Despite the abundance of dietary guidelines, it is hard to find evidence that dietary composition has major effects on longevity. In the Malmo Diet and Cancer Study, all-cause mortality rates were not significantly related to the fat content of the diet in either men or women . The rate of death attributable to cardiovascular disease, however, was significantly inversely related to dietary fat intake in men, but not in women. The EPIC study evaluated dietary intake as a predictor of mortality among over 70,000 people at least 60 years of age in 10 European countries . Instead of evaluating simple dietary composition (i.e. percent of calories from fat, carbohydrate, protein, and alcohol), they constructed a 'Mediterranean diet score' reflecting the dietary composition previously shown in Greece to be associated with longevity. The score was derived from points for answering dietary questions on consumption of various types of foods. Higher scores, indicating dietary composition more like that of the traditional 'Mediterranean diet', were derived from high consumption of vegetables, legumes, fruits, cereals, fish, and unsaturated fat relative to saturated fat; low consumption of meat and dairy products, and moderate alcohol consumption. The score was inversely and approximately linearly related to subsequent mortality. This suggested that throughout Europe, mortality rates were lower in those eating the 'Mediterranean diet'. This favorable diet is described not specifically by fat and carbohydrate content, but by types of foods. A higher score may depend more on type of fat consumed rather than total quantity.
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