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There are accumulative evidences that the prevalence of cigarette smoking has gradually declined in most high-income countries since the 1990s, in part due to public health campaigns emphasizing on the relationship between tobacco use and detrimental health effects. In late 2000s electronic (e)-cigarettes were introduced in the world, as less harmful nicotine products that may also help people in quitting smoking. Since then, the use of e-cigarettes has increased rapidly from the time when their introduction in the global market. In this work we present a collection of position statements and opinions of scientific bodies and Organizations, regarding the safety of e-cigarettes, as well as their association with human health, and particularly, cardiovascular diseases.

Background: Whether older immigrant populations from the Mediterranean region, continue to follow the MD long after they immigrated is not known. Aim: Compare adherence to the MD and successful aging levels between Greeks living in Greece (GG) and Greeks living abroad (GA). Methods: Anthropometrical, clinical, psychological, sociodemographic, dietary and lifestyle parameters were assessed in a cross-sectional manner in a sample of 252 GG and 252 GA. Mediterranean Diet Score (MedDietScore range 0-55) was used to assess adherence to the MD. Successful aging was evaluated with the validated successful aging index (SAI range 0-10). Results: GA presented higher adherence to MD (p 0.05). MedDietScore was positively associated with SAI among both groups after adjusting for possible confounders (0.041 ± 0.014, p = 0.003 GG and 0.153 ± 0.035, p

The aim of the present work was to investigate the association of dietary habits and lifestyle characteristics with successful aging among native Greeks and Greeks of Diaspora (Canada and France). During 2005-2019, 2,434 Greek men and women, living in Greece, in France, and in Canada, over 65 years of age were enrolled voluntarily in the study. Anthropometric, clinical and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures, while successful aging was evaluated using the validated Successful Aging Index (SAI, range 0-10). The SAI of the overall sample was 2.8 ± 1.4. Greeks of Diaspora had higher SAI levels compared to their counterparts in Greece (

BACKGROUND: The potential for diet to prevent and treat mental health conditions is an exciting area of investigation; however, the impact of different protein sources on mental health outcomes is unclear. OBJECTIVE: To evaluate the association between dietary protein intake and psychological distress, in people aged >50 years of age, living in Greece. METHODS: A combined data set of older people living in the Athens metropolitan area and 20 Greek islands, from the ATTICA (n = 1,128) and MEDIS (n = 2,221) population-based cross-sectional studies was developed. Anthropometric, clinical and socio-demographic and lifestyle characteristics, and protein consumption (total, animal, plant) consumed based on validated FFQ, were derived through standard procedures and questionnaires. “Psychological distress” (PDS) was assessed as a combined variable representing symptoms of depression and anxiety using Item Response Theory methodology and fitting a Graded Response Model. RESULTS: Animal protein, but not plant protein intake, was associated with higher PDS following adjustment for age, sex, education level, Mediterranean diet adherence and physical activity (b±SE: 0.399±0.090, p = 0.003). Following analysis by Mediterranean diet adherence level, among low adherers, animal protein intake was positively associated with PDS (b±SE: 1.119±0.174, p = 0.003), and no associations were observed in moderate or high adherence groupsin regards to plant protein intake and PDS. CONCLUSIONS: Animal protein intake is associated with PDS, suggesting a bi-directional relationship, which may be influenced by Mediterranean diet adherence.

BACKGROUND: The association between sodium intake and successful aging is not elucidated to date. OBJECTIVE: To evaluate the association between sodium intake and successful aging, in people aged >50 years, living in Greece. METHODS: A cross-sectional study was conducted in middle aged and older adult participants of the ATTICA (n = 1,128) and MEDIS (n = 2,221) epidemiological studies. Anthropometric, clinical, socio-demographic and lifestyle characteristics derived through standard procedures and questionnaires. Sodium intake was measured based on the USDA Food Composition database; table salt or salt from processed foods were not evaluated. Successful aging was assessed using the Successful Aging Index (SAI, range 0–10, higher values indicating higher successful aging) comprising of health-related, social, lifestyle and clinical characteristics. RESULTS: Participants with ≥1500 mg/day sodium intake had 20.2% on average lower SAI score compared to those with 70-males/>70-females, –90% vs. 82.5%, p

Objective: The aim of the present study was to investigate the differences between the consumption of plant-based v. animal-based protein-rich diets on successful ageing, as well as to identify the optimal combination of dietary protein intake for facilitating successful ageing in people aged >50 years. Design: A combined analysis was conducted in older adults of the ATTICA and MEDIS population-based cross-sectional studies. Anthropometrical, clinical and sociodemographic characteristics, lifestyle parameters, dietary habits and level of protein intake were derived through standard procedures. Successful ageing was evaluated using the validated Successful Aging Index (SAI) composed of ten health-related social, lifestyle and clinical characteristics. Setting: Athens area and twenty Greek islands. Participants: A total of 3349 Greek women and men over 50 years old. Results: Participants with high consumption of plant proteins were more likely to be male, physically active, with higher daily energy intake, higher adherence to the Mediterranean diet and higher level of SAI (P < 0·001). Participants with ‘Low animal & High plant’ and ‘High animal & High plant’ protein consumption had a 6 and 7 % higher SAI score, respectively, compared with the other participants (P < 0·001). In contrast, ‘Low animal & Low plant’ and ‘High animal & Low plant’ protein intake was negatively associated with SAI as compared to the combination of all other consumption categories (P < 0·02). Conclusions: The consumption of a plant-based protein-rich diet seems to be a beneficial nutritional choice that should be promoted and encouraged to older people since it may benefit both individual’s health and prolong successful ageing.

Comparing lifestyle and successful aging between Greeks living in Greece (GG) and Greeks living abroad (GA) using a multidimensional model of successful aging including both biomedical and non-medical components.Anthropometric, clinical, psychological, socio-demographic, dietary and lifestyle parameters were assessed in a random sample of 252 GG and 252 GA. Successful aging was evaluated using the validated successful aging index (SAI range 0-10).GA had better financial and educational status and scored higher in all social activity parameters (p's 0.05). GA were more likely to be physically active (p 0.001), had higher adherence to the Mediterranean diet (p 0.001) and were less likely to be smoking (p = 0.008). Depression was more evident among GG compared to GA (p 0.001). GA was aging significantly more successfully than GG (p 0.001). Men irrespective of location were aging significantly more successfully than women (p 0.05).Place of residence and personal choices significantly affect the level of healthy aging among people with similar genetic backgrounds.

Background/Study context: The aim of the present work was to investigate the association of Waist-to-Height Ratio (WHtR) with Successful Aging (SA) status and compare it to classic anthropometric i...

The aim was to investigate the association between homocysteine (Hcy) and acute coronary syndrome (ACS) and to test the potential moderating role of Mediterranean diet. An age and gender matched case-control study was conducted among 1491 patients with a first ACS event and 3037 adults free of cardiovascular disease (CVD). Adherence to the Mediterranean diet was measured using the MedDietScore (range 0-55). An increase in Hcy levels was associated with a 1% and 3% higher likelihood of ACS among younger (45 yrs) and middle-aged (45-60yrs) adults (

The potential health benefits of olive oil consumption, particularly within the context of the Mediterranean diet, have been extensively investigated. However, its specific health benefits remain to be confirmed. The aim of the present work is to review the scientific evidence regarding the specific impact of olive oil consumption on human health, including the prevention of cardiovascular disease, cancers, and diabetes mellitus. Ten related meta-analyses were reviewed to this effect. Olive oil consumption was found to be beneficial for several chronic non-communicable diseases (e.g. including cardiovascular disease, breast cancer and type 2 diabetes), whereas there were contradictory findings regarding its impact on several biomarkers. In conclusion, the aggregated evidence supports the assertion that olive oil consumption is beneficial for human health, and particularly for the prevention of cardiovascular diseases, breast cancer, and type 2 diabetes mellitus.

To evaluate modifiable, lifestyle risk factors of cardiovascular disease (CVD) among older adults, across ageing, in the Mediterranean area.During 2005-2017, 3131 individuals from 26 Mediterranean islands of 5 countries, ≥65 years of age, were voluntarily enrolled. Anthropometrical, clinical and socio-demographic characteristics, dietary habits, lifestyle parameters were measured through standard procedures. Analyses were performed by year and across consecutive age groups of the participants.A decrease in the prevalence of current smoking (p 0.001), engagement in physical activities (p = 0.001) and participation in social events (p = 0.001) for every year increase in age was found. Moderate alcohol drinking increased through ageing (p = 0.008), whereas adherence to Mediterranean diet remained stable, but adequate (p = 0.90). Trend analysis also revealed that a quadratic (U-shape) function better characterized the association between ageing and total cardiometabolic risk factors burden (p for trend0.001).The gaps in the understanding of factors affecting longevity and healthy ageing remain; public health authorities and stakeholders should focus on the lifestyle determinants of healthy ageing, that seems to be an effective mean for improving older peoples' health.

Objective: To investigate the association of Mediterranean food group consumption with successful aging (SA), among people more than 50 years old. Method: Dietary habits, as well as several bio-clinical characteristics of the Greek participants enrolled in the ATTICA ( n = 1,128 men and women from Athens metropolitan area) and the MEDIS ( n = 2,221 men and women from selected Greek islands) cohort studies were investigated in relation to SA; SA was measured using a validated 10-scale index. Results: Multivariate discriminant food group analysis revealed that legumes consumption, followed by vegetables, cereals, and poultry were associated with higher levels of SA index (explained variability: 7.9%), mainly among islanders, but not among mainland participants. Further analysis revealed that alcohol consumption was positively associated with SA for mainlanders (ATTICA study) but inversely for islanders (MEDIS study; all p’s < .05). Conclusion: The differential and hierarchical effect of various foods on SA and the diet-environmental interaction revealed in the present work may help health professionals to better understand the role of diet on SA, and to prioritize the nutritional needs of older people for better quality of life.

The aim of the present work was to evaluate the relation between car use and the level of successful aging of a random sample of older adults living in the Mediterranean basin.During 2005-2011, 2749 older (aged 65-100 years) from 22 islands and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled in the Mediterranean islands cross-sectional study. Sociodemographics, medical conditions, and dietary and lifestyle habits were derived throughout standard procedures. Car use was recorded with a standard binary question. A successful aging index ranging from 0-10 was used.Older adults who used a car on regular basis had significantly higher levels of successful aging, as well as less prevalence of obesity and hypertension while were more physically active (P .001). After adjusting for several confounders car use was still positively related with elderly islander's successful aging level (beta coefficient [95% confidence interval]: 0.65 [0.54-0.77]).In conclusion, the activity of car use seems to be an indicator of quality of life among older adults, as measured through successful aging.

The aim of the present study was to investigate the association between midday napping, sleeping hours, and successful aging among 2564 older (65+ years) individuals living in the insular Mediterranean region. Anthropometric, clinical, and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures, while successful aging was evaluated using the validated Successful Aging Index (SAI, range 0–10). Of the 2564 participants, 74% reported midday napping. The SAI score was 2.9/10 for non-midday nappers vs. 3.5/10 for midday nappers (p = 0.001). Midday nappers were more likely to be physically active (p = 0.01) and to have higher adherence to the Mediterranean diet (p = 0.02) compared to non-midday nappers. In a fully adjusted model, midday nappers had 6.7% higher SAI score compared to the rest (p &lt, 0.001), and the effect of midday napping was more prominent among males and participants 80+ years of age. Further analysis indicated a significant U-shaped trend between sleeping hours/day and SAI score (p &lt, 0.001), with 8–9 h total of sleep/day, midday napping included, proposed as optimal in achieving the best SAI score. Midday napping seems to be a beneficial habit that should be promoted and encouraged in older people.

Tea is one of the most-widely consumed beverages in the world with a number of different beneficial health effects, mainly ascribed to the polyphenolic content of the tea catechins. The aim of this study was to examine the consumption of green, black, or no tea, in relation to the previously validated successful ageing index (SAI, higher values &ldquo, healthier&rdquo, ageing) in a combined analysis of adults aged &gt, 50 years old from the ATTICA (n = 1128 adults from Athens, Greece metropolitan area) and the MEDiterranean Islands Study (MEDIS) (n = 2221 adults from various Greek island and Mani) studies. After adjusting for age, sex, smoking, and coffee consumption, green tea was positively associated with SAI (b &plusmn, SE: 0.225 &plusmn, 0.055, p &lt, 0.001), while black tea was negatively associated with SAI (unstandardized b coefficient &plusmn, Standard error: &minus, 0.807 &plusmn, 0.054, p &lt, 0.001). Green tea (vs black tea) consumption, had higher odds of a SAI of over 3.58 out of 10 (OR: 1.77, 95% CI: 1.38&ndash, 2.28). Green tea consumption was also associated with higher levels of physical activity (p &lt, 0.001) and reduced likelihood of hypertension (p = 0.006) compared with black tea. Two possible mechanisms are that green tea possesses high levels of catechins such as (&minus, )-epigallocatechin 3-gallate and l-theanine compared with black tea. Therefore, the present analysis supports both the role of green tea constituents in successful ageing, as well as its role as an important component of an overall healthy diet in adults aged 50 years and over from these two epidemiological studies.

The quality of carbohydrates in the diet, including whole grains, matters greatly to health. There is emerging evidence supporting various protective effects from whole grain consumption against certain chronic diseases. However, being free of disease is not a requirement for healthy ageing, as many older adults have one or more health conditions but, when well controlled, have little influence on their wellbeing. The present study aimed to evaluate the association between whole grain consumption on successful aging, through an analysis of a sample of n = 3349, over-50-years-old men and women participating in the ATTICA and MEDIS population-based cross-sectional studies. Successful aging was evaluated using the validated successful aging index (SAI, range 0&ndash, 10) comprising of health-related social, lifestyle and clinical components. High whole grain intake was positively associated with SAI as compared with low (b &plusmn, SE: 0.278 &plusmn, 0.091, p = 0.002), whereas no significant associations were observed between moderate whole grain consumption and SAI (p &gt, 0.05). Increased whole grain intake has been associated with several health benefits, and, as is shown here, with higher successful aging levels. Therefore, consumption of whole grains should be encouraged, especially by replacing refined grains, without increasing total energy intake.

The consumption of dietary fats, which occur naturally in various foods, poses important impacts on health. The aim of this study was to elucidate the association of exclusive use of olive oil for culinary purposes with successful aging in adults aged &gt, 50 years old and residing in Greece. Use of olive oil in food preparation and bio-clinical characteristics of the Greek participants enrolled in the ATTICA (n = 1128 adults from Athens metropolitan area) and the MEDiterranean Islands Study (MEDIS) (n = 2221 adults from various Greek islands and Mani) studies, were investigated in relation to successful aging (SA). Participants were divided into the following three categories: (a) no olive oil consumption, (b) combined consumption of olive oil and other dietary fats, and (c) exclusive olive oil consumption. The SA was measured using the previously validated successful aging index (SAI). After adjusting for age, sex, and smoking habits, combined consumption of olive oil and other fats (vs. no olive oil use) was not significantly associated with SAI levels (p = 0.114). However, exclusive olive oil intake (vs. no use of olive oil) was significantly associated with SAI (p = 0.001), particularly among those aged older than 70 years. Therefore, the exclusive consumption of olive oil, as opposed to either combined or no olive oil consumption, beneficially impacts successful aging, particularly among individuals over 70 years of age. Primary public health prevention strategies should seek to encourage the enhanced adoption of such dietary practices in order to promote healthy aging and longevity.

The aim of this study was to evaluate several sociodemographic, lifestyle, and clinical characteristics of the IKARIA study participants and to find healthy aging trajectories of multimorbidity of Ikarian islanders. During 2009, 1410 people (aged 30+) from Ikaria Island, Greece, were voluntarily enrolled in the IKARIA study. Multimorbidity was defined as the combination of at least two of the following chronic diseases: hypertension, hypercholesterolemia, diabetes, obesity, cancer, CVD, osteoporosis, thyroid, renal, and chronic obstructive pulmonary disease. A healthy aging index (HAI) ranging from 0 to 100 was constructed using 4 attributes, i.e., depression symptomatology, cognitive function, mobility, and socializing. The prevalence of multimorbidity was 51% among men and 65.5% among women, while the average number of comorbidities was 1.7 ± 1.4 for men and 2.2 ± 1.4 for women. The most prevalent chronic diseases among men with multimorbidity were hypertension, hypercholesterolemia, and obesity while among women they were hypertension, hypercholesterolemia, and thyroid disease. Multimorbidity was correlated with HAI (Spearman’s rho = −0.127, p &lt, 0.001) and for every 10-unit increase in HAI, participants had 20% lower odds of being multimorbid. Multimorbidity in relation to HAI revealed a different trend across aging among men and women, coinciding only in the seventh decade of life. Aging is usually accompanied by chronic diseases, but multimorbidity seems to also be common among younger adults. However, healthy aging is a lifelong process that may lead to limited co-morbidities across the lifespan.

Several lifestyle parameters including diet, physical activity and sleep were associated in isolation with the presence of Metabolic Syndrome (MetS) in adults, to date there is a paucity of studies which evaluated their combined role aging populations and especially with respect to gender. Therefore, the aim of the present study was to provide a global consideration of the lifestyle factors associated with MetS among elderly individuals. Cross-sectional observational study. 21 Mediterranean islands and the rural Mani region (Peloponnesus) of Greece. during 2005-2015, 2749 older (aged 65-100 years) from were voluntarily enrolled in the study. Dietary habits, energy intake, physical activity status, sociodemographic characteristics, lifestyle parameters (sleeping and smoking habits) and clinical profile aspects were derived through standard procedures. The presence of MetS was defined using the definition provided by NCEP ATP III (revised) and cluster analysis was used to identify overall dietary habit patterns. The overall prevalence of MetS in the study sample was 36.2%, but occurred more frequently in females (40.0% vs. 31.8%, respectively, p=0.03). Individuals with MetS were more likely to sleep during the day (89.4% vs. 76.8% respectively, p=0.039) and frequent ‘siesta’ was positively linked to the odds of MetS presence in females (Odds Ratio (OR) =3.43, 95% Confidence Intervals (CI): 1.08-10.9), but not for men (p=0.999). The lower carbohydrate (i.e., 45.2% of total daily energy, 120±16gr/day) dietary cluster was inversely associated with the odds for MetS presence, but only for men (OR=0.094, 95%CI: 0.010-0.883). Lifestyle parameters including sleep and diet quality are strongly associated with the presence of MetS in elderly cohort, but different their level of influence appears to be different, depending on gender. Further research is needed to better consider the role of lifestyle characteristics in the management of MetS in clinical practice.

There are places around the world that are characterized by high longevity rates; among these places are islands in Eastern Aegean Sea (Ikaria Island). Sparse data suggest that islanders' nutritional habits are based on both local products and the coastal transport development; however, the level of adherence to the traditional Mediterranean lifestyle is relatively unknown. This review explores eating habits and behaviors, as well as the health status of people living in Eastern Aegean Sea islands.

The determinants that promote successful ageing still remain unknown. The aim of the present work was to evaluate the role of skeletal muscle mass and body fat percentage (BF%), in the level of successful ageing.during 2005-2011, 2663 older (aged 65-100 years) from 21 Mediterranean islands and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled in the study. Appendicular skeletal muscle mass (ASM), skeletal muscle mass index (SMI) and BF% were calculated using population formulas. Dietary habits, energy intake, expenditure and energy balance were derived throughout standard procedures. A successful ageing index ranging from 0 to 10 was used.The mean ASM mass was 24±6.0kg, the SMI was 0.84±0.21 and the BF% was 44%. Females had lower SMI and higher BF% in comparison with males, respectively [(SMI: 0.66±0.09 vs. 1.03±0.11; BF%: 51% vs. 34%, (p0.001)]. High successful agers had better rates in ASM (p=0.01), SMI (p0.001) and BF% (p0.001), compared with the medium and low successful ones. Changes in SMI [b-coefficient (95% CI):2.14 (1.57 to 2.71)] were positively associated with successful ageing, while changes in BF% [b-coefficient (95% CI): -0.04 (-0.05 to -0.03)] were inversely associated with successful ageing. Results from sensitivity analysis showed that the effects of variations on body composition were consistent, less pronounced in the positive energy balance group and more pronounced among the oldest old.Body composition changes seem to be associated with lower quality of life in the older adults, as measured through successful ageing.

The aim of the present work was to evaluate the association between the level of adherence to the Mediterranean diet and successful aging, taking into consideration the overall dietary pattern, rather than individual foods, among middle-aged and older individuals.A harmonized dataset of middle-aged and older participants (50 years old) from the ATTICA (n = 1,128) and MEDIS (n = 2,221) population-based cross-sectional studies was used. Socio-demographic, anthropometric, clinical and lifestyle characteristics were measured in both studies and harmonized using standardized procedures. Level of adherence to the Mediterranean diet was evaluated using the MedDietScore (range 0-55, "Low" adherence34, "High"38). Successful aging was evaluated using the validated successful aging index (SAI, range 0-10) comprising of health-related, social, lifestyle and clinical characteristics.Adherence to the Mediterranean diet was positively associated with SAI (b ± SE "High" vs. "Low": 1.094 ± 0.130, p 0.001 and "Moderate" vs "Low": 0.476 ± 0.156, p = 0.003).Higher adherence to the Mediterranean diet was independently associated with a higher level of successful aging. Mediterranean diet or dietary patterns that are close to this pattern, should be actively promoted and encouraged to middle aged and older people to achieve successful aging.

OBJECTIVE Τo evaluate the combined modifying effect of dietary habits and/or features of healthy aging, on the lipoprotein-alpha [Lp(a)] and CVD risk association. DESIGN AND METHODS Τhe ATTICA is a prospective, population-based study conducted in the greater metropolitan area of Athens (Attica, Greece). During 2001-2002, 3042 CVD-free adults (men/women: 1514/1528, 18-89 years) agreed to participate. In 2011-2012, the 10-year study follow-up was performed, recording the fatal/non-fatal CVD incidence in 2020 participants (mean follow-up: 8.41 years). Various bio-clinical characteristics [including low-density lipoprotein-cholesterol (LDL-C), Lp(a)] were derived through standard procedures. Dietary habits were assessed through the MedDietScore (an index assessing adherence to the Mediterranean diet with theoretical range 0-55). A validated successful aging index (SAI), ranging from 0 to 10, was used to assess healthy aging. RESULTS Lp(a) levels were positively associated with 10-year CVD incidence (Hazard Ratio: 1.02, 95%CI 1.01-1.04); when MedDietScore was included in the model the observed association between Lp(a) levels and CVD risk disappeared (1.00, 95%CI 0.98-1.01), and a mediating effect of Mediterranean diet was revealed (Sobel's test p

Background: Metabolic syndrome (MetS) as a combination of features has been known to significantly increase cardiovascular disease risk, while MetS presence is linked to lifestyle parameters, including physical activity and dietary habits; recently, the potential impact of sleeping habits has also become an issue under consideration. The aim of this study was to investigate the role of sleep quantity in several MetS components. Methods: Design: a cross-sectional observational study. Setting: 26 Mediterranean islands (MEDIS) and the rural Mani region (Peloponnesus) of Greece. Participants: during 2005–2017, 3130 older (aged 65–100 years) Mediterranean residents were voluntarily enrolled. Measurements: dietary habits (including MedDietScore assessment), physical activity status, sociodemographic characteristics, lifestyle parameters (sleeping and smoking habits), and clinical profile aspects, including MetS components [i.e., waist circumference, systolic and diastolic blood pressure, fasting glucos...

Previous studies have reported associations between levels of protein and carbohydrate intake with several health outcomes. Yet, their effect on successful (or healthy) aging remains unknown. The purpose of the present work was to investigate the association of protein and carbohydrate intake levels with successful aging. A cross-sectional analysis was carried out on the participants of two epidemiological studies; the ATTICA and the MEDIS studies. Anthropometrical, clinical and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures. Successful aging was evaluated using a validated index (SAI) composed of 10 health-related social, lifestyle and clinical characteristics. SAI levels were lower in low protein—high carbohydrate diet group (B = − 0.08, p = 0.04), but higher in high protein—high carbohydrate group (B = 0.06, p = 0.04), as compared to low protein and low carbohydrate diet, in participants living in insular areas. Protein—carbohydrate diet was not associated with SAI (all p’s > 0.05) among participants living in urban areas (p for diet—study interaction

High levels of lipoprotein(a) [Lp(a)] are associated with increased risk of acute coronary syndrome (ACS). We explored whether Lp(a) exhibits a stronger association with premature ACS.A case-control study was conducted; 1457 patients with a history of ACS (54.8 ± 13 years, 86% males) and 2090 age-sex matched adults free of cardiovascular disease were enrolled. Bio-clinical characteristics [risk factors, low-density lipoprotein-cholesterol, Lp(a)] were derived through standard procedures.A 10 mg/dL increase in Lp(a) was associated with 4% (95% CI, 1.01 to 1.02) higher likelihood of having ACS in younger (45 years) and 2% (95% CI, 1.01 to 1.02) higher likelihood in middle-aged (45-60 years) individuals. Adjusting for common risk factors, elevated Lp(a), i.e.50 mg/dL, was still associated with increased likelihood of ACS in younger adults (45 years) (OR = 2.88, 95% CI, 1.7 to 4.6) and in middle aged ones (45 and 60 years) (OR = 2.06, 95% CI, 1.4 to 3.2), but not in older participants (60 years) (OR = 1.31, 95% CI, 0.8 to 2.4).Lp(a) seems to be an independent risk factor for ACS in individuals45 years, and high Lp(a) levels increase by ∼3folds the risk for ACS. The association is preserved but is less in middle-aged individuals (45-60 years) and is abolished60 years.

Background: Adherence to a Mediterranean dietary pattern is a well-established protective factor against cardiovascular disease (CVD). However, diet quality is only one aspect of the overall healthy lifestyle adopted by Mediterranean populations. The latter has never been evaluated as a multi-factorial composite lifestyle. Thus, the aim of the present study was to provide a broader picture of the Mediterranean lifestyle and its effects on CVD risk, among elderly individuals. Methods: During 2005–2015, 2,749 older (aged 65–100 years) from 21 Mediterranean islands (MEDIS) and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled onto the study. Dietary habits, physical activity status, socio-demographic characteristics, lifestyle parameters (sleep, smoking habits, social life and educational status) and clinical profile aspects were derived through standard procedures. Results: The overall prevalence of the traditional CVD risk factors were 62.3% for hypertension, 22.3% for diabetes mellitus (type 2) and 47.7% for hypercholesterolemia. The presence of diabetes mellitus was positively predicted by the geriatric depression scale (GDS) [odds ratio (OR) =1.13, 95% confidence interval (CI): 1.02–1.25] and by an urban residential environment (OR =2.57, 95% CI: 1.10–6.06) after adjusting for several confounders. Presence of hypertension was predicted by increasing age (OR =1.07, 95% CI: 1.02–1.12), increasing body mass index (BMI) (OR =1.12, 95% CI: 1.04–1.21), the habit of midday sleep (OR =2.07, 95% CI: 1.07–4.02) and inversely predicted by the frequency of socializing with friends (OR =0.767, 95% CI: 0.616–0.955). The estimated score in the GDS was the only independent positive predictor for the presence of hypercholesterolemia (OR =1.10, 95% CI: 1.01–1.21). Conclusions: Lifestyle parameters such as social life, midday sleep (siesta) and residential environment are strongly associated with the presence of CVD risk factors in elderly and should be part of broader CVD prevention strategies to reduce the burden of the disease., peer-reviewed

OBJECTIVES: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. METHODS: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. RESULTS: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p