Longevity in elderly Greek migrants to Australia may be explained by adherence to a traditional Greek Mediterranean diet?
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Between 1988 and 1991 data were collected on diet, health and lifestyle on 818 people aged 70 and over from countries/cultures experiencing longevity: Swedes, Greeks, Australians (Greeks and Anglo-Celts) and Japanese. This was known as the Food Habits in Later Life study (FHILL). Subjects from these 5 cohorts were followed up for 5–7 years to determine survival status and to examine the effect of diet and lifestyle variables on longevity. The FHILL study was the first to develop a score which captured the key features of a traditional plant-based Mediterranean diet pattern (MDPS). A higher score (i.e greater adherence to this dietary pattern) improved overall survival in both Greek and non-Greek elderly reducing the risk of death by 50% after 5–7 years. Of the 5 cohorts studied, first generation elderly Greeks in Australia had the lowest risk of death, even though they had the highest rates of obesity and other cardiovascular disease (CVD) risk factors (developed in the early years of migration with the introduction of energy dense foods). This was called a “Greek migrant Morbidity Mortality Paradox”. Greek migrants appeared to be “getting away” with these CVD risk factors because of their continued adherence to a Mediterranean diet, especially legumes. This paper reviews a) the findings from the FHILL study b) other studies on Greek migrants to Australia c) clinical studies investigating possible mechanisms. We propose that the Mediterranean diet may be operating to reduce the risk of death and attenuate established CVD risk factors by beneficially altering the gut microbiome.