Because of the cumulative effect of adverse factors throughout life, it is particularly important for older persons to adopt diet and lifestyle practices that minimize their risk of death from illness and maximize their prospects for healthful aging, according to background information in the article. Dietary patterns and lifestyle factors are associated with death from all causes, coronary heart disease, cardiovascular diseases, and cancer, but few studies have investigated these factors in combination.
Kim Knoops, M.Sc., of Wageningen University, the Netherlands and colleagues investigated the single and combined effect of a Mediterranean diet (rich in plant foods and fish, low in meat and dairy products, and with a high ratio of monounsaturated fatty acids to polyunsaturated fatty acids), being physically active (approximately 30 minutes of activity per day or more), moderate alcohol use, and nonsmoking on all-cause and cause-specific death in European elderly individuals. The study, HALE (Healthy Ageing: a Longitudinal study in Europe), was conducted between 1988 and 2000 and was comprised of individuals enrolled in the Survey in Europe on Nutrition and the Elderly: a Concerned Action (SENECA) and the Finland, Italy, the Netherlands, Elderly (FINE) studies. It included 1,507 apparently healthy men and 832 women, aged 70 to 90 years in 11 European countries.
The researchers found that adhering to a Mediterranean diet was associated with a 23 percent lower risk of all-cause death; moderate alcohol use, a 22 percent lower risk; physical activity, a 37 percent lower risk; and nonsmoking, a 35 percent lower risk. Similar results were observed for death from coronary heart disease, cardiovascular diseases, and cancer. Having all four low risk factors lowered the all-cause death rate by 65 percent. In total, 60 percent of all deaths, 64 percent of deaths from coronary heart disease, 61 percent from cardiovascular diseases, and 60 percent from cancer were associated with lack of adherence to this low-risk pattern.
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The researchers looked at the genetic makeup of study participants and grouped them according to which polymorphisms they had. They found that postmenopausal women who had low-activity versions of genes associated with GSTs (known as GSTM1, GSTT1 and GSTP1) had a lower risk of breast cancer. Women with a combination of the lowest-activity forms of GSTM1 and GSTP1 had 64 percent lower risk of the cancer, and women with a combination of the lowest-activity forms of GSTT1 and GSTP1 had a 74 percent lower risk of the cancer.
Among women with high-activity versions of GST-related genes, though, they saw no evidence that fish oils reduced breast cancer risk. That held true for both pre- and postmenopausal women.
Interestingly, laboratory studies have shown that cancer growth is suppressed by n-3 fatty acid byproducts, and the suppression is enhanced by drugs that increase lipid peroxidation. When antioxidants are introduce to battle the effects of peroxidation, though, the cancer continues to grow.
"Our findings may have practical implications in treatment and prevention strategies for breast cancer," says Gago-Dominguez. "Marine n-3 fatty acids have been shown to enhance the cancer-killing effect of certain chemotherapy drugs and radiotherapy in experimental studies. Since these anti-cancer agents may act, at least in part, through similar oxidative mechanisms as n-3 fatty acids-which is why patients under chemotherapy are advised not to take antioxidant vitamin supplements-understanding the anti-cancer effect of marine n-3 fatty acids may be important to finding the mechanisms for killing cancer cells."
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