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February 9, 2005

Mediterranean Diet, Lifestyle Factors, and Mortality—Reply

Author Affiliations

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

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

In Reply: Dr Craighead expresses concern that in our study of 1507 apparently healthy men and 832 healthy women, aged 70 to 90 years, in 11 European countries, national heritage might be an important confounder, and this is certainly possible. However, in our analyses, testing region (northern or southern Europe) and study center as possible confounders did not affect our estimates. Testing for interaction between dietary and lifestyle factors and region showed that none of the interaction terms was statistically significant at α = 0.1. When we stratified our analysis for northern and southern Europe, we found similar estimates for both regions. In northern Europe, 35% of the population followed a Mediterranean type of diet compared with 65% in southern Europe. The median of the Mediterranean diet score within each study center was similar to that of the whole population, as was the association between dietary and lifestyle factors. Similar results have also been found in Danish and Greek populations.13

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