Predictors of cardiovascular disease mortality in the Melbourne Collaborative Cohort Study

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The Melbourne Collaborative Cohort Study was set up in the early 1990s to investigate prospectively the role of diet and other lifestyle factors in causing common chronic diseases including common cancers and cardiovascular disease. Between 1990 and 1994, 41,500 people, aged 40-69 were recruited into the MCCS. About 30% of the cohort are southern European migrants to Australia who were deliberately over-sampled to extend the range of dietary and lifestyle exposures. Migrants from southern Europe have an adverse risk factor profile in relation to obesity, body fat distribution, physical activity patterns, diabetes, smoking, blood pressure and cholesterol levels, yet their death rates from heart disease are 30-40% lower than the Australian average. A major objective of this study is to investigate the possibility that particular aspects of the diet and cuisine of migrants from southern Europe (olive oil as the major dietary fat, and high intakes of a variety of vegetables and fruit) protect against heart disease and stroke by providing high levels of a wide range of natural antioxidants. It represents the most comprehensive prospective study of diet and cardiovascular disease mortality ever conducted in Australia. A particularly powerful feature is the combination of detailed self-reported dietary intake, the very wide range of exposures to dietary factors implicated in CVD (as risk factors or protective agents), and the objective markers of dietary intake (biochemical markers of dietary intake patterns in blood collected at recruitment, body weight, body fat and body fat distribution). The data should provide a strong rationale for specific dietary recommendations as part of population-based strategies to reduce the incidence of premature mortality from heart disease and stroke in the Australian population.