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Leukocyte telomere length (LTL) is a proposed marker of biological age. Here we report the measurement and initial characterization of LTL in 474,074 participants in UK Biobank. We confirm that older age and male sex associate with shorter LTL, with women on average ~7 years younger in 'biological age' than men. Compared to white Europeans, LTL is markedly longer in African and Chinese ancestries. Older paternal age at birth is associated with longer individual LTL. Higher white cell count is associated with shorter LTL, but proportions of white cell subtypes show weaker associations. Age, ethnicity, sex and white cell count explain ~5.5% of LTL variance. Using paired samples from 1,351 participants taken ~5 years apart, we estimate the within-individual variability in LTL and provide a correction factor for this. This resource provides opportunities to investigate determinants and biomedical consequences of variation in LTL.

BACKGROUND: To evaluate modifiable, lifestyle risk factors of cardiovascular disease (CVD) among older adults, across ageing, in the Mediterranean area. METHODS: 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. RESULTS: 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 trend <0.001). CONCLUSIONS: 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.

BACKGROUND: The role of diet and inflammation in successful ageing is not transparent, and as such, is still being investigated. The aim of the present work was to evaluate the inflammatory potential of dietary habits in the successful ageing of a random sample of older adults living in the Mediterranean basin and who participated in the MEDIS (MEDiterranean ISlands) study. METHODS: During 2005-2016, 3,128 older adults (aged 65-100 years) from 24 Mediterranean islands and the rural Mani region (Peloponnesus) of Greece were enrolled in the study. A multidimensional successful ageing index consisting of 10 components was employed. A validated and reproducible Food Frequency Questionnaire (FFQ) was used to evaluate the dietary habits of the older adults. A nutrition anti-inflammatory (NAI) score based on the participants' specific dietary habits was assessed. RESULTS: Participants with high NAI scores (proinflammatory nutrition) had a higher prevalence of hypercholesterolemia and lower levels of successful ageing. After adjusting for several confounders, the NAI score was associated with successful ageing (-0.03, 95% CI -0.5 to -0.006). Stratified analysis by gender and advanced age revealed heterogeneity in the NAI score, predicting successful ageing. CONCLUSIONS: The inflammatory potential of nutrition was reported as an important factor for successful ageing, suggesting that further research is needed on the role of anti- and proinflammatory dietary habits in healthy and successful ageing.

PURPOSE: 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. METHODS: 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. RESULTS: 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

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.

The definition and determinants of successful aging is still controversial. Although dietary habits have long been associated with aging, eating habits and behaviors have rarely been included in various proposed indices of successful aging. The aim of this work was to evaluate determinants of successful aging together with assessment of dietary habits in relation to healthcare facility use among elders living in the Mediterranean basin. During 2005-2011, 2663 elderly (aged 65-100 years) individuals from 21 Mediterranean islands and rural Mani region (Peloponnesus) were voluntarily enrolled in the study. A successful aging index ranging from a score of 0 to a score of 10 was constructed using 10 attributes, i.e., education, financial status, physical activity, body mass index, depression, participation in social activities with friends and family, number of yearly excursions, number of cardiovascular disease risk factors and adherence to the Mediterranean diet. The applied factor analysis on the components of the index extracted three main components for successful aging: psychosocial-economic, bioclinical and lifestyle; confirming the multiple dimensions of aging. After adjusting for confounders, a 1/10-unit increase in the successful aging index was associated with 0.8 less annual visits to healthcare centers (95% CI -1.3 to-0.2). Stratified analysis by gender revealed heterogeneity of factors predicting successful aging. These findings suggest that successful aging is a multidimensional and complex concept that exhibits gender heterogeneity. Annual use of health care services by the elders was found to be related to level of successful aging.

To evaluate the role of geography i.e., continental vs. insular Mediterranean, on successful aging among older inhabitants. During 2005-2014, 2693 elderly (aged 65 to 100 years) individuals from 21 Mediterranean islands in Greece, Italy and Spain as well as Cyprus, Malta, and the rural region of Mani (southeast continental region of Greece keeping old-time traditions), were voluntarily recruited. Successful aging was evaluated using a validated index composed of 10 health-related socio-lifestyle and clinical characteristics. After accounting for age, sex, body mass index (BMI), physical activity, smoking habits, MedDietScore and access to health care services, the older inhabitants of islands were found to have a higher level of the successful aging index when compared to their counterparts in Mani (Beta=0.174, p

The aim of the present study was to evaluate lifestyle and health determinants of cardiovascular disease (CVD) risk among Greek elderly residents living in Eastern Aegean islands, in both Greece and Turkey.

The determinants that promote living beyond life expectancy and successful aging still remain unknown. The aim of the present work was to evaluate the role of energy balance in successful aging, in a random sample of older adults living in the Mediterranean basin.

Dehydration during pregnancy may be harmful for the mother and fetus; thus our objective was to understand whether pregnant women balance water intake and loss. The Water Balance Questionnaire (WBQ) was modified to reflect pregnancy (WBQ-P). Validation was performed using 3-day diaries (n=60) and hydration indices in urine (osmolality, specific gravity, pH and color, n=40). The WBQ-P was found valid according to Kedhal τ-b coefficient agreement. The WBQ-P was administered to 95, 100 and 97 women per trimester, in Greece. Median (IQR) water balance, intake and loss were, respectively, 203 (-577, 971), 2917 (2187, 3544) and 2658 (2078, 3391) ml/day; these did not differ among the trimesters or between pregnant and non-pregnant women. However, more pregnant women were falling in the higher quartiles of water balance distribution. No differences in sources of water intake were identified except that women in the third trimester had lower water intake from beverages. © 2014 Informa UK Ltd. All rights reserved.

Background and Aim: The aim of the present work was to evaluate the relationship between energy-generating nutrients and the presence of central and overall obesity after correcting for socio-demographic, lifestyle and clinical characteristics, among healthy elders. Methods and Results: During 2005-2007, 553 elderly men and 637 elderly women (mean age 74 ± 7. years) from eight Mediterranean islands in Greece and Cyprus, were enrolled. The retrieved information included demographic, bio-clinical and dietary characteristics. MedDietScore assessed adherence to the Mediterranean dietary pattern.The prevalence of obesity was 27% in males and 39% in females (p< 0.001), while 73% of males and 87% of females had central obesity. The prevalence of diabetes, hypercholesterolemia and hypertension was higher in the obese than in the non-obese participants (p< 0.01). After adjusting for various confounders, a 1% increase in carbohydrate consumption was associated with a 12% (95% CI 0.78-0.99) lower likelihood of having central obesity, while a 1% increase in carbohydrate and protein consumption was associated with a 14% (95% CI 0.78-0.95) and 16% (95% CI 0.72-0.97) lower likelihood of being obese, respectively. Vegetable protein was found to be associated with a 15% (95% CI 0.77-0.93) lower likelihood of being obese while, only low glycemic index carbohydrates seem to be associated with a 6% (95% CI 0.90-0.98) lower likelihood of having central obesity. Conclusions: The presented findings suggest that a diet high in carbohydrates and vegetable protein is associated with a lower likelihood of being obese and may help elderly people to preserve normal weight. © 2009 Elsevier B.V.

Study objective: To evaluate the prevalence of sexual activity and contraception methods used by Greek adolescents. To assess the effect of various factors in the decision making on sexual activity. Design: A cross-sectional study design was applied. Setting-Participants: The population (N = 1538) consisted of a random sample, stratified according to locality and population density, of 20 public junior high and high schools located in the urban district of Athens, Greece. Interventions: Anonymous self-completed questionnaires were used to assess sexual practices, contraception methods, and factors affecting sexual activity choices. Measures: Spearman association calculations and chi-square were used, while regression analysis models were also applied. Main Outcome: We examined the sexual practices among Greek adolescents, and indicated the psychosocial factors that may influence adolescents' sexual behavior. Results: 16% of the adolescents have had sexual intercourse, while the boy/girl ratio was 3/1 (P < 0.05). Mean age of sexual debut was 14 ± 1.5 years. An additional 20% have had any other sexual experience at a mean age 13.5 ± 1.5 years. Although sexually active adolescents generally use condoms (90.6%), only 32% use them properly (at every and throughout sexual contact). At least half of them do not have adequate protection (no method used or unreliable methods applied), while 8.2% of the girls have used emergency contraception. Adolescents with unstable home environment (divorce, recent death, not living with mother) or sexually experienced peers, as well as those that seek sexual education from siblings or friends have higher possibilities of being sexually active. Conclusion: Greek adolescents can be sexually active at a young age and they need sexual education on safe sex practices. © 2010 North American Society for Pediatric and Adolescent Gynecology.

Objective To investigate whether the socio-economic status (SES) of elderly eastern Mediterranean islanders is associated with their dietary habits, particularly with adherence to the traditional Mediterranean diet.Design Cross-sectional.Setting Adherence to the Mediterranean diet was measured by the MedDietScore (range: 0-55), whereas SES was estimated using education and financial status.Subjects During 2005-2007, 300 men and women from Cyprus, 100 from Samothraki, 142 from Mitilini, 114 from Kefalonia, 131 from Crete, 150 from Lemnos, 150 from Corfu and 103 from Zakynthos (aged 65-100 years), free of known chronic diseases, participated in the survey.Results Multiple linear regression analysis revealed that belonging to the highest SES was associated with a higher MedDietScore (P < 001), after adjusting for potential sociodemographic, lifestyle, dietary and clinical confounders. A significant positive association was also found between MedDietScore and years of school (P = 0004), as well as financial status (P = 0001).Conclusions Older Greek people of higher SES seem to follow a relatively healthier diet. Both education and income seem to play a role in this issue. Thus, public health policy makers should focus on people with low SES in order to improve their quality of diet and, consequently, their health status. © 2010 The Authors.

Objective: To evaluate time trends in the availability of soft drinks, to identify food choices associated with their consumption and to assess the relationship between socio-economic status and daily soft drink availability in a wide range of European countries. Design: Data on food and beverage availability collected through the national household budget surveys and harmonized in the DAFNE (Data Food Networking) project were used. Averages and variability of soft drink availability were estimated and tests for time trends were performed. The daily availability of food groups which appear to be correlated with that of soft drinks was further estimated. Multivariate logistic and linear regression models were applied to evaluate the association between socio-economic status and the acquisition of soft drinks.Setting Twenty-four European countries.Subjects Nationally representative samples of households. Results: The availability of soft drinks is steadily and significantly increasing. Households in West and North Europe reported higher daily availability of soft drinks in comparison to other European regions. Soft drinks were also found to be correlated with lower availability of plant foods and milk and higher availability of meat and sugar products. Lower socio-economic status was associated with more frequent and higher availability of soft drinks in the household. Conclusions: Data collected in national samples of twenty-four European countries showed disparities in soft drink availability among socio-economic strata and European regions. The correlation of soft drinks with unfavourable dietary choices has public health implications, particularly among children and adolescents. Copyright © 2010 The Authors.