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Centenarians and diet: what they eat in the Western part of Sicily

Centenarians and diet: what they eat in the Western part of Sicily This paper pays attention to the modifiable lifestyle factors such as diet and nutrition that might influence life extension and successful ageing. Previous data reported that in Sicily, the biggest Mediterranean island, there are some places where there is a high frequency of male centenarians with respect to the Italian average. The present data show that in Sicani Mountain zone there are more centenarians with respect to the Italian average. In fact, in five villages of Sicani Mountains, there were 19 people with an age range of 100–107 years old from a total population of 18,328 inhabitants. So, the centenarian number was 4.32-fold higher than the national average (10.37 vs. 2.4/10,000); the female/male ratio was 1.1:1 in the study area, while the national ratio is 4.54:1. Unequivocally, their nutritional assessment showed a high adherence to the Mediterranean nutritional profile with low glycemic index food consumed. To reach successful ageing it is advisable to follow a diet with low quantity of saturated fat and high amount of fruits and vegetables rich in phytochemicals. Keywords: Ageing, Centenarian, Longevity, Mediterranean diet Introduction showing protective effect on health and longevity [5-7]. The Mediterranean diet has been widely recommended Mediterranean diet is characterized by a high intake of for a healthy lifestyle since Ancel Keys first used the term monounsaturated fat, plant proteins, whole grains (fish is in 1975 [1]. The essential concept is that this is not a set not always present), moderate intake of alcohol, and low of changes to our usual diet dictated by scientific experi- consumption of red meat, refined grains, and sweets. Fur- ments, but a set of food habits and recipes traditionally ther, the consumption of large amount of olive oil and enjoyed by the ordinary people of Mediterranean coun- olives in meals dominates all the Mediterranean cuisine [8]. tries, who have been found to have lower rates of coron- Historically, the beneficial properties of virgin olive oil ary and other age-related chronic diseases, including were attributed to the high proportion of monounsatu- cancer, than most developed countries [2,3]. rated fatty acids (MUFAs), namely oleic acid, rather than In recent years, researchers have been extremely inter- to the phenolic fraction. Nevertheless, several seed oils, ested in the clear advantage of the Mediterranean nutri- including sunflower, soybean, and rapeseed, rich in tional recommendation that exists and is used in the MUFA have been demonstrated to be ineffective in bene- Mediterranean surrounding area. In fact, there is no sin- ficially altering chronic disease risk factors. Therefore, it gle Mediterranean diet but several interpretations based is likely that the polyphenols in olive oil may mediate on the Mediterranean country’s political, economic and these health benefits [8,9]. cultural tradition [4]. There are at least thirty-six structurally distinct pheno- Since 1990, increasing evidence suggests that these lics that have been identified in virgin olive oil, but not diets have a beneficial influence on several diseases such all phenolic compounds and their concentration are as cardiovascular diseases, metabolic syndromes, hence present in every virgin olive oil. Such differences in the phenolic compound are dependent on several factors like * Correspondence: [email protected] the variety of the olive fruit, the region in which the olive Department of Molecular and Biomolecular Sciences (STEMBIO), fruit is grown, the agricultural techniques used, the ma- University of Palermo, Via Archifari 32, 90213, Palermo, Italy 3 turity of the olive fruit at harvest, the extraction process Immunohaemathology Unit, University Hospital, University of Palermo, Via del Vespro, 127, 90137, Palermo, Italy and the storage method [10]. Full list of author information is available at the end of the article © 2012 Vasto et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Vasto et al. Immunity & Ageing 2012, 9:10 Page 2 of 6 http://www.immunityageing.com/content/9/1/10 The Sicanian Mountains (or Sicani), bordered by a very peculiar area where there is a high frequency of Ficuzza wood in the North, Caltanissetta in the East, centenarians with respect to the Italian average [11,12]. Salemi in the West and Agrigento to the South represent The goal of this study was to characterize the dietary Figure 1 Example of MNA administered to healthy centenarians. Vasto et al. Immunity & Ageing 2012, 9:10 Page 3 of 6 http://www.immunityageing.com/content/9/1/10 habits of centenarians residing around the Sicani moun- 10 female and 9 males among a population of 18,327 tains, in 5 villages, namely Giuliana, Bisacquino, Castro- inhabitants. In this area the centenarian number was novo, Chiusa Scalafani, and Prizzi. 4.32-fold higher than the national average (10.37 vs. 2.4/ 10,000). It is noteworthy that the male centenarian num- Materials and Methods ber was 11.51-fold higher than the national average 19 centenarians (10 females and 9 males) living at home (10.24 vs. 0.89/10,000). Female/male ratio was 1.1:1 in in the five municipalities of Bisacquino, Castronovo, the study area, while the national ratio was 4.54:1. Chiusa Scalafani, Giuliana and Prizzi in the Western part All the centenarians live in a family home, mostly with of Sicily, Italy, were identified for the present study. their relatives. Individual ADL and IADL scores were in These villages are located above sea-level, on the South- the category of moderately independent for both gen- Western edge of the Sicani Mountains. Subjects were ders. A good anamnesis on a single individual reported a individuated by general practitioners and their age poor auditory acuity and poor eyesight, while they were checked in the birth registries. As a further control, in free from cardiac heart disease, severe cognitive impair- the interview, particular attention was paid to the con- ment, severe physical impairment, clinically evident can- cordance between reported age and personal chronolo- cer or renal insufficiency. gies (age of marriage and of military service for men, age In Figure 1, MNA example administrated to healthy of first and last pregnancy for women, age of children, centenarian is shown [13], whereas Figure 2 reports a among others). The subjects underwent a physical exam- typical daily diet. Centenarians recruited in these area ination and a morning fasting blood venous sample was tended to be physically active, non-obese, small in stat- obtained for studying blood chemistry parameters. An- ure, with a regular BMI (23.6 ± 3.1), suggestive of some thropometric measures included height, weight, and the degree of calorie restriction with high intake of seasonal body mass index (BMI) [weight (kg)/height (m2)]. Fur- plant food and low meat intake. Their diet shows a low thermore, the Mini Nutritional Assessment (MNA), glycemic index because low of refined carbohydrate (no Basic Activities of Daily Living (ADL) and the Instru- white bread, low amount of pasta, no sweeteners, sweet mental Activities of Daily Living (IADL) were admini- beverages, can food, frozen already prepared vegetables strated. ADL and IADL were assessed by interviewing or dishes, cookies cakes or snacks). Furthermore, they participants and their caregivers [13,14]. Physical items have a good intake of olive and virgin olive oil from dif- (meal taking, bowel and bladder continence, standing ferent cultivar namely: Nocellara of Belice, Biancolilla, ability, extent of general activities, bathing and dressing Giarraffa and Ogliarola that seems to have important abilities), sensory items (auditory acuity and eyesight) and anti-oxidant properties (unpublished data). In Figure 3, cognitive abilities (comprehension and self-expression) BMI and MNA are plotted together showing a perfect were included in the ADL. Each item was classified into accordance between nutrition and body mass index. five categories of self-sufficiency: completely independent, independent but slow, independent with difficulty, par- Discussion tially dependent and completely dependent, using a point In Italy in 2010 the population aged one hundred years score from 12 to 1, respectively. and over has 14 thousand units, hence the centenarian The study was approved by local University Hospital prevalence is 2.4/10.000. Currently there are almost five Ethics Committee; the purpose and procedures of the centenarian women for one man. However, in Italy there study were explained to the subjects, and informed and is a North to South gradient in the female/male ratio in written consent was obtained from the participants or centenarians [15]. To gain insight into the role of gender caregivers. and environment, we have started a demographic study in Sicily showing that in mountain zones of Sicily there Results is a zone of male longevity with similar features to those Table 1 depicts the prevalence of centenarians in Italy found in Sardinia, in the so-called Blue Zone [11,12,16]. and in the study area; we have identified 19 centenarian, In both cases the municipalities concerned do not Table 1 Distribution of Centenarian population in five villages of Sicani Mountains and in Italy Total Population Males Females Total Centenarians Male Centenarians Female Centenarians Sicani Mountains 18,328 8,793 9,535 19 9 10 (10.37) (10.24) (10.48) Italy 60,626,442 29,413,274 31,213,168 14,473 2,612 11,861 (2.39) (0.89) (3.80) Centenarian prevalence x 10,000 inhabitants between brackets. For data on Italian Centenarians see [15]. Vasto et al. Immunity & Ageing 2012, 9:10 Page 4 of 6 http://www.immunityageing.com/content/9/1/10 One of the places in the Western part of Sicily, charac- terized by a high presence of oldest old people, is the area of “Monti Sicani”, between the provinces of Agrigento and Palermo [11,12]. “Monti Sicani” encompasses the area between the cities of Palermo and Agrigento from North to South and between the city of Caltanissetta and Trapani from West to East. The territory is characterized by a hilly area of clayey sandstone or pasture and a mountain area above 900 m, consists of pelagic limestone rocks of the Mesozoic. This area is characterized by olive tree agriculture, which tolerates a large range of soil con- ditions, preferring a neutral to alkaline soil type. Looking at the national ratio of centenarian per inha- bitants in these area we have found more than a four- fold increase in centenarian, and regarding male female ratio of 1.1:1 times. Since Sicilian population genetics structure is very homogeneous and in Hardy-Weinberg equilibrium [19], the explanation for these data probably resides in the environmental characteristics of the study Figure 2 Example of daily menu. sample. In this area, we have found a high number of cente- narians in good health, with a notable increase of male include polluted areas and are small, with the lowest centenarians. Unequivocally, their nutritional assessment number of inhabitants. Therefore, longevity is more showed a high adherence to the Mediterranean nutri- prevalent in men living in a small town, without pollu- tional profile with low glycemic index food consumed. tion, likely because of different working conditions, dif- According to the scores of ADL and IADL, centenarians ferent life style i.e. reduced smoking and alcohol abuse of both gender demonstrated a good level of indepen- and Mediterranean diet. Accordingly, both these areas in dency. They did not have any cardiac risk factors or Sicily and in Sardinia also share low mortality from can- major age related diseases (e.g. cardiac heart disease, se- cers and cardiovascular diseases [11,16-18]. vere cognitive impairment, severe physical impairment, Legend: MNA=mini nutritional assessment (17-24) BMI= Body mass index (18-24) On x axis, centenarian age On y axis: MNA and BMI Figure 3 Mini nutritional assessment and Body mass index in healthy centenarian population. Vasto et al. Immunity & Ageing 2012, 9:10 Page 5 of 6 http://www.immunityageing.com/content/9/1/10 clinically evident cancer or renal insufficiency), although play a major role in healthy ageing and nutrition has a some had decreased auditory and visual acuity. Their life significant influence. It has been estimated that the is characterized by social networking, acceptable physical number of centenarians will approach 3.2 million world- activity and small amount of food divided among three wide by 2050 and that means an 18-fold increase with meals, which contain a little amount of carbohydrate and respect to the last century [27]. Consequently, under- meat and a lot of seasonal fruit and vegetables. In relation standing the influence of dietary life-style in the process to biochemical parameters in centenarians, most biochem- of healthy ageing is of paramount importance to devel- ical parameters including cholesterol and triglycerides opment new strategies leading to healthy life extension. were within normal limits (data not shown) and better Finally, our results are consistent with data described in than those previously reported in a study of Sicilian elderly Dan Buettner’s book on the importance of the diets in 5 [20]. Furthermore, this reported modified Mediterranean- populations with high longevity [28]. To reach success- style show a low glycemic load. ful ageing it is advisable to follow a diet with low quan- tity of saturated fat and high amount of fruits and The Glycemic index (GI) is defined as a kinetic param- vegetable, rich in phytochemicals. eter that reflects the potency of food to raise blood glu- cose level and glucose clearance. The GI of a specific Competing interests diet is calculated by averaging the GI values of the food The authors declare that they have no competing interests. items, statistically weighted by the carbohydrate contri- Acknowledgements bution. Diets based on refined carbohydrate foods that C.R. is a PhD student of PhD course in Molecular Medicine directed by C.C. are quickly digested, absorbed, and metabolized (i.e., and this paper is submitted in partial fulfillment of requirement for herr PhD high glycemic index diets) have been associated with degree. This work was supported by grants from the Ministry of Education, University and Research ex60% to C.C.- The Authors are deeply indebted increased risk of lifestyle diseases in particular with an with Dr. Marchese for the access to centenarians living in the villages of increased risk of type 2 diabetes, because of postprandial Bisacquino, Chiusa Sclafani and Giuliana and Dr. Pizzolanti for the hyperglycemia and hyperinsulinemia related to eating information on the centenarians living in Castronovo and Prizzi. high-GI carbohydrates. Low GI is known to protect Author details against heart disease in women, and cross-sectional stud- 1 Department of Molecular and Biomolecular Sciences (STEMBIO), University ies indicate low GI may reduce high-density-lipoprotein of Palermo, Via Archifari 32, 90213, Palermo, Italy. Department of Pathobiology and Medical and Forensic Biotechnologies (DIBIMEF), University cholesterol and triacylglycerol levels in both sexes. More of Palermo, Corso Tukory, 211, 90138, Palermo, Italy. Immunohaemathology interesting, new observational studies have reported Unit, University Hospital, University of Palermo, Via del Vespro, 127, 90137, increased risks of coronary heart disease associated with Palermo, Italy. higher intakes of carbohydrates from high glycemic index Authors’ contributions foods. Epidemiological evidence has emerged linking SV wrote the paper. All authors edited the paper and approved its final dietary glycemic index to visceral fat and inflammatory version. disease mortality [21-23]. Therefore, the Mediterranean Received: 13 April 2012 Accepted: 23 April 2012 diet is an anti-inflammatory diet [24]: it is puzzling that Published: 23 April 2012 Italian centenarians are remarkably enriched in “good” References genotypes involved in control of inflammation, confirm- 1. Keys A, Menotti A, Karvonen MJ, Aravanis C, Blackburn H, Buzina R, Djordjevic ing that a good control of inflammatory responses (gen- BS, Dontas AS, Fidanza F, Keys MH, et al: The diet and 15-year death rate in etic and/or environmental) is advantageous for longevity the seven countries study. Am J Epidemiol 1986, 124:903–915. 2. Fidanza F, Alberti A, Lanti M, Menotti A: Mediterranean diet score: [25,26]. correlation with 25-year mortality from coronary heart disease in the Overall, our data confirm our previous suggestion that Seven Countries Study. Nutr Metab Cardiovasc Dis 2004, 14:254–258. longevity concerns subjects, living in small town, without 3. Sacks FM, Obarzanek E, Windhauser MM, Svetkey LP, Vollmer WM, pollution, with different working conditions, lifestyles McCullough M, Karanja N, Lin PH, Steele P, Proschan MA, et al: Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). and close adherence to a Mediterranean diet. The reason A multicenter controlled-feeding study of dietary patterns to lower why longevity has been observed particularly in small mu- blood pressure. Ann Epidemiol 1995, 5:108–118. nicipalities is not surprising. It is a well established, in fact, 4. Berry EM, Arnoni Y, Aviram M: The Middle Eastern and biblical origins of the Mediterranean diet. Public Health Nutr 2011, 14:2288–2295. that individuals with greater access to social support and 5. Tyrovolas S, Panagiotakos DB: The role of Mediterranean type of diet on family network have better health and lower levels of the development of cancer and cardiovascular disease, in the elderly: a mortality, particularly when adult daughters are present. systematic review. Maturitas 2010, 65:122–130. 6. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A: Adherence to Nevertheless, our data are collected in a relative small Mediterranean diet and health status: meta-analysis. BMJ 2008, 337:a1344. sample of subjects; accordingly, our data needed to be 7. Fung TT, Hu FB, Wu K, Chiuve SE, Fuchs CS, Giovannucci E: The confirmed by larger population-based studies. Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets and colorectal cancer. Am J Clin Nutr 2010, 92:1429–1435. To conclude, our work show a segment of our popula- 8. Bulló M, Lamuela-Raventós R, Salas-Salvadó J: Mediterranean diet and tion that is growing faster and represent a typical ex- oxidation: nuts and olive oil as important sources of fat and ample of successful ageing. Genetic and environment antioxidants. Curr Top Med Chem 2011, 11:1797–1810. Vasto et al. Immunity & Ageing 2012, 9:10 Page 6 of 6 http://www.immunityageing.com/content/9/1/10 9. Aguilera CM, Mesa MD, Ramirez-Tortosa MC, Nestares MT, Ros E, Gil A: Sunflower oil does not protect against LDL oxidation as virgin olive oil does in patients with peripheral vascular disease. Clinical Nutrition 2010, 23:673–681. 10. Cicerale S, Conlan XA, Sinclair AJ, Keast RS: Chemistry and health of olive oil phenolics. Crit Rev Food Sci Nutr 2009, 49:218–236. 11. Bürkle A, Caselli G, Franceschi C, Mariani E, Sansoni P, Santoni A, Vecchio G, Witkowski JM, Caruso C: Pathophysiology of ageing, longevity and age related diseases. Immun Ageing 2007, 4:4. 12. Vasto S, Scapagnini G, Rizzo C, Monastero R, Marchese A, Caruso C: Mediterranean diet and longevity: a survey in Sicani mountains population. Rejuvenation research. 2012, 15:184–188. 13. Sancarlo D, D’Onofrio G, Franceschi M, Scarcelli C, Niro V, Addante F, Copetti M, Ferrucci L, Fontana L, Pilotto A: Prognostic Index (m-MPI) including the Mini Nutritional Assessment Short-Form (MNA-SF) for the prediction of one-year mortality in hospitalized elderly patients. J Nutr Health Aging 2011, 15:169–173. 14. Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969, 9:179–186. 15. www.stat.unipd.it/ricerca/fulltext?wp=388 (in Italian) 16. Poulain M, Pes GM, Grasland C, Carru C, Ferrucci L, Baggio G, Franceschi C, Deiana L: Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study. Exp Gerontol 2004, 39:1423–1429. 17. Caselli G, Lipsi RM: Survival differences among the oldest old in Sardinia: who, what, where, and why? DEMOGRAPHIC RESEARCH 2006, 14:267–294. 18. Marchese AG: La quarta età tra umanesimo letterario e Biomedicina. Palma Editrice, Palermo: Indagine sulla longevità dei Monti Sicani; 2011 (in Italian). 19. Piazza A, Olivetti E, Griffo RM, Rendine S, Amoroso A, Barbanti M, Caruso C, Conighi C, Conte R, Favoino B, et al: The distribution of HLA antigens in Italy. Gene Geogr 1989, 3:141–164. 20. Lio D, Malaguarnera M, Maugeri D, Ferlito L, Bennati E, Scola L, Motta M, Caruso C: Laboratory parameters in centenarians of Italian ancestry. Exp Gerontol 2008, 43:119–122. 21. McGeoch SC, Holtrop G, Fyfe C, Lobley GE, Pearson DW, Abraham P, Megson IL, Macrury SM, Johnstone AM: Food intake and dietary glycaemic index in free-living adults with and without type 2 diabetes mellitus. Nutrients 2011, 3:683–693. 22. Brand-Miller J, Buyken AE: The glycemic index issue. Curr Opin Lipidol 2012, 23:62–67. 23. Hare-Bruun H, Nielsen BM, Grau K, Oxlund AL, Heitmann BL: Should glycemic index and glycemic load be considered in dietary recommendations? Nutr Rev 2008, 66:569–590. 24. Lucas L, Russell A, Keast R: Molecular mechanisms of inflammation. Anti- inflammatory benefits of virgin olive oil and the phenolic compound oleocanthal. Curr Pharm Des 2011, 17:754–768. 25. Candore G, Caruso C, Colonna-Romano G: Inflammation, genetic background and longevity. Biogerontology 2010, 11:565–573. 26. Vasto S, Candore G, Balistreri CR, Caruso M, Colonna-Romano G, Grimaldi MP, Listi F, Nuzzo D, Lio D, Caruso C: Inflammatory networks in ageing, age-related diseases and longevity. Mech Ageing Dev 2007, 128:83–91. 27. www.un.org/spanish/esa/population/wpp2000h.pdf 28. Buettner D: The Blue Zone: Lessons for living longer from the people who’ve lived the longest. Washington, DC: National Geographic Society; 2008. doi:10.1186/1742-4933-9-10 Cite this article as: Vasto et al.: Centenarians and diet: what they eat in the Western part of Sicily. Immunity & Ageing 2012 9:10. Submit your next manuscript to BioMed Central and take full advantage of: • Convenient online submission • Thorough peer review • No space constraints or color figure charges • Immediate publication on acceptance • Inclusion in PubMed, CAS, Scopus and Google Scholar • Research which is freely available for redistribution Submit your manuscript at www.biomedcentral.com/submit http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Immunity & Ageing Springer Journals

Centenarians and diet: what they eat in the Western part of Sicily

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Springer Journals
Copyright
Copyright © 2012 by Vasto et al.; licensee BioMed Central Ltd.
Subject
Biomedicine; Immunology; Geriatrics/Gerontology; Aging
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1742-4933
DOI
10.1186/1742-4933-9-10
pmid
22524271
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Abstract

This paper pays attention to the modifiable lifestyle factors such as diet and nutrition that might influence life extension and successful ageing. Previous data reported that in Sicily, the biggest Mediterranean island, there are some places where there is a high frequency of male centenarians with respect to the Italian average. The present data show that in Sicani Mountain zone there are more centenarians with respect to the Italian average. In fact, in five villages of Sicani Mountains, there were 19 people with an age range of 100–107 years old from a total population of 18,328 inhabitants. So, the centenarian number was 4.32-fold higher than the national average (10.37 vs. 2.4/10,000); the female/male ratio was 1.1:1 in the study area, while the national ratio is 4.54:1. Unequivocally, their nutritional assessment showed a high adherence to the Mediterranean nutritional profile with low glycemic index food consumed. To reach successful ageing it is advisable to follow a diet with low quantity of saturated fat and high amount of fruits and vegetables rich in phytochemicals. Keywords: Ageing, Centenarian, Longevity, Mediterranean diet Introduction showing protective effect on health and longevity [5-7]. The Mediterranean diet has been widely recommended Mediterranean diet is characterized by a high intake of for a healthy lifestyle since Ancel Keys first used the term monounsaturated fat, plant proteins, whole grains (fish is in 1975 [1]. The essential concept is that this is not a set not always present), moderate intake of alcohol, and low of changes to our usual diet dictated by scientific experi- consumption of red meat, refined grains, and sweets. Fur- ments, but a set of food habits and recipes traditionally ther, the consumption of large amount of olive oil and enjoyed by the ordinary people of Mediterranean coun- olives in meals dominates all the Mediterranean cuisine [8]. tries, who have been found to have lower rates of coron- Historically, the beneficial properties of virgin olive oil ary and other age-related chronic diseases, including were attributed to the high proportion of monounsatu- cancer, than most developed countries [2,3]. rated fatty acids (MUFAs), namely oleic acid, rather than In recent years, researchers have been extremely inter- to the phenolic fraction. Nevertheless, several seed oils, ested in the clear advantage of the Mediterranean nutri- including sunflower, soybean, and rapeseed, rich in tional recommendation that exists and is used in the MUFA have been demonstrated to be ineffective in bene- Mediterranean surrounding area. In fact, there is no sin- ficially altering chronic disease risk factors. Therefore, it gle Mediterranean diet but several interpretations based is likely that the polyphenols in olive oil may mediate on the Mediterranean country’s political, economic and these health benefits [8,9]. cultural tradition [4]. There are at least thirty-six structurally distinct pheno- Since 1990, increasing evidence suggests that these lics that have been identified in virgin olive oil, but not diets have a beneficial influence on several diseases such all phenolic compounds and their concentration are as cardiovascular diseases, metabolic syndromes, hence present in every virgin olive oil. Such differences in the phenolic compound are dependent on several factors like * Correspondence: [email protected] the variety of the olive fruit, the region in which the olive Department of Molecular and Biomolecular Sciences (STEMBIO), fruit is grown, the agricultural techniques used, the ma- University of Palermo, Via Archifari 32, 90213, Palermo, Italy 3 turity of the olive fruit at harvest, the extraction process Immunohaemathology Unit, University Hospital, University of Palermo, Via del Vespro, 127, 90137, Palermo, Italy and the storage method [10]. Full list of author information is available at the end of the article © 2012 Vasto et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Vasto et al. Immunity & Ageing 2012, 9:10 Page 2 of 6 http://www.immunityageing.com/content/9/1/10 The Sicanian Mountains (or Sicani), bordered by a very peculiar area where there is a high frequency of Ficuzza wood in the North, Caltanissetta in the East, centenarians with respect to the Italian average [11,12]. Salemi in the West and Agrigento to the South represent The goal of this study was to characterize the dietary Figure 1 Example of MNA administered to healthy centenarians. Vasto et al. Immunity & Ageing 2012, 9:10 Page 3 of 6 http://www.immunityageing.com/content/9/1/10 habits of centenarians residing around the Sicani moun- 10 female and 9 males among a population of 18,327 tains, in 5 villages, namely Giuliana, Bisacquino, Castro- inhabitants. In this area the centenarian number was novo, Chiusa Scalafani, and Prizzi. 4.32-fold higher than the national average (10.37 vs. 2.4/ 10,000). It is noteworthy that the male centenarian num- Materials and Methods ber was 11.51-fold higher than the national average 19 centenarians (10 females and 9 males) living at home (10.24 vs. 0.89/10,000). Female/male ratio was 1.1:1 in in the five municipalities of Bisacquino, Castronovo, the study area, while the national ratio was 4.54:1. Chiusa Scalafani, Giuliana and Prizzi in the Western part All the centenarians live in a family home, mostly with of Sicily, Italy, were identified for the present study. their relatives. Individual ADL and IADL scores were in These villages are located above sea-level, on the South- the category of moderately independent for both gen- Western edge of the Sicani Mountains. Subjects were ders. A good anamnesis on a single individual reported a individuated by general practitioners and their age poor auditory acuity and poor eyesight, while they were checked in the birth registries. As a further control, in free from cardiac heart disease, severe cognitive impair- the interview, particular attention was paid to the con- ment, severe physical impairment, clinically evident can- cordance between reported age and personal chronolo- cer or renal insufficiency. gies (age of marriage and of military service for men, age In Figure 1, MNA example administrated to healthy of first and last pregnancy for women, age of children, centenarian is shown [13], whereas Figure 2 reports a among others). The subjects underwent a physical exam- typical daily diet. Centenarians recruited in these area ination and a morning fasting blood venous sample was tended to be physically active, non-obese, small in stat- obtained for studying blood chemistry parameters. An- ure, with a regular BMI (23.6 ± 3.1), suggestive of some thropometric measures included height, weight, and the degree of calorie restriction with high intake of seasonal body mass index (BMI) [weight (kg)/height (m2)]. Fur- plant food and low meat intake. Their diet shows a low thermore, the Mini Nutritional Assessment (MNA), glycemic index because low of refined carbohydrate (no Basic Activities of Daily Living (ADL) and the Instru- white bread, low amount of pasta, no sweeteners, sweet mental Activities of Daily Living (IADL) were admini- beverages, can food, frozen already prepared vegetables strated. ADL and IADL were assessed by interviewing or dishes, cookies cakes or snacks). Furthermore, they participants and their caregivers [13,14]. Physical items have a good intake of olive and virgin olive oil from dif- (meal taking, bowel and bladder continence, standing ferent cultivar namely: Nocellara of Belice, Biancolilla, ability, extent of general activities, bathing and dressing Giarraffa and Ogliarola that seems to have important abilities), sensory items (auditory acuity and eyesight) and anti-oxidant properties (unpublished data). In Figure 3, cognitive abilities (comprehension and self-expression) BMI and MNA are plotted together showing a perfect were included in the ADL. Each item was classified into accordance between nutrition and body mass index. five categories of self-sufficiency: completely independent, independent but slow, independent with difficulty, par- Discussion tially dependent and completely dependent, using a point In Italy in 2010 the population aged one hundred years score from 12 to 1, respectively. and over has 14 thousand units, hence the centenarian The study was approved by local University Hospital prevalence is 2.4/10.000. Currently there are almost five Ethics Committee; the purpose and procedures of the centenarian women for one man. However, in Italy there study were explained to the subjects, and informed and is a North to South gradient in the female/male ratio in written consent was obtained from the participants or centenarians [15]. To gain insight into the role of gender caregivers. and environment, we have started a demographic study in Sicily showing that in mountain zones of Sicily there Results is a zone of male longevity with similar features to those Table 1 depicts the prevalence of centenarians in Italy found in Sardinia, in the so-called Blue Zone [11,12,16]. and in the study area; we have identified 19 centenarian, In both cases the municipalities concerned do not Table 1 Distribution of Centenarian population in five villages of Sicani Mountains and in Italy Total Population Males Females Total Centenarians Male Centenarians Female Centenarians Sicani Mountains 18,328 8,793 9,535 19 9 10 (10.37) (10.24) (10.48) Italy 60,626,442 29,413,274 31,213,168 14,473 2,612 11,861 (2.39) (0.89) (3.80) Centenarian prevalence x 10,000 inhabitants between brackets. For data on Italian Centenarians see [15]. Vasto et al. Immunity & Ageing 2012, 9:10 Page 4 of 6 http://www.immunityageing.com/content/9/1/10 One of the places in the Western part of Sicily, charac- terized by a high presence of oldest old people, is the area of “Monti Sicani”, between the provinces of Agrigento and Palermo [11,12]. “Monti Sicani” encompasses the area between the cities of Palermo and Agrigento from North to South and between the city of Caltanissetta and Trapani from West to East. The territory is characterized by a hilly area of clayey sandstone or pasture and a mountain area above 900 m, consists of pelagic limestone rocks of the Mesozoic. This area is characterized by olive tree agriculture, which tolerates a large range of soil con- ditions, preferring a neutral to alkaline soil type. Looking at the national ratio of centenarian per inha- bitants in these area we have found more than a four- fold increase in centenarian, and regarding male female ratio of 1.1:1 times. Since Sicilian population genetics structure is very homogeneous and in Hardy-Weinberg equilibrium [19], the explanation for these data probably resides in the environmental characteristics of the study Figure 2 Example of daily menu. sample. In this area, we have found a high number of cente- narians in good health, with a notable increase of male include polluted areas and are small, with the lowest centenarians. Unequivocally, their nutritional assessment number of inhabitants. Therefore, longevity is more showed a high adherence to the Mediterranean nutri- prevalent in men living in a small town, without pollu- tional profile with low glycemic index food consumed. tion, likely because of different working conditions, dif- According to the scores of ADL and IADL, centenarians ferent life style i.e. reduced smoking and alcohol abuse of both gender demonstrated a good level of indepen- and Mediterranean diet. Accordingly, both these areas in dency. They did not have any cardiac risk factors or Sicily and in Sardinia also share low mortality from can- major age related diseases (e.g. cardiac heart disease, se- cers and cardiovascular diseases [11,16-18]. vere cognitive impairment, severe physical impairment, Legend: MNA=mini nutritional assessment (17-24) BMI= Body mass index (18-24) On x axis, centenarian age On y axis: MNA and BMI Figure 3 Mini nutritional assessment and Body mass index in healthy centenarian population. Vasto et al. Immunity & Ageing 2012, 9:10 Page 5 of 6 http://www.immunityageing.com/content/9/1/10 clinically evident cancer or renal insufficiency), although play a major role in healthy ageing and nutrition has a some had decreased auditory and visual acuity. Their life significant influence. It has been estimated that the is characterized by social networking, acceptable physical number of centenarians will approach 3.2 million world- activity and small amount of food divided among three wide by 2050 and that means an 18-fold increase with meals, which contain a little amount of carbohydrate and respect to the last century [27]. Consequently, under- meat and a lot of seasonal fruit and vegetables. In relation standing the influence of dietary life-style in the process to biochemical parameters in centenarians, most biochem- of healthy ageing is of paramount importance to devel- ical parameters including cholesterol and triglycerides opment new strategies leading to healthy life extension. were within normal limits (data not shown) and better Finally, our results are consistent with data described in than those previously reported in a study of Sicilian elderly Dan Buettner’s book on the importance of the diets in 5 [20]. Furthermore, this reported modified Mediterranean- populations with high longevity [28]. To reach success- style show a low glycemic load. ful ageing it is advisable to follow a diet with low quan- tity of saturated fat and high amount of fruits and The Glycemic index (GI) is defined as a kinetic param- vegetable, rich in phytochemicals. eter that reflects the potency of food to raise blood glu- cose level and glucose clearance. The GI of a specific Competing interests diet is calculated by averaging the GI values of the food The authors declare that they have no competing interests. items, statistically weighted by the carbohydrate contri- Acknowledgements bution. Diets based on refined carbohydrate foods that C.R. is a PhD student of PhD course in Molecular Medicine directed by C.C. are quickly digested, absorbed, and metabolized (i.e., and this paper is submitted in partial fulfillment of requirement for herr PhD high glycemic index diets) have been associated with degree. This work was supported by grants from the Ministry of Education, University and Research ex60% to C.C.- The Authors are deeply indebted increased risk of lifestyle diseases in particular with an with Dr. Marchese for the access to centenarians living in the villages of increased risk of type 2 diabetes, because of postprandial Bisacquino, Chiusa Sclafani and Giuliana and Dr. Pizzolanti for the hyperglycemia and hyperinsulinemia related to eating information on the centenarians living in Castronovo and Prizzi. high-GI carbohydrates. Low GI is known to protect Author details against heart disease in women, and cross-sectional stud- 1 Department of Molecular and Biomolecular Sciences (STEMBIO), University ies indicate low GI may reduce high-density-lipoprotein of Palermo, Via Archifari 32, 90213, Palermo, Italy. Department of Pathobiology and Medical and Forensic Biotechnologies (DIBIMEF), University cholesterol and triacylglycerol levels in both sexes. More of Palermo, Corso Tukory, 211, 90138, Palermo, Italy. Immunohaemathology interesting, new observational studies have reported Unit, University Hospital, University of Palermo, Via del Vespro, 127, 90137, increased risks of coronary heart disease associated with Palermo, Italy. higher intakes of carbohydrates from high glycemic index Authors’ contributions foods. Epidemiological evidence has emerged linking SV wrote the paper. All authors edited the paper and approved its final dietary glycemic index to visceral fat and inflammatory version. disease mortality [21-23]. Therefore, the Mediterranean Received: 13 April 2012 Accepted: 23 April 2012 diet is an anti-inflammatory diet [24]: it is puzzling that Published: 23 April 2012 Italian centenarians are remarkably enriched in “good” References genotypes involved in control of inflammation, confirm- 1. Keys A, Menotti A, Karvonen MJ, Aravanis C, Blackburn H, Buzina R, Djordjevic ing that a good control of inflammatory responses (gen- BS, Dontas AS, Fidanza F, Keys MH, et al: The diet and 15-year death rate in etic and/or environmental) is advantageous for longevity the seven countries study. Am J Epidemiol 1986, 124:903–915. 2. Fidanza F, Alberti A, Lanti M, Menotti A: Mediterranean diet score: [25,26]. correlation with 25-year mortality from coronary heart disease in the Overall, our data confirm our previous suggestion that Seven Countries Study. Nutr Metab Cardiovasc Dis 2004, 14:254–258. longevity concerns subjects, living in small town, without 3. Sacks FM, Obarzanek E, Windhauser MM, Svetkey LP, Vollmer WM, pollution, with different working conditions, lifestyles McCullough M, Karanja N, Lin PH, Steele P, Proschan MA, et al: Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). and close adherence to a Mediterranean diet. The reason A multicenter controlled-feeding study of dietary patterns to lower why longevity has been observed particularly in small mu- blood pressure. Ann Epidemiol 1995, 5:108–118. nicipalities is not surprising. It is a well established, in fact, 4. Berry EM, Arnoni Y, Aviram M: The Middle Eastern and biblical origins of the Mediterranean diet. Public Health Nutr 2011, 14:2288–2295. that individuals with greater access to social support and 5. Tyrovolas S, Panagiotakos DB: The role of Mediterranean type of diet on family network have better health and lower levels of the development of cancer and cardiovascular disease, in the elderly: a mortality, particularly when adult daughters are present. systematic review. Maturitas 2010, 65:122–130. 6. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A: Adherence to Nevertheless, our data are collected in a relative small Mediterranean diet and health status: meta-analysis. BMJ 2008, 337:a1344. sample of subjects; accordingly, our data needed to be 7. Fung TT, Hu FB, Wu K, Chiuve SE, Fuchs CS, Giovannucci E: The confirmed by larger population-based studies. Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets and colorectal cancer. Am J Clin Nutr 2010, 92:1429–1435. To conclude, our work show a segment of our popula- 8. Bulló M, Lamuela-Raventós R, Salas-Salvadó J: Mediterranean diet and tion that is growing faster and represent a typical ex- oxidation: nuts and olive oil as important sources of fat and ample of successful ageing. Genetic and environment antioxidants. Curr Top Med Chem 2011, 11:1797–1810. Vasto et al. Immunity & Ageing 2012, 9:10 Page 6 of 6 http://www.immunityageing.com/content/9/1/10 9. Aguilera CM, Mesa MD, Ramirez-Tortosa MC, Nestares MT, Ros E, Gil A: Sunflower oil does not protect against LDL oxidation as virgin olive oil does in patients with peripheral vascular disease. Clinical Nutrition 2010, 23:673–681. 10. Cicerale S, Conlan XA, Sinclair AJ, Keast RS: Chemistry and health of olive oil phenolics. Crit Rev Food Sci Nutr 2009, 49:218–236. 11. Bürkle A, Caselli G, Franceschi C, Mariani E, Sansoni P, Santoni A, Vecchio G, Witkowski JM, Caruso C: Pathophysiology of ageing, longevity and age related diseases. Immun Ageing 2007, 4:4. 12. Vasto S, Scapagnini G, Rizzo C, Monastero R, Marchese A, Caruso C: Mediterranean diet and longevity: a survey in Sicani mountains population. Rejuvenation research. 2012, 15:184–188. 13. Sancarlo D, D’Onofrio G, Franceschi M, Scarcelli C, Niro V, Addante F, Copetti M, Ferrucci L, Fontana L, Pilotto A: Prognostic Index (m-MPI) including the Mini Nutritional Assessment Short-Form (MNA-SF) for the prediction of one-year mortality in hospitalized elderly patients. J Nutr Health Aging 2011, 15:169–173. 14. Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969, 9:179–186. 15. www.stat.unipd.it/ricerca/fulltext?wp=388 (in Italian) 16. Poulain M, Pes GM, Grasland C, Carru C, Ferrucci L, Baggio G, Franceschi C, Deiana L: Identification of a geographic area characterized by extreme longevity in the Sardinia island: the AKEA study. Exp Gerontol 2004, 39:1423–1429. 17. Caselli G, Lipsi RM: Survival differences among the oldest old in Sardinia: who, what, where, and why? DEMOGRAPHIC RESEARCH 2006, 14:267–294. 18. Marchese AG: La quarta età tra umanesimo letterario e Biomedicina. Palma Editrice, Palermo: Indagine sulla longevità dei Monti Sicani; 2011 (in Italian). 19. Piazza A, Olivetti E, Griffo RM, Rendine S, Amoroso A, Barbanti M, Caruso C, Conighi C, Conte R, Favoino B, et al: The distribution of HLA antigens in Italy. Gene Geogr 1989, 3:141–164. 20. Lio D, Malaguarnera M, Maugeri D, Ferlito L, Bennati E, Scola L, Motta M, Caruso C: Laboratory parameters in centenarians of Italian ancestry. Exp Gerontol 2008, 43:119–122. 21. McGeoch SC, Holtrop G, Fyfe C, Lobley GE, Pearson DW, Abraham P, Megson IL, Macrury SM, Johnstone AM: Food intake and dietary glycaemic index in free-living adults with and without type 2 diabetes mellitus. Nutrients 2011, 3:683–693. 22. Brand-Miller J, Buyken AE: The glycemic index issue. Curr Opin Lipidol 2012, 23:62–67. 23. Hare-Bruun H, Nielsen BM, Grau K, Oxlund AL, Heitmann BL: Should glycemic index and glycemic load be considered in dietary recommendations? Nutr Rev 2008, 66:569–590. 24. Lucas L, Russell A, Keast R: Molecular mechanisms of inflammation. Anti- inflammatory benefits of virgin olive oil and the phenolic compound oleocanthal. Curr Pharm Des 2011, 17:754–768. 25. Candore G, Caruso C, Colonna-Romano G: Inflammation, genetic background and longevity. Biogerontology 2010, 11:565–573. 26. Vasto S, Candore G, Balistreri CR, Caruso M, Colonna-Romano G, Grimaldi MP, Listi F, Nuzzo D, Lio D, Caruso C: Inflammatory networks in ageing, age-related diseases and longevity. Mech Ageing Dev 2007, 128:83–91. 27. www.un.org/spanish/esa/population/wpp2000h.pdf 28. Buettner D: The Blue Zone: Lessons for living longer from the people who’ve lived the longest. Washington, DC: National Geographic Society; 2008. doi:10.1186/1742-4933-9-10 Cite this article as: Vasto et al.: Centenarians and diet: what they eat in the Western part of Sicily. Immunity & Ageing 2012 9:10. Submit your next manuscript to BioMed Central and take full advantage of: • Convenient online submission • Thorough peer review • No space constraints or color figure charges • Immediate publication on acceptance • Inclusion in PubMed, CAS, Scopus and Google Scholar • Research which is freely available for redistribution Submit your manuscript at www.biomedcentral.com/submit

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Immunity & AgeingSpringer Journals

Published: Apr 23, 2012

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