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The MEDiterranean Islands Epidemiological Study

Acronym: MEDIS

Study’s Supervisor(s): Assoc. Prof. Demosthenes Panagiotakos, DrMed Assoc. Prof. Evangelos Polychronopoulos, MD, PhD

Coordinating Center: Harokopio University, Athens, Greece

Start date: 15th June 2005

Study’s Principal Investigators (PI): A. Zeimbekis, MD (Lesvos), V. Bountziouka, RD, MSc, Phd (Samothraki, Siros & Naxos) Prof C. Lionis, MD, PhD (Crete), G Metallinos, MD (Corfu), S. Tyrovolas, RD, MSc, PhD (Zakynthos), Assoc Prof A. Matala, PhD (Ikaria), Prof S. Piscopo, PhD (Malta Republic) Prof J.A. Mari Tur, PhD (Mallorca, Minorca islands, Spain)

Study’s field investigators: M. Tornaritis, A. Polystipioti, N. Papairakleous, M. Economou, (Cyprus Republic), A. Zeimbekis, K. Gelastopoulou, I. Vlachou (Lesvos), V. Bountziouka (Samothraki) F. Anastasiou, I. Tsiligianni, M. Antonopoulou, N. Tsakountakis, K. Makri, C. Lionis (Crete), E. Niforatou, V. Alpentzou, M. Voutsadaki, M. Galiatsatos (Cephalonia), K. Voutsa, E. Lioliou, M. Miheli (Corfu), A. Katsarou, G. Pounis, S. Tyrovolas, E. Papavenetiou, E. Apostolidou, G. Papavassiliou, P. Stravopodis (Zakynthos), S. Tyrovolas, E. Tourloukis, V. Bountziouka, A. Aggelopoulou, K. Kaldaridou, E. Qira, (Siros & Naxos), A. Matala (Ikaria), S. Piscopo (Malta Republic), I. Protopappa (Ikaria).

Funding: The Study was partially funded by Research grants from the Hellenic Heart Foundation and the Harokopio University.

The aim of the MEDIS study was to evaluate the relationships between socio-demographic, clinical, lifestyle (activities and dietary habits) and psychological characteristics and the presence of various cardiovascular disease risk factors, among elderly individuals without history of chronic disease, living in Mediterranean Islands. Methodology Design Cross sectional epidemiological study. Participants The MEDIS (MEDiterranean ISlands) study is a health and nutrition survey which aimed to evaluate bio-clinical, lifestyle, behavioral and dietary characteristics of elderly people living in Mediterranean islands. A random, population-based, multistage sampling method with 3 age groups (65-75, 75-85, >85) and 2 gender levels was used to select men (75 ± 7 yr) and women (74 ± 7 yr), from the Republic of Cyprus, the Republic of Malta, Mallorca, Minorca (Spain) and the islands of Lesvos, Samothraki, Cephalonia, Crete, Corfu, Lemnos, Zakynthos, Siros, Naxos, Ikaria in Greece. Individuals residing in assisted-living centers, as well as those with a clinical history of CVD or cancer were not included in the survey. The target sample size was 300 people from Cyprus, 350 from Mallorca & Minorca (Spain), 250 from Malta and 150 from each of the other Greek islands. Of the people initially selected, 876 men and 936 women (n = 1812) agreed to participate (Cyprus, n = 300; Malta n=250; Lesvos, n = 142; Samothraki, n = 100; Cephalonia, n = 115; Crete, n = 131; Corfu, n = 149; Lemnos n = 150; Zakynthos, n = 103; Siros, n = 150; Naxos, n = 145; Ikaria n= 76). 699 (31%) of these participants were living in rural areas on the islands. The participation rate varied according to island, from 51% to 100%. A group of health scientists (i.e. physicians, dietitians and nurses) with experience in field investigation collected all the required information, using a quantitative questionnaire and standard procedures. Ethics The collected data were confidential and the study followed the ethical considerations provided by the World Medical Association (52nd WMA General Assembly, Edinburgh, Scotland, October 2000). The Harokopio Institutional Review Board approved the design, procedures and aims of the study (16/19-12-2006). Moreover, the IRB of the University of Malta also approved the study. Before the interviews, participants were informed about the aims and procedures of the study and gave their consent.