Linking Mediterranean Diet and Lifestyle with Cardio Metabolic Disease and Depressive Symptoms: A Study on the Elderly in Europe
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Description, Key Variables, Covariates and Measurement
2.1.1. Health Outcome Indicators
2.1.2. Mediterranean Diet
- In a regular week, how often do you have a serving of dairy products, such as a glass of milk, cheese in a sandwich, a cup of yogurt or a can of high protein supplement?”
- In a regular week, how often do you have a serving of legumes, beans or eggs?”
- In a regular week, how often do you eat meat, fish or poultry?”
- In a regular week, how often do you consume a serving of fruits or vegetables?”
2.1.3. Variables Related to Individual Socio-Demographic Characteristics
2.1.4. Other Personal Traits and Lifestyle Indicators
2.2. Statistical Analysis
3. Results
3.1. Cardio Metabolic Disorders (CMDs)
3.2. Body-Mass Index (BMI)
3.3. Depressive Symptoms
3.4. Robustness Check
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Incidence of CMD | Freq. | Percent |
---|---|---|
0 | 99,561 | 44.37 |
1 | 69,426 | 30.94 |
2 | 37,112 | 16.54 |
3 | 14,588 | 6.5 |
4 | 3292 | 1.47 |
5 | 385 | 0.17 |
Total | 224,364 |
BMI (kg/m2) | Freq. | % |
---|---|---|
Below 18.5—underweight | 2350 | 1.08 |
18.5−24.9—normal | 74,574 | 34.18 |
25−29.9—overweight | 90,671 | 41.56 |
30 and above—obese | 50,556 | 23.17 |
Total | 218,151 |
EURO-D Scale | ||
---|---|---|
Depressive Symptoms | Freq. | % |
0. None | 37,553 | 22.39 |
1 | 36,280 | 21.63 |
2 | 28,622 | 17.07 |
3 | 21,816 | 13.01 |
4 | 15,741 | 9.39 |
5 | 10,697 | 6.38 |
6 | 7054 | 4.21 |
7 | 4452 | 2.65 |
8 | 2716 | 1.62 |
9 | 1567 | 0.93 |
10 | 814 | 0.49 |
11 | 309 | 0.18 |
12 | 77 | 0.05 |
Total | 167,698 |
Appendix B
How Often Serving of Legumes or Eggs (Br027_Inv) | % | |
5—Every day | 13,585 | 10.72 |
4—3−6 times week | 34,249 | 27.03 |
3—Twice week | 36,680 | 28.95 |
2—Once week | 29,161 | 23.02 |
1—Less than once a week | 13,013 | 10.27 |
Total | 126,688 | |
How often serving of meat, fish or chicken (br028_inv) | % | |
5—Every day | 49,449 | 39.02 |
4—3−6 times week | 53,076 | 41.88 |
3—Twice week | 16,536 | 13.05 |
2—Once week | 5585 | 4.41 |
1—Less than once a week | 2076 | 1.64 |
Total | 126,722 | |
How often serving of fruits or vegetables (br029_inv) | % | |
5—Every day | 97,848 | 77.21 |
4—3−6 times week | 20,140 | 15.89 |
3—Twice week | 5347 | 4.22 |
2—Once week | 2013 | 1.59 |
1—Less than once a week | 1381 | 1.09 |
Total | 126,729 |
Appendix C
Eastern Europe | Western Europe |
Bulgaria | Austria |
Czech Republic | Belgium |
Hungary | France |
Poland | Germany |
Romania | Luxembourg |
Slovakia | Netherlands |
Switzerland | |
Northern Europe | Southern Europe |
Denmark | Croatia |
Estonia | Cyprus |
Finland | Greece |
Latvia | Italy |
Lithuania | Malta |
Sweden | Portugal |
Slovenia | |
Spain |
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N | Mean | SD | Min | Max | |
---|---|---|---|---|---|
Chronic CMD | 224,364 | 0.90 | 1.01 | 0 | 5 |
BMI 2 (kg/m2) | 218,151 | 27.12 | 4.71 | 12.46 | 98.62 |
EURO-D | 167,698 | 2.37 | 2.22 | 0 | 12 |
Mediterranean diet (yes = 1) | 126,729 | 0.07 | 0.25 | 0 | 1 |
Gender (female = 1) | 224,364 | 0.56 | 0.50 | 0 | 1 |
Marital status (not living with partner = 1) | 223,297 | 0.28 | 0.45 | 0 | 1 |
age (years) | 224,364 | 64.99 | 7.79 | 50.00 | 80.00 |
Ethnicity (Hispanic = 1) | 223,000 | 0.07 | 0.26 | 0 | 1 |
educ: tertiary (1/0) | 221,367 | 0.22 | 0.42 | 0 | 1 |
educ: secondary (1/0) | 221,367 | 0.59 | 0.49 | 0 | 1 |
educ: primary/none (1/0) | 221,367 | 0.18 | 0.39 | 0 | 1 |
sports/physical activity (yes = 1) | 171,906 | 0.60 | 0.49 | 0 | 1 |
ever smoked daily (no = 1) | 170,073 | 0.52 | 0.50 | 0 | 1 |
household income (euros) | 172,531 | 32,780.64 | 60,592.12 | 0 | 9,589,806.00 |
employment status (employed = 1) | 219,663 | 0.29 | 0.45 | 0 | 1 |
Covariates | Dependent Variable: Chronic_CMD (Incidence of CMD) | ||
---|---|---|---|
(1) | (2) | (3) | |
CMD_Diet | CMD_Individual | CMD_All Vars | |
MED_diet (follows = 1; no = 0) | −0.0526 ** | −0.0552 *** | −0.0456 ** |
(0.0207) | (0.0202) | (0.0210) | |
female (female = 1; male = 0) | −0.0670 *** | −0.0862 *** | |
(0.0236) | (0.0227) | ||
marital status (NOT living with partner = 1; yes = 0) | 0.0108 | −0.0051 | |
(0.0087) | (0.0086) | ||
age | 0.0722 *** | 0.0512 *** | |
(0.0090) | (0.0084) | ||
age^2 | −0.0003 *** | −0.0002 *** | |
(0.0001) | (0.0001) | ||
ethnicity (Hispanic = 1; Non-Hisp = 0) | 0.0930 * | 0.1007 ** | |
(0.0491) | (0.0502) | ||
tertiary educ (tertiary = 1; No = 0) | −0.2215 *** | ||
(0.0219) | |||
secondary educ (secondary = 1: No = 0) | −0.1197 *** | ||
(0.0210) | |||
sports (active sports = 1; Not = 0) | −0.1715 *** | ||
(0.0176) | |||
ever smoked daily (no = 1; yes = 0) | −0.0537 *** | ||
(0.0126) | |||
household income | −0.0000 | ||
(0.0000) | |||
household income^2 | 0.0000 | ||
(0.0000) | |||
employment status (employed = 1; no = 0) | −0.1303 *** | ||
(0.0129) | |||
Constant | 0.8479 *** | −2.4345 *** | −1.1856 *** |
(0.0056) | (0.3006) | (0.2968) | |
Observations | 129,083 | 128,062 | 124,549 |
Number of id_n | 85,836 | 85,150 | 83,600 |
Year FE | YES | YES | YES |
COUNTRY FE | YES | YES | YES |
Covariates | Dependent Variable: BMI (Kg/M2; Continuous Measure) | ||
---|---|---|---|
(1) | (2) | (3) | |
BMI_Diet | BMI_Individual | BMI_All Vars | |
MED_diet (follows = 1; no = 0) | −0.0033 | 0.0023 | 0.0106 |
(0.0267) | (0.0353) | (0.0351) | |
female (female = 1; male = 0) | −0.5603 *** | −0.7368 *** | |
(0.1567) | (0.1591) | ||
marital status (NOT living with partner = 1; yes = 0) | −0.0481 | −0.0864 * | |
(0.0484) | (0.0469) | ||
age | 0.4092 *** | 0.3826 *** | |
(0.0416) | (0.0373) | ||
age^2 | −0.0031 *** | −0.0031 *** | |
(0.0003) | (0.0003) | ||
ethnicity (Hispanic = 1; Non-Hisp = 0) | 0.3479 * | 0.4085 | |
(0.1798) | (0.2531) | ||
tertiary educ (tertiary = 1; No = 0) | −1.8495 *** | ||
(0.0909) | |||
secondary educ (secondary = 1: No = 0) | −0.8852 *** | ||
(0.0743) | |||
sports (active sports = 1; Not = 0) | −0.3072 *** | ||
(0.0282) | |||
ever smoked daily (no = 1; yes = 0) | 0.2074 *** | ||
(0.0658) | |||
household income | −0.0000 | ||
(0.0000) | |||
household income^2 | 0.0000 | ||
(0.0000) | |||
employment status (employed = 1; no = 0) | −0.2747 *** | ||
(0.0440) | |||
Constant | 26.9819 *** | 13.7261 *** | 16.7651 *** |
(0.0258) | (1.4073) | (1.3087) | |
Observations | 125,412 | 124,783 | 121,800 |
Number of id_n | 84,317 | 83,826 | 82,361 |
Year FE | YES | YES | YES |
COUNTRY FE | YES | YES | YES |
Covariates | Dependent Variable: EURO-D (Level of Depressive Symptoms Scale: 0 to 12) | ||
---|---|---|---|
(1) | (2) | (3) | |
EURO-D_Diet | EURO-D_Individual | EURO-D_All Vars | |
MED_diet (follows = 1; no = 0) | −0.1490 ** | −0.1366 ** | −0.1118 ** |
(0.0591) | (0.0534) | (0.0514) | |
female (female = 1; male = 0) | 0.7515 *** | 0.6932 *** | |
(0.0484) | (0.0471) | ||
marital status (NOT living with partner = 1; yes = 0) | 0.4443 *** | 0.3803 *** | |
(0.0319) | (0.0300) | ||
age | −0.2301 *** | −0.3010 *** | |
(0.0136) | (0.0205) | ||
age^2 | 0.0019 *** | 0.0022 *** | |
(0.0001) | (0.0002) | ||
ethnicity (Hispanic = 1; Non-Hisp = 0) | 0.3401 *** | 0.2972 ** | |
(0.1040) | (0.1199) | ||
tertiary educ (tertiary = 1; No = 0) | −0.6769 *** | ||
(0.0650) | |||
secondary educ (secondary = 1: No = 0) | −0.4580 *** | ||
(0.0479) | |||
sports (active sports = 1; Not = 0) | −0.5708 *** | ||
(0.0375) | |||
ever smoked daily (no = 1; yes = 0) | −0.1936 *** | ||
(0.0168) | |||
household income | −0.0000 ** | ||
(0.0000) | |||
household income^2 | 0.0000 *** | ||
(0.0000) | |||
employment status (employed = 1; no = 0) | −0.4417 *** | ||
(0.0376) | |||
Constant | 1.9684 *** | 8.2313 *** | 12.4658 *** |
(0.0194) | (0.4836) | (0.6568) | |
Observations | 126,018 | 125,045 | 121,803 |
Number of id_n | 84,234 | 83,577 | 82,135 |
Year FE | YES | YES | YES |
COUNTRY FE | YES | YES | YES |
Covariates | (1) | (2) | (3) | (4) | (5) | (6) |
---|---|---|---|---|---|---|
CMD | CMD | BMI | BMI | EURO-D | EURO-D | |
MED2 (follows = 1; no = 0) | −0.0229 *** | −0.0174 ** | 0.0111 | 0.0210 | −0.2014 *** | −0.1510 *** |
(0.0088) | (0.0088) | (0.0215) | (0.0285) | (0.0408) | (0.0368) | |
female (female = 1; male = 0) | −0.0859 *** | −0.7370 *** | 0.6952 *** | |||
(0.0228) | (0.1591) | (0.0466) | ||||
marital status (NOT living with partner = 1; yes = 0) | −0.0053 | −0.0855 * | 0.3744 *** | |||
(0.0086) | (0.0464) | (0.0306) | ||||
age | 0.0513 *** | 0.3823 *** | −0.2995 *** | |||
(0.0084) | (0.0373) | (0.0207) | ||||
age^2 | −0.0002 *** | −0.0031*** | 0.0022 *** | |||
(0.0001) | (0.0003) | (0.0002) | ||||
ethnicity (Hispanic = 1; Non-Hisp = 0) | 0.1010 ** | 0.4078 | 0.3020 ** | |||
(0.0504) | (0.2523) | (0.1200) | ||||
tertiary educ (tertiary = 1; No = 0) | −0.2211 *** | −1.8502 *** | −0.6720 *** | |||
(0.0220) | (0.0910) | (0.0652) | ||||
secondary educ (secondary = 1: No = 0) | −0.1196 *** | −0.8854 *** | −0.4562 *** | |||
(0.0211) | (0.0745) | (0.0480) | ||||
sports (active sports = 1; Not = 0) | −0.1713 *** | −0.3078 *** | −0.5660 *** | |||
(0.0177) | (0.0280) | (0.0369) | ||||
ever smoked daily (no = 1; yes = 0) | −0.0536 *** | 0.2072 *** | −0.1923 *** | |||
(0.0126) | (0.0659) | (0.0167) | ||||
household income | −0.0000 | −0.0000 | −0.0000 ** | |||
(0.0000) | (0.0000) | (0.0000) | ||||
household income^2 | 0.0000 | 0.0000 | 0.0000 ** | |||
(0.0000) | (0.0000) | (0.0000) | ||||
employment status (employed = 1; no = 0) | −0.1303 *** | −0.2748 *** | −0.4412 *** | |||
(0.0129) | (0.0440) | (0.0375) | ||||
Constant | 0.8500 *** | −1.1873 *** | 26.9788 *** | 16.7752 *** | 1.9911 *** | 12.4211 *** |
(0.0061) | (0.2965) | (0.0251) | (1.3072) | (0.0207) | (0.6645) | |
Observations | 129,083 | 124,549 | 125,412 | 121,800 | 126,018 | 121,803 |
Number of id_n | 85,836 | 83,600 | 84,317 | 82,361 | 84,234 | 82,135 |
Year FE | YES | YES | YES | YES | YES | YES |
COUNTRY FE | YES | YES | YES | YES | YES | YES |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Vall Castelló, J.; Tubianosa, C. Linking Mediterranean Diet and Lifestyle with Cardio Metabolic Disease and Depressive Symptoms: A Study on the Elderly in Europe. Int. J. Environ. Res. Public Health 2020, 17, 7053. https://doi.org/10.3390/ijerph17197053
Vall Castelló J, Tubianosa C. Linking Mediterranean Diet and Lifestyle with Cardio Metabolic Disease and Depressive Symptoms: A Study on the Elderly in Europe. International Journal of Environmental Research and Public Health. 2020; 17(19):7053. https://doi.org/10.3390/ijerph17197053
Chicago/Turabian StyleVall Castelló, Judit, and Charisse Tubianosa. 2020. "Linking Mediterranean Diet and Lifestyle with Cardio Metabolic Disease and Depressive Symptoms: A Study on the Elderly in Europe" International Journal of Environmental Research and Public Health 17, no. 19: 7053. https://doi.org/10.3390/ijerph17197053