Modified Mediterranean diet and survival: Author's reply

doi:10.1136/bmj.330.7503.1329-b

BMJ 2005;330:1329-1330 (4 June), doi:10.1136/bmj.330.7503.1329-b

Letter

Modified Mediterranean diet and survival

Author's reply

The first 150 words of the full text of this article appear below.

EDITOR—Cereda et al argue that lipid profile and bloodpressure at baseline should be controlled for and that our studydoes not necessarily show a benefit of the Mediterranean diet(modified or not) among younger individuals. Blood lipids andblood pressure are determined by diet, alcohol intake, and physicalactivity, which have been evaluated in our study, as well asby poorly identified genetic factors. Blood lipids and bloodpressure are therefore more likely to act as mediators of theeffects of the evaluated factors rather than as confounders.Mediators, in contrast with confounders, should not be controlledfor in the statistical analysis.¹ Suggestive evidence existsthat the Mediterranean diet may also be beneficial among youngeradults,² but we agree that this deserves further investigation.

Vos disagrees with the title "modified Mediterranean diet" andalso cites references indicating that the benefit from polyunsaturatedlipids may be limited to . . . [Full text of this article]

Antonia Trichopoulou, professor of nutrition and preventive medicine

Department of Hygiene and Epidemiology, University of Athens Medical School, Athens 11527, Greeceantonia@nut.uoa.gr

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