Elderly Greek-born Australians (GA) consistently show lower rates of all-cause and CVD mortality compared with Australian-born. Paradoxically, however, this is in spite of a higher prevalence of CVD risk factors. This paper reviews the findings from the Food Habits in Later Life (FHILL) study, other studies on Greek migrants to Australia and clinical studies investigating dietary mechanisms which may explain the "morbidity mortality paradox". The FHILL study collected data between 1988 and 1991 on diet, health and psycho-social variables on 818 people aged 70 and over from Sweden, Greece, Australia (Greeks and Anglo-Celts), Japan and were followed up for 5-7 years to determine survival status. The FHILL study was the first to develop a score which captured the key features of a traditional plant-based Mediterranean diet pattern (MDPS). A higher score improved overall survival in both Greek and non-Greek elderly reducing the risk of death by 50% after 5-7 years. Of the 5 cohorts studied, elderly GA had the lowest risk of death, even though they had the highest rates of obesity and other CVD risk factors (developed in the early years of migration with the introduction of energy dense foods). GA appeared to be "getting away" with these CVD risk factors because of their continued adherence in old age to a Mediterranean diet, especially legumes. We propose that the Mediterranean diet may, in part, be operating to reduce the risk of death and attenuate established CVD risk factors in GA by beneficially altering the gut microbiome and its metabolites.
与澳大利亚出生的老年人相比，希腊出生的澳大利亚老人全死因死亡率和心血 管疾病死亡率一直都较低，然而，这与其心血管疾病风险因子的高发率相矛 盾。本文综述了希腊人移民到澳大利亚后生活饮食习惯对后期生命的研究，其 研究结果可能能够用膳食机制解释临床研究的“发病率死亡率悖论”。本课题收 集了1988-1991 年之间关于生活饮食习惯对后期生命的研究，包括来自瑞典、 希腊、澳大利亚（希腊人和盎格鲁- 凯尔特人）、日本的818 名70 岁及其以上 老人饮食、健康和社会心理等参数资料，随访5-7 年以确定其生存状态。该研 究首次形成以得分来获得以传统植物为基础的地中海膳食模式的主要特征。较 高的得分能够提高希腊老人和非希腊老人总的生存率，并使其5-7 年后的死亡 风险降低50%。5 个队列研究中，希腊出生的澳大利亚老人死亡风险最低，尽 管他们的肥胖和其它心血管疾病风险因子的发生率最高（在移民早期因高能量 密度食物的摄入而形成的）。希腊出生的澳大利亚人似乎“摆脱了”心血管疾病 风险因子，因为他们在年老时仍然坚持地中海膳食，尤其是豆类。我们认为地 中海膳食可能能够通过改变希腊出生的澳大利亚人的肠道微生物及其代谢产 物，部分降低其死亡风险并减弱已确定的心血管疾病风险因子。