The mountainous Cretan dietary patterns and their relationship with cardiovascular risk factors: the Hellenic Isolated Cohorts MANOLIS study

Objective: We carried out de novo recruitment of a population-based cohort (MANOLIS study) and describe the specific population, which displays interesting characteristics in terms of diet and health in old age, through deep phenotyping. Design: Cross-sectional study where anthropometric, biochemical and clinical measurements were taken in addition to interview-based completion of an extensive questionnaire on health and lifestyle parameters. Dietary patterns were derived through principal component analysis based on a validated FFQ. Setting: Geographically isolated Mylopotamos villages on Mount Idi, Crete, Greece. Subjects: Adults (n 1553). Results: Mean age of the participants was 61.6 years and 55.8% were women. Of the population, 82.7% were overweight or obese with a significantly different prevalence between overweight men and women (43.4 v. 34.7%, P = 0.002). The majority (70.6%) of participants were married, while a larger proportion of women were widowed than men (27.8 v. 3.5%, P<0.001). Smoking was more prevalent in men (38.7 v. 8.2%, P<0.001), as 88.8% of women had never smoked. Four dietary patterns emerged as characteristic of the population; these were termed 'local', 'high fat and sugar, 'Greek cafe/tavern' and 'olive oil, fruits and vegetables'. Individuals more adherent to the local dietary pattern presented higher blood glucose (beta = 4.026, P<0.001). Similarly, individuals with higher compliance with the Greek cafe/tavern pattern had higher waist-to-hip ratio (beta = 0.012, P<0.001), blood pressure (beta = 1.015, P=0.005) and cholesterol (beta = 5.398, P<0.001). Conclusions: Profiling of the MANOLIS elderly population identifies unique unhealthy dietary patterns that are associated with cardiometabolic indices.