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There are accumulative evidences that the prevalence of cigarette smoking has gradually declined in most high-income countries since the 1990s, in part due to public health campaigns emphasizing on the relationship between tobacco use and detrimental health effects. In late 2000s electronic (e)-cigarettes were introduced in the world, as less harmful nicotine products that may also help people in quitting smoking. Since then, the use of e-cigarettes has increased rapidly from the time when their introduction in the global market. In this work we present a collection of position statements and opinions of scientific bodies and Organizations, regarding the safety of e-cigarettes, as well as their association with human health, and particularly, cardiovascular diseases.

Background: Whether older immigrant populations from the Mediterranean region, continue to follow the MD long after they immigrated is not known. Aim: Compare adherence to the MD and successful aging levels between Greeks living in Greece (GG) and Greeks living abroad (GA). Methods: Anthropometrical, clinical, psychological, sociodemographic, dietary and lifestyle parameters were assessed in a cross-sectional manner in a sample of 252 GG and 252 GA. Mediterranean Diet Score (MedDietScore range 0-55) was used to assess adherence to the MD. Successful aging was evaluated with the validated successful aging index (SAI range 0-10). Results: GA presented higher adherence to MD (p 0.05). MedDietScore was positively associated with SAI among both groups after adjusting for possible confounders (0.041 ± 0.014, p = 0.003 GG and 0.153 ± 0.035, p

The aim of the present work was to investigate the association of dietary habits and lifestyle characteristics with successful aging among native Greeks and Greeks of Diaspora (Canada and France). During 2005-2019, 2,434 Greek men and women, living in Greece, in France, and in Canada, over 65 years of age were enrolled voluntarily in the study. Anthropometric, clinical and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures, while successful aging was evaluated using the validated Successful Aging Index (SAI, range 0-10). The SAI of the overall sample was 2.8 ± 1.4. Greeks of Diaspora had higher SAI levels compared to their counterparts in Greece (

BACKGROUND: The potential for diet to prevent and treat mental health conditions is an exciting area of investigation; however, the impact of different protein sources on mental health outcomes is unclear. OBJECTIVE: To evaluate the association between dietary protein intake and psychological distress, in people aged >50 years of age, living in Greece. METHODS: A combined data set of older people living in the Athens metropolitan area and 20 Greek islands, from the ATTICA (n = 1,128) and MEDIS (n = 2,221) population-based cross-sectional studies was developed. Anthropometric, clinical and socio-demographic and lifestyle characteristics, and protein consumption (total, animal, plant) consumed based on validated FFQ, were derived through standard procedures and questionnaires. “Psychological distress” (PDS) was assessed as a combined variable representing symptoms of depression and anxiety using Item Response Theory methodology and fitting a Graded Response Model. RESULTS: Animal protein, but not plant protein intake, was associated with higher PDS following adjustment for age, sex, education level, Mediterranean diet adherence and physical activity (b±SE: 0.399±0.090, p = 0.003). Following analysis by Mediterranean diet adherence level, among low adherers, animal protein intake was positively associated with PDS (b±SE: 1.119±0.174, p = 0.003), and no associations were observed in moderate or high adherence groupsin regards to plant protein intake and PDS. CONCLUSIONS: Animal protein intake is associated with PDS, suggesting a bi-directional relationship, which may be influenced by Mediterranean diet adherence.

BACKGROUND: The association between sodium intake and successful aging is not elucidated to date. OBJECTIVE: To evaluate the association between sodium intake and successful aging, in people aged >50 years, living in Greece. METHODS: A cross-sectional study was conducted in middle aged and older adult participants of the ATTICA (n = 1,128) and MEDIS (n = 2,221) epidemiological studies. Anthropometric, clinical, socio-demographic and lifestyle characteristics derived through standard procedures and questionnaires. Sodium intake was measured based on the USDA Food Composition database; table salt or salt from processed foods were not evaluated. Successful aging was assessed using the Successful Aging Index (SAI, range 0–10, higher values indicating higher successful aging) comprising of health-related, social, lifestyle and clinical characteristics. RESULTS: Participants with ≥1500 mg/day sodium intake had 20.2% on average lower SAI score compared to those with 70-males/>70-females, –90% vs. 82.5%, p

The aim of the present work was to investigate the association of dietary habits and lifestyle characteristics with successful aging among native Greeks and Greeks of Diaspora (Canada and France). During 2005-2019, 2,434 Greek men and women, living in Greece, in France, and in Canada, over 65 years of age were enrolled voluntarily in the study. Anthropometric, clinical and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures, while successful aging was evaluated using the validated Successful Aging Index (SAI, range 0-10). The SAI of the overall sample was 2.8 ± 1.4. Greeks of Diaspora had higher SAI levels compared to their counterparts in Greece (p's .05). Actually, Greeks of Diaspora had almost 1.9 units higher SAI compared to native Greeks (p

Objective: The aim of the present study was to investigate the differences between the consumption of plant-based v. animal-based protein-rich diets on successful ageing, as well as to identify the optimal combination of dietary protein intake for facilitating successful ageing in people aged >50 years. Design: A combined analysis was conducted in older adults of the ATTICA and MEDIS population-based cross-sectional studies. Anthropometrical, clinical and sociodemographic characteristics, lifestyle parameters, dietary habits and level of protein intake were derived through standard procedures. Successful ageing was evaluated using the validated Successful Aging Index (SAI) composed of ten health-related social, lifestyle and clinical characteristics. Setting: Athens area and twenty Greek islands. Participants: A total of 3349 Greek women and men over 50 years old. Results: Participants with high consumption of plant proteins were more likely to be male, physically active, with higher daily energy intake, higher adherence to the Mediterranean diet and higher level of SAI (P < 0·001). Participants with ‘Low animal & High plant’ and ‘High animal & High plant’ protein consumption had a 6 and 7 % higher SAI score, respectively, compared with the other participants (P < 0·001). In contrast, ‘Low animal & Low plant’ and ‘High animal & Low plant’ protein intake was negatively associated with SAI as compared to the combination of all other consumption categories (P < 0·02). Conclusions: The consumption of a plant-based protein-rich diet seems to be a beneficial nutritional choice that should be promoted and encouraged to older people since it may benefit both individual’s health and prolong successful ageing.

Comparing lifestyle and successful aging between Greeks living in Greece (GG) and Greeks living abroad (GA) using a multidimensional model of successful aging including both biomedical and non-medical components.Anthropometric, clinical, psychological, socio-demographic, dietary and lifestyle parameters were assessed in a random sample of 252 GG and 252 GA. Successful aging was evaluated using the validated successful aging index (SAI range 0-10).GA had better financial and educational status and scored higher in all social activity parameters (p's 0.05). GA were more likely to be physically active (p 0.001), had higher adherence to the Mediterranean diet (p 0.001) and were less likely to be smoking (p = 0.008). Depression was more evident among GG compared to GA (p 0.001). GA was aging significantly more successfully than GG (p 0.001). Men irrespective of location were aging significantly more successfully than women (p 0.05).Place of residence and personal choices significantly affect the level of healthy aging among people with similar genetic backgrounds.

The aim was to investigate the association between homocysteine (Hcy) and acute coronary syndrome (ACS) and to test the potential moderating role of Mediterranean diet. An age and gender matched case-control study was conducted among 1491 patients with a first ACS event and 3037 adults free of cardiovascular disease (CVD). Adherence to the Mediterranean diet was measured using the MedDietScore (range 0-55). An increase in Hcy levels was associated with a 1% and 3% higher likelihood of ACS among younger (45 yrs) and middle-aged (45-60yrs) adults (

The potential health benefits of olive oil consumption, particularly within the context of the Mediterranean diet, have been extensively investigated. However, its specific health benefits remain to be confirmed. The aim of the present work is to review the scientific evidence regarding the specific impact of olive oil consumption on human health, including the prevention of cardiovascular disease, cancers, and diabetes mellitus. Ten related meta-analyses were reviewed to this effect. Olive oil consumption was found to be beneficial for several chronic non-communicable diseases (e.g. including cardiovascular disease, breast cancer and type 2 diabetes), whereas there were contradictory findings regarding its impact on several biomarkers. In conclusion, the aggregated evidence supports the assertion that olive oil consumption is beneficial for human health, and particularly for the prevention of cardiovascular diseases, breast cancer, and type 2 diabetes mellitus.

OBJECTIVE: The aim of the present study was to investigate the differences between the consumption of plant-based v. animal-based protein-rich diets on successful ageing, as well as to identify the optimal combination of dietary protein intake for facilitating successful ageing in people aged >50 years. DESIGN: A combined analysis was conducted in older adults of the ATTICA and MEDIS population-based cross-sectional studies. Anthropometrical, clinical and sociodemographic characteristics, lifestyle parameters, dietary habits and level of protein intake were derived through standard procedures. Successful ageing was evaluated using the validated Successful Aging Index (SAI) composed of ten health-related social, lifestyle and clinical characteristics. SETTING: Athens area and twenty Greek islands. PARTICIPANTS: A total of 3349 Greek women and men over 50 years old. RESULTS: Participants with high consumption of plant proteins were more likely to be male, physically active, with higher daily energy intake, higher adherence to the Mediterranean diet and higher level of SAI (P < 0·001). Participants with 'Low animal & High plant' and 'High animal & High plant' protein consumption had a 6 and 7 % higher SAI score, respectively, compared with the other participants (P < 0·001). In contrast, 'Low animal & Low plant' and 'High animal & Low plant' protein intake was negatively associated with SAI as compared to the combination of all other consumption categories (P < 0·02). CONCLUSIONS: The consumption of a plant-based protein-rich diet seems to be a beneficial nutritional choice that should be promoted and encouraged to older people since it may benefit both individual's health and prolong successful ageing.

The aim of this study was to evaluate several sociodemographic, lifestyle, and clinical characteristics of the IKARIA study participants and to find healthy aging trajectories of multimor-bidity of Ikarian islanders. During 2009, 1410 people (aged 30+) from Ikaria Island, Greece, were voluntarily enrolled in the IKARIA study. Multimorbidity was defined as the combination of at least two of the following chronic diseases: hypertension; hypercholesterolemia; diabetes; obesity; cancer; CVD; osteoporosis; thyroid, renal, and chronic obstructive pulmonary disease. A healthy aging index (HAI) ranging from 0 to 100 was constructed using 4 attributes, i.e., depression symptomatology, cognitive function, mobility, and socializing. The prevalence of multimorbidity was 51% among men and 65.5% among women, while the average number of comorbidities was 1.7 ± 1.4 for men and 2.2 ± 1.4 for women. The most prevalent chronic diseases among men with multimorbidity were hypertension, hypercholesterolemia, and obesity while among women they were hypertension, hypercholesterolemia, and thyroid disease. Multimorbidity was correlated with HAI (Spearman’s rho = −0.127, p < 0.001) and for every 10-unit increase in HAI, participants had 20% lower odds of being multimorbid. Multimorbidity in relation to HAI revealed a different trend across aging among men and women, coinciding only in the seventh decade of life. Aging is usually accompanied by chronic diseases, but multimorbidity seems to also be common among younger adults. However, healthy aging is a lifelong process that may lead to limited co-morbidities across the lifespan. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Objective: The aim of the present study was to investigate the differences between the consumption of plant-based v. animal-based protein-rich diets on successful ageing, as well as to identify the optimal combination of dietary protein intake for facilitating successful ageing in people aged >50 years. Design: A combined analysis was conducted in older adults of the ATTICA and MEDIS population-based cross-sectional studies. Anthropometrical, clinical and sociodemographic characteristics, lifestyle parameters, dietary habits and level of protein intake were derived through standard procedures. Successful ageing was evaluated using the validated Successful Aging Index (SAI) composed of ten health-related social, lifestyle and clinical characteristics. Setting: Athens area and twenty Greek islands. Participants: A total of 3349 Greek women and men over 50 years old. Results: Participants with high consumption of plant proteins were more likely to be male, physically active, with higher daily energy intake, higher adherence to the Mediterranean diet and higher level of SAI (P < 0·001). Participants with 'Low animal & High plant' and 'High animal & High plant' protein consumption had a 6 and 7 % higher SAI score, respectively, compared with the other participants (P < 0·001). In contrast, 'Low animal & Low plant' and 'High animal & Low plant' protein intake was negatively associated with SAI as compared to the combination of all other consumption categories (P < 0·02). Conclusions: The consumption of a plant-based protein-rich diet seems to be a beneficial nutritional choice that should be promoted and encouraged to older people since it may benefit both individual's health and prolong successful ageing. © 2020 The Authors.

Introduction: The effects of protein consumption on overall human health and longevity remain one of the most controversial issues in nutrition science to date. Aim: To evaluate the association between dietary protein intake and psychological distress, in people aged >65 years of age, living in insular Greece. Methodology: Data from older people living in 20 Greek islands, from the MEDiterranean Islands Study (MEDIS) (n=2,221) population-based cross-sectional study were used. Anthropometric, clinical and socio-demographic and lifestyle characteristics, and protein consumption (total, animal, plant) consumed based on validated FFQ, were derived through standard procedures and questionnaires. Psychological distress was assessed as a combined variable representing symptoms of depression and anxiety. Results: Animal protein, but not plant protein intake, was associated with higher PDS following adjustment for age, sex, education level, Mediterranean diet adherence and physical activity (b±SE: 0.403 ± 0.090, p=0.003). Following analysis by Mediterranean diet adherence level, among low adherers, animal protein intake was positively associated with Psychological Distress (b±SE: 1.119 ± 0.174, p=0.008); no associations were observed in moderate or high adherence groups or as regards plant protein intake and Psychological Distress. Conclusions: The present study suggests that plant protein sources form an important part of the overall dietary pattern and that low to moderate red meat intake within a Mediterranean diet pattern may be associated with lower Psychological Distress.

Background/Study context: The aim of the present work was to investigate the association of Waist-to-Height Ratio (WHtR) with Successful Aging (SA) status and compare it to classic anthropometric i...

Aim: The aim of the present work was to evaluate the association between the level of adherence to the Mediterranean diet and successful aging, taking into consideration the overall dietary pattern, rather than individual foods, among middle-aged and older individuals. Methods: A harmonized dataset of middle-aged and older participants (>50 years old) from the ATTICA (n = 1,128) and MEDIS (n = 2,221) population-based cross-sectional studies was used. Socio-demographic, anthropometric, clinical and lifestyle characteristics were measured in both studies and harmonized using standardized procedures. Level of adherence to the Mediterranean diet was evaluated using the MedDietScore (range 0–55, “Low” adherence 38). Successful aging was evaluated using the validated successful aging index (SAI, range 0−10) comprising of health-related, social, lifestyle and clinical characteristics. Results: Adherence to the Mediterranean diet was positively associated with SAI (b ± SE “High” vs. “Low”: 1.094 ± 0.130, p < 0.001 and “Moderate” vs “Low”: 0.476 ± 0.156, p = 0.003). Conclusion: Higher adherence to the Mediterranean diet was independently associated with a higher level of successful aging. Mediterranean diet or dietary patterns that are close to this pattern, should be actively promoted and encouraged to middle aged and older people to achieve successful aging. © 2020 Elsevier B.V.

The aim of the present study was to investigate the association between midday napping, sleeping hours, and successful aging among 2564 older (65+ years) individuals living in the insular Mediterranean region. Anthropometric, clinical, and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures, while successful aging was evaluated using the validated Successful Aging Index (SAI; range 0–10). Of the 2564 participants, 74% reported midday napping. The SAI score was 2.9/10 for non-midday nappers vs. 3.5/10 for midday nappers (p = 0.001). Midday nappers were more likely to be physically active (p = 0.01) and to have higher adherence to the Mediterranean diet (p = 0.02) compared to non-midday nappers. In a fully adjusted model, midday nappers had 6.7% higher SAI score compared to the rest (p < 0.001), and the effect of midday napping was more prominent among males and participants 80+ years of age. Further analysis indicated a significant U-shaped trend between sleeping hours/day and SAI score (p < 0.001), with 8–9 h total of sleep/day, midday napping included, proposed as optimal in achieving the best SAI score. Midday napping seems to be a beneficial habit that should be promoted and encouraged in older people. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Background/Study context : The aim of the present work was to investigate the association of Waist-to-Height Ratio (WHtR) with Successful Aging (SA) status and compare it to classic anthropometric indices, among middle-aged and older individuals. Methods : Among various socio-demographic, clinical and lifestyle characteristics, height, weight, waist circumference (WC), Waist-to-Hip Ratio (WHR) and WHtR of the Greek participants, over 50 years old, enrolled in the ATTICA (n = 1,128) and the MEDIS (n = 2,221) in relation to SA; SA was evaluated using the validated Successful Aging Index (SAI, range 0-10) comprising of health-related, social, lifestyle, and clinical parameters. Results : WHtR was inversely associated with SAI with every 0.1-unit increase, lowering SAI by almost 0.5 units (b-coefficient±SE: -4.71 ± 0.26; 95%CI: -5.21, -4.20). Also, WHtR was more strongly associated with SAI (b = -0.352), surpassing the effect of age and sex (b = -0.347 and 0.11, respectively). With respect to the other anthropometric indices (weight, height, WC, WHR), WHtR exhibited the highest explanatory ability (Adjusted R 2 = 0.345); the higher the adjusted R 2 the higher explanatory ability. Conclusions : WHtR was revealed as the best determinant of successful aging, with respect to other anthropometric indices (weight, height, WC, WHR). The present findings are of significant public health importance for better understanding the role of body mass distribution on the aging process.