Publication:
The Mediterranean diet and physical activity: better together than apart for the prevention of premature mortality.

dc.contributor.authorHershey, Maria Soledad
dc.contributor.authorMartínez-González, Miguel Ángel
dc.contributor.authorÁlvarez-Álvarez, Ismael
dc.contributor.authorMartínez Hernández, José Alfredo
dc.contributor.authorRuiz-Canela, Miguel
dc.date.accessioned2023-05-03T15:21:10Z
dc.date.available2023-05-03T15:21:10Z
dc.date.issued2021-08-31
dc.description.abstractDiet and physical activity (PA) have been studied extensively in epidemiology as single or combined lifestyle factors; however, their interaction has not been studied thoroughly. Studying potential synergisms between lifestyle components with a comprehensive interaction analysis, including additive measures of interaction, provides key insights into the nature of their joint effect and helps target interventions more effectively. First, a comprehensive review was conducted to assess the potential research gap regarding reported interaction analyses conducted in studies assessing the Mediterranean diet (MedDiet) in combination with PA on all-cause mortality. Thereafter, we prospectively assessed the joint association of the MedDiet with PA on all-cause mortality in the Seguimiento Universidad de Navarra (SUN) cohort, followed by both multiplicative and additive interaction analyses. The conjoint effect of low adherence to the MedDiet and low PA observed an increased risk greater than the individual risk factors, suggesting a potential additive interaction or synergism between both exposures, with relative risk due to interaction (RERI) and (95 % confidence interval (95 % CI)) = 0·46 (–0·83 to 1·75) and attributable proportion (95 % CI) due to interaction of 36 % (–0·62, 1·34). No multiplicative interaction was detected. Studying interactions between lifestyle factors, such as the MedDiet and PA, is particularly relevant given the current research gaps in studying the complexities of combined aspects of lifestyle in comparison with isolated behaviours. Our findings underline the important public health message of adhering to both the MedDiet and PA for the prevention of premature mortality.
dc.identifier.doi10.1017/S0007114521002877
dc.identifier.essn1475-2662
dc.identifier.pmcPMC9530916
dc.identifier.pmid34462020
dc.identifier.pubmedURLhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9530916/pdf
dc.identifier.unpaywallURLhttps://www.cambridge.org/core/services/aop-cambridge-core/content/view/B78B188D114FE7762330EB690E7DFEBA/S0007114521002877a.pdf/div-class-title-the-mediterranean-diet-and-physical-activity-better-together-than-apart-for-the-prevention-of-premature-mortality-div.pdf
dc.identifier.urihttp://hdl.handle.net/10668/22567
dc.issue.number7
dc.journal.titleThe British journal of nutrition
dc.journal.titleabbreviationBr J Nutr
dc.language.isoen
dc.organizationHospital Universitario Virgen de la Victoria
dc.organizationInstituto de Investigación Biomédica de Málaga-IBIMA
dc.page.number1413-1424
dc.pubmedtypeReview
dc.pubmedtypeJournal Article
dc.pubmedtypeResearch Support, Non-U.S. Gov't
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.accessRightsopen access
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectAdditive interaction
dc.subjectAll-cause mortality
dc.subjectInteractions
dc.subjectLifestyle factors
dc.subjectMediterranean diet
dc.subjectPhysical activity
dc.subject.meshHumans
dc.subject.meshMortality, Premature
dc.subject.meshDiet, Mediterranean
dc.subject.meshExercise
dc.titleThe Mediterranean diet and physical activity: better together than apart for the prevention of premature mortality.
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number128
dspace.entity.typePublication

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