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Eur J Cardiovasc Prev Rehabil. 2006 Dec;13(6):894-900.

Lifestyle, Mediterranean diet and survival in European post-myocardial infarction patients.

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  • 1Julius Center for Health Sciences and Primary Care, Department for Nutritional Sciences, University Medical Center Utrecht, Utrecht, The Netherlands. j.iestra@umcutrecht.nl

Abstract

BACKGROUND:

The extent and benefits of adherence to lifestyle and dietary recommendations in secondary prevention are largely unknown.

DESIGN:

We examined the frequency of healthy dietary and lifestyle behaviours and their impact on survival in post-myocardial infarction (MI) patients in a prospective cohort study of elderly Europeans.

METHODS:

Adherence to a Mediterranean-type diet was measured with a modified Mediterranean Diet Score (MDS) on an eight-point scale.

RESULTS:

Participants were 426 men and women, aged 70 years or more, from 10 European countries, with a history of MI. During 10 years of follow-up mortality was 53%. Frequency of non-smoking behaviour (85%), moderate to vigorous physical activity (54%), moderate alcohol consumption (45%) and a Mediterranean-type diet (63%) in patients differed only marginally as compared with 'healthy' elderly. The median MDS in patients from northern Europe was two points lower than in southern Europe. Non-smoking [hazards ratio (HR) 0.62; 95% confidence interval (95% CI) 0.44-0.88], physical activity (HR 0.69; 95% CI 0.53-0.90), moderate alcohol consumption (HR 0.77; 95% CI 0.58-1.02) and a Mediterranean-type diet (HR 0.75; 95% CI 0.57-0.97) were associated with lower all-causes mortality. Presence of at least three healthy behaviours was associated with 40% lower mortality.

CONCLUSION:

There is a strong relationship between lifestyle and dietary habits and mortality in post-MI patients. The findings implicate that substantial health gain can be obtained by better adherence to dietary and lifestyle recommendations.

[PubMed - indexed for MEDLINE]
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