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.contributor.funderSpanish Government
dc.contributor.funderInstituto de Salud Carlos III
dc.contributor.funderEuropean Regional Development Fund
dc.contributor.funderNavarra Regional Government
dc.contributor.funderUniversity of Navarra
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.description.sponsorshipThe SUN project has received funding from the Spanish Government-Instituto de Salud Carlos III, and the European Regional Development Fund (FEDER) (RD 06/0045, CIBER-OBN, Grants PI10/02658, PI10/02293, PI13/00615, PI14/01668, PI14/01798, PI14/01764, PI17/01795, PI20/00564 and G03/140), the Navarra Regional Government (27/2011, 45/2011, 122/2014), and the University of Navarra. MSH receives financial support from the Programa de Ayudas de la Asociación de Amigos de la Universidad de Navarra.
dc.description.version
dc.identifier.citationHershey MS, Martínez-González MÁ, Álvarez-Álvarez I, Martínez Hernández JA, Ruiz-Canela M. The Mediterranean diet and physical activity: better together than apart for the prevention of premature mortality. Br J Nutr. 2022;128(7):1413-1424.
dc.identifier.doi10.1017/S0007114521002877
dc.identifier.essn1475-2662
dc.identifier.issn1475-2662
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.provenanceRealizada curación de contenido 25/06/2025
dc.publisherCambridge University Press
dc.pubmedtypeReview
dc.pubmedtypeJournal Article
dc.pubmedtypeResearch Support, Non-U.S. Gov't
dc.relation.projectIDRD 06/0045
dc.relation.projectIDPI10/02658
dc.relation.projectIDPI10/02293
dc.relation.projectIDPI13/00615
dc.relation.projectIDPI14/01668
dc.relation.projectIDPI14/01798
dc.relation.projectIDPI14/01764
dc.relation.projectIDPI17/01795
dc.relation.projectIDPI20/00564
dc.relation.projectIDG03/140
dc.relation.publisherversionhttps://www.cambridge.org/core/journals/british-journal-of-nutrition/article/mediterranean-diet-and-physical-activity-better-together-than-apart-for-the-prevention-of-premature-mortality/B78B188D114FE7762330EB690E7DFEBA
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.decsRiesgo
dc.subject.decsMortalidad
dc.subject.decsArticulaciones
dc.subject.decsEjercicio Físico
dc.subject.decsMortalidad Prematura
dc.subject.decsDieta Mediterránea
dc.subject.decsDieta
dc.subject.decsEpidemiología
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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