Nutrition and mortality in the elderly over 10 years of follow-up: the Three-City study

In the last 20 years, many prospective cohort studies have assessed the relationships between food consumption and mortality. Result interpretation is mainly hindered by the limited adjustment for confounders and, to a lesser extent, the small sample sizes. The aim of this study was to investigate the association between dietary habits and all-cause mortality in a multicentre prospective cohort that included non-institutionalised, community-based elderly individuals (Three-City Study). A brief FFQ was administered at baseline. Hazard ratios (HR) and 95 % CI for all-cause mortality were estimated relative to the consumption frequency of several food groups, using Cox proportional hazards models adjusted for sex, centre, socio-demographic characteristics and health status indicators. Among the 8937 participants (mean age: 742 years, 607 % women), 2016 deaths were recorded during an average follow-up of 9 years. The risk of death was significantly lower among subjects with the highest fruit and vegetable consumption (HR 090; 95 % CI 082, 099, P=003) and with regular fish consumption (HR 089; 95 % CI 081, 097, P=001). The benefit of olive oil use was found only in women (moderate olive oil use: HR 080; 95 % CI 068, 094, P=0007; intensive use: HR 072; 95 % CI 060, 085, P=00002). Conversely, daily meat consumption increased the mortality risk (HR 112; 95 % CI, 101, 124, P=003). No association was found between risk of death and diet diversity and use of various fats. These findings suggest that fruits/vegetables, olive oil and regular fish consumptions have a beneficial effect on the risk of death, independently of the socio-demographic features and the number of medical conditions.