Adherence to a Mediterranean lifestyle can be beneficial for non-Mediterranean populations

Scientific evidence during the last decades has shown that adhering to a healthy lifestyle is related to a lower premature mortality and a longer life expectancy. The Mediterranean lifestyle index was developed to assess the adherence to a traditional Mediterranean lifestyle. It includes, in addition to the dietary habits, adequate rest, physical activity, eating in company and socializing with friends. Most of the evidence on this lifestyle pattern and its positive health effects comes from Mediterranean countries but little is known about the health associations in non-Mediterranean populations. The aim of the current study was to investigate the association between a Mediterranean lifestyle and all-cause, cancer and cardiovascular disease (CVD) mortality in a British population.

Participants in the study were 110,799 individuals aged 40 to 75 years from the UK Biobank cohort, who were free of CVD or cancer between 2009 and 2012 and were followed-up to 2021. The Mediterranean lifestyle was assessed at baseline through the Mediterranean Lifestyle (MEDLIFE) index (*) consisting of a lifestyle questionnaire and diet assessment which included three areas:

  1. Mediterranean food consumption.
  2. Mediterranean dietary habits and,
  3. Physical activity, rest, social habits, and conviviality.

The current study showed that adhering to the Mediterranean diet based on locally available products was associated with lower all-cause (29%) and cancer (28%) mortality and that the overall Mediterranean way of life was also strongly protective of such outcomes. The authors highlight the transferability of a culturally adapted Mediterranean lifestyle to a non-Mediterranean population.

They explain that the MEDLIFE index comprehensively captures multiple lifestyle components that share interrelated biological mechanisms and may have synergistic effects. Those mechanisms, although not fully known, may include:

  1. Anti-inflammatory and antioxidant properties of the Mediterranean diet that may protect from platelet aggregation, improve endothelial function, allow longer telomere length, slow down cell proliferation, angiogenesis, and metastasis, and may prevent DNA damage
  2. Anti-aging effects of physical activity at multiple levels
  3. Sleep disturbances and inadequate rest that have been linked with increased inflammatory markers, morbidity, and mortality and
  4. Social support and integration that might decrease stress-induced inflammatory reactions, thus lowering chronic morbidity and mortality.

The researchers conclude that their findings suggest that the Mediterranean lifestyle, adapted to the local characteristics of each place, could be adopted by non-Mediterranean populations to promote a healthy lifestyle.

1. Mediterranean food consumption, with 12 items on food intake (eg: sweets, legumes, red meat, fruits, and nuts);

2. Mediterranean dietary habits with seven items about habits and practices around meals (eg, limiting salt at meals and consumption of healthy beverages);
Wine consumption: Red/white wine (1 glass, 100 ml): Women: > 0 to ≤ 1 serv/d, Men: > 0 to ≤ 2 serv/d;

3. Physical activity, rest, social habits and conviviality with six items on resting and collective activities (eg, regular naps, sedentary habits, collective sports, and socializing with friends)
Each item was scored 0 (non adherent) or 1 point (adherent), with a total MEDLIFE index score ranging from 0 to 25 and higher values representing higher adherence to the Mediterranean lifestyle.
ReferencesAdherence to a Mediterranean lifestyle can be beneficial for non-Mediterranean populations


Maroto-Rodriguez J, Delgado-Velandia M, Ortolá R, Perez-Cornago A, Kales SN, Rodríguez Artalejo F, Sotos-Prieto M. Association of a Mediterranean Lifestyle With All-Cause and Cause Specific Mortality: A Prospective Study from the UK Biobank. Mayo Clin Proc. 2024 Apr;99(4):551-563.