都可以降低全因死亡率，但对于身体活动的最佳强度及其与老年人 MedDiet 的联合作用知之甚少。我们评估了休闲时间身体活动（LTPA）和 MedDiet 依从性与全因死亡率的单独和联合关联。
我们前瞻性研究了来自 PREvención con DIeta MEDiterránea 研究的 7356 名高血管风险的老年人（67±6.2 岁）。在基线和之后的每年，使用经过验证的问卷测量 MedDiet 依从性和 LTPA。
在 6.8 年的随访后，我们记录了 498 例死亡。在多因素 Cox 回归模型中，MedDiet 依从性和总、轻和中高强度 LTPA 与全因死亡率呈负相关（所有 p<0.01）。与最低 MedDiet 依从性（1 分位）和最低总 LTPA（1 分位）相比，最高 MedDiet 依从性（第 3 分位）和最高总 LTPA（第 3 分位）的组合类别全因死亡的调整后危险比降低了 73%（危险比 0.27，95%置信区间 0.19-0.38，p<0.001）。死亡率风险的降低在总、轻强度和中高强度 LTPA 之间没有明显差异。
我们发现，无论强度（总、轻和中高强度）如何，较高水平的 LTPA 和更高的 MedDiet 依从性与较低的全因死亡率独立且联合相关。轻强度 LTPA 与死亡率呈负相关的发现是相关的，因为这种强度水平对于老年人来说是可行的选择。
