Adherence to a Mediterranean diet and onset of disability in older persons


Higher adherence to a Mediterranean-type diet is linked to lower risk of mortality, cardiovascular disease and Alzheimer’s disease while its association with disability has never been assessed. The aim of the study was to investigate the relation between adherence to a Mediterranean diet (MeDi) and disability in activities of daily living. The study sample consisted of 1,410 individuals from Bordeaux, France, included in 2001–2002 in the Three-City Study and re-examined at least once over 5 years. Adherence to a MeDi (scored as 0–9) was computed from a food frequency questionnaire and 24H recall. Disability in Basic and Instrumental ADL (B-IADL) was evaluated on the Lawton–Brody and Katz scales. Statistical analyses were stratified by gender and adjusted for potential confounders. No association between MeDi adherence and baseline disability in B-IADL was highlighted in men or in women in multivariate models. Risk of onset of disability in B-IADL over time was not significantly associated with MeDi adherence in men. In women, MeDi adherence was inversely associated with the risk of incident disability in B-IADL (HR = 0.90, 95% Confidence Interval 0.82–0.98 for 1 point of the score). Women with the highest MeDi adherence (score 6–8) had a 50% (22–68%) relative risk reduction of incident disability in B-IADL over time than women in the lowest MeDi category (score 0–3). In addition to its well-documented beneficial effects on health, adherence to a Mediterranean-type diet could contribute to slow down the disablement process in women.

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Funding/Support The Three-City Study is conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the Institut de Santé Publique et Développement of the Victor Segalen Bordeaux 2 University, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, Mutuelle Générale de l’Education Nationale, Institut de la Longévité, Regional Governments of Aquitaine and Bourgogne, Fondation de France, and Ministry of Research—INSERM Programme “Cohortes et collections de données biologiques.” Financial support for 3C-COGINUT project was provided by the French National Research Agency (ANR-06-PNRA-005). C. Féart was funded by the French National Research Agency (ANR-06-PNRA-005). C. Samieri was funded by the Institut Carnot Lisa (Lipides pour l’Industrie et la santé, Lipids for Industry, Safety and Health). Study sponsors played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

Conflict of Interest

P. Barberger-Gateau received fees for conferences from Danone, Lesieur, Bauch&Lomb and Aprifel and benefits from research grants from Danone and Lesieur. The other authors declared no support from any institution for the submitted work.

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Correspondence to Catherine Féart.

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Féart, C., Pérès, K., Samieri, C. et al. Adherence to a Mediterranean diet and onset of disability in older persons. Eur J Epidemiol 26, 747 (2011).

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  • Mediterranean diet
  • Disability
  • Activities of daily living