The Mediterranean diet is characterised by a high intake of vegetables, legumes, fruits, and cereals; a moderate to high intake of fish; a low intake of saturated fats, but high intake of unsaturated fats, particularly olive oil; a low intake of dairy products and meat; and a modest intake of alcohol, mostly as wine.

Current evidence suggests that such a diet may be beneficial to health.

The study involved over 74,000 healthy men and women, aged 60 or more, living in nine European countries. Information on diet, lifestyle, medical history, smoking, physical activity levels, and other relevant factors was recorded. Adherence to a modified Mediterranean diet was measured using a recognised scoring scale.

A higher dietary score was associated with a lower overall death rate. A two point increase corresponded to an 8% reduction in mortality, while a three or four point increase was associated with a reduction of total mortality by 11% or 14% respectively.

So, for example, a healthy man aged 60 who adheres well to the diet (dietary score of 6-9) can expect to live about one year longer than a man of the same age who does not adhere to the diet.

The association was strongest in Greece and Spain, probably because people in these countries follow a genuinely Mediterranean diet, say the authors.

Adherence to a Mediterranean type diet, which relies on plant foods and unsaturated fats, is associated with a significantly longer life expectancy, and may be particularly appropriate for elderly people, who represent a rapidly increasing group in Europe, they conclude.

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According to Rebecca Foster, a nutrition scientist at the British Nutrition Foundation, diets in the UK were nothing like as healthy as those followed by many European counterparts. She says that although dietary surveys show that Brits are eating fewer calories, less total fat and are reducing salt intake, they are still not meeting the UK dietary guidelines, which are in line with the characteristics of the Mediterranean diet. Mediterranean countries such as Spain and Greece eat a lot more fruit and vegetables and less saturated fat. But Foster says the study findings could in part be down to genetic factors, rather than simply diet alone.

Dietary studies are often hard to carry out as it is difficult to define which constituent of the diet provides the most benefit, says Belinda Linden, of the British Heart Foundation, but that should not stop them trying, as large and in-depth dietary studies such as these contribute to a greater understanding of the way different diets affect health, and adds detailed evidence to previous findings confirming that this type of diet, can be linked with prolonged life.

Linden says however that diet is only one part of the lifestyle change needed to reduce coronary heart disease and we must also aim to increase our activity levels, control our weight and stop smoking.

The study is published in the British Medical Journal.