Mangia, Mangia! Exploring Dietary Biomarkers in Mediterranean Food Groups

As we all may have learned at some point, a healthy diet can be a fundamental factor for a healthy life. But have we ever considered which diet may be the healthiest, or most beneficial in preventing frailty, cognitive decline, and other chronic diseases for older adults? Researchers from Spain, at BMC Medicine, believe they have found evidence that the Mediterranean diet may be associated with preventing cognitive decline and other chronic diseases. The researchers developed dietary biomarkers for Mediterranean diet food groups, and then evaluated its association with mortality during a 20-year follow-up.

This project is part of an ongoing study that is evaluating a sample of older adults in the Tuscany, Italy area. At baseline, 1,155 participants ages 65 years or better were enrolled into the study. Multiple measurements were taken from participants in this study; baseline 24-hour urine samples and habitual dietary intake (i.e., how often the consumption of 198 foods and drinks were consumed) was assessed at baseline by trained interviewers. The latter measurement was taken at baseline, 3, 6, and 9 years of follow-up. The researchers found copious numbers of associations, some significant and others not. But the key finding for them was that adherence to Mediterranean food groups was inversely associated with long-term mortality. In other words, the greater the adherence to a Mediterranean diet, the greater the association with lower risk of mortality in older adults at even a 20-year follow-up.

Researchers believe that their study has two important takeaways, for both older adults and clinicians. They believe the findings strongly suggest that biomarkers on dietary food provide a more objective and accurate assessment of diet quality in older adults than do self-reported questionnaires. Researchers also believe that measurement of dietary biomarkers may contribute to dietary counseling with older adults.


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Hidalgo-Liberona N, Meroño T, Zamora-Ros R, Rabassa M, Semba R, Tanaka T, … & Cherubini A. (2021). Adherence to the Mediterranean diet assessed by a novel dietary biomarker score and mortality in older adults: the InCHIANTI cohort study. BMC Medicine. 2021;19(1):1-13.

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