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February 9, 2005

Mediterranean Diet, Lifestyle Factors, and Mortality

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293(6):674-675. doi:10.1001/jama.293.6.674-b

To the Editor: The risk estimates in the article reporting results of the HALE Project1 apparently did not consider residual confounding from previous health status at baseline, particularly absence of disability and/or chronic disease. Health status is certainly related to overall mortality, the outcome in the HALE study. However, it can also be related to some of the exposures that were considered in this study. A good self-perceived health status and the absence of chronic illnesses are strongly associated with physical activity in community-dwelling elderly people2 and with drinking alcohol.3 This could explain in part the mortality reduction associated with physical activity and alcohol consumption observed in the HALE Project.

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