Mediterranean Diet Linked to Lower Risk of Death
Eating habits can be assessed not only by what individuals say about their diet but also by changes in their blood composition. Researchers found a connection between the metabolic profile of the Mediterranean diet and a reduced risk of death, with results replicated across several independent samples.
The Mediterranean diet emphasizes vegetables, fruits, legumes, nuts, fish, and olive oil while limiting red and processed meats, animal fats, refined grains, and sweets. Studies have repeatedly linked this diet to a lower risk of cardiovascular diseases and type 2 diabetes. However, adherence to the diet is usually assessed through questionnaires, which may not accurately reflect actual eating habits.
Estefania Toledo from the University of Navarra and her colleagues investigated how biomarkers of the Mediterranean diet relate to the risk of death. They analyzed data from 1,880 participants in the Spanish PREDIMED study, with an average age of 67.1 years. Participants were randomly assigned to groups: one followed a Mediterranean diet with added extra virgin olive oil or nuts, while the other adhered to a low-fat diet.
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Observations lasted an average of 13.2 years. Those with a pronounced metabolic profile of the Mediterranean diet had a 23% lower risk of death from all causes compared to those with the least pronounced indicators. This difference remained after adjusting for age, sex, body mass index, and other risk factors.
The results were also verified in three independent American cohorts, involving 12,704 men and women, observed for an average of 25 years. Here, the connection was similar: participants with a pronounced metabolic signature of the Mediterranean diet had a 23% lower risk of death compared to those with the lowest score. This pattern persisted even after accounting for BMI.
The metabolic signature included numerous indicators: 45 types of lipids and 19 amino acids, along with two vitamins and one xenobiotic. The overall profile of these substances consistently correlated with a lower risk of death.
The authors suggested that these results indicate several beneficial processes simultaneously. The Mediterranean diet includes olive oil, nuts, and fish—sources of various fatty acids that can influence lipid metabolism and cardiometabolic health. The overall metabolic profile may be linked to lower levels of chronic inflammation, increased antioxidant potential, and better insulin sensitivity.
However, these mechanisms were not directly tested, and not all results for specific causes of death were as convincing as for overall risk. In American cohorts, a higher adherence to the Mediterranean diet was associated with a lower likelihood of dying from cardiovascular diseases, but no significant link was found for cancer after re-evaluation.
Another important detail: the metabolic signature was assessed not only at the beginning of the study but also after one year. This period was also associated with a decrease in the risk of death, but long-term dietary habits and metabolic characteristics played a more significant role than short-term dietary changes.
