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Dietary patterns and survival of older Europeans: The EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition)

  • Christina Bamia (a1), Dimitrios Trichopoulos (a2), Pietro Ferrari (a3), Kim Overvad (a4), Lone Bjerregaard (a5), Anne Tjønneland (a6), Jytte Halkjær (a6), Françoise Clavel-Chapelon (a7), Emmanuelle Kesse (a8), Marie-Christine Boutron-Ruault (a7), Paolo Boffetta (a9), Gabriele Nagel (a10), Jacob Linseisen (a11), Heiner Boeing (a12), Kurt Hoffmann (a12), Christina Kasapa (a1), Anastasia Orfanou (a1), Chrysoula Travezea (a1), Nadia Slimani (a3), Teresa Norat (a13), Domenico Palli (a14), Valeria Pala (a15), Salvatore Panico (a16), Rosario Tumino (a17), Carlotta Sacerdote (a18), H Bas Bueno-de-Mesquita (a19), Patricia MCM Waijers (a19), Petra HM Peeters (a20), Yvonne T van der Schouw (a20), Antonio Berenguer (a21), Carmen Martinez-Garcia (a22), Carmen Navarro (a23), Aurelio Barricarte (a24), Miren Dorronsoro (a25), Göran Berglund (a26), Elisabet Wirfält (a26), Ingegerd Johansson (a27), Gerd Johansson (a28), Sheila Bingham (a29), Kay-Tee Khaw (a30), Elizabeth A Spencer (a31), Tim Key (a31), Elio Riboli (a3) and Antonia Trichopoulou (a1)...

To investigate the association of a posteriori dietary patterns with overall survival of older Europeans.

Design and setting

This is a multi-centre cohort study. Cox regression analysis was used to investigate the association of the prevailing, a posteriori-derived, plant-based dietary pattern with all-cause mortality in a population of subjects who were 60 years or older at recruitment to the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort). Analyses controlled for all known potential risk factors.


In total, 74 607 men and women, 60 years or older at enrolment and without previous coronary heart disease, stroke or cancer, with complete information about dietary intakes and potentially confounding variables, and with known survival status as of December 2003, were included in the analysis.


An increase in the score which measures the adherence to the plant-based diet was associated with a lower overall mortality, a one standard deviation increment corresponding to a statistically significant reduction of 14% (95% confidence interval 5–23%). In country-specific analyses the apparent association was stronger in Greece, Spain, Denmark and The Netherlands, and absent in the UK and Germany.


Greater adherence to the plant-based diet that was defined a posteriori in this population of European elders is associated with lower all-cause mortality. This dietary score is moderately positively correlated with the Modified Mediterranean Diet Score that has been constructed a priori and was also shown to be beneficial for the survival of the same EPIC-Elderly cohort.

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Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
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