Objective: To investigate whether the socio-economic status (SES) of elderly eastern Mediterranean islanders is associated with their dietary habits, particularly with adherence to the traditional Mediterranean diet. Design: Cross-sectional. Setting: Adherence to the Mediterranean diet was measured by the MedDietScore (range: 0-55), whereas SES was estimated using education and financial status. Subjects: During 2005-2007, 300 men and women from Cyprus, 100 from Samothraki, 142 from Mitilini, 114 from Kefalonia, 131 from Crete, 150 from Lemnos, 150 from Corfu and 103 from Zakynthos (aged 65-100 years), free of known chronic diseases, participated in the survey. Results: Multiple linear regression analysis revealed that belonging to the highest SES was associated with a higher MedDietScore (P , 0?01), after adjusting for potential sociodemographic, lifestyle, dietary and clinical confounders. A significant positive association was also found between MedDietScore and years of school (P 5 0?004), as well as financial status (P 5 0?001). Conclusions: Older Greek people of higher SES seem to follow a relatively healthier diet. Both education and income seem to play a role in this issue. Thus, public health policy makers should focus on people with low SES in order to improve their quality of diet and, consequently, their health status.

Aim: To evaluate validity of the Greek version of a global measure of perceived stress PSS−14 (Perceived Stress Scale-14 item). Materials and Methods: The original PSS−14 (theoretical range 0−56) was translated into Greek and then back-translated. One hundred men and women (39±10 years old, 40 men) participated in the validation process. Firstly, participants completed the Greek PSS−14 and, then they were interviewed by a psychologist specializing in stress management. Cronbach's alpha (α) evaluated internal consistency of the measurement, whereas Kendall's tau-b and Bland & Altman methods assessed consistency with the clinical evaluation. Exploratory and Confirmatory Factor analyses were conducted to reveal hidden factors within the data and to confirm the two-dimensional character of the scale. Results: Mean (SD) PSS−14 score was 25(7.9). Strong internal consistency (Cronbach's α = 0.847) as well as moderate-to-good concordance between clinical assessment and PSS−14 (Kendall's tau-b = 0.43, p<0.01) were observed. Two factors were extracted. Factor one explained 34.7% of variability and was heavily laden by positive items, and factor two that explained 10.6% of the variability by negative items. Confirmatory factor analysis revealed that the model with 2 factors had chi-square equal to 241.23 (p<0.001), absolute fix indexes were good (i.e. GFI=0.733, AGFI=0.529), and incremental fix indexes were also adequate (i.e. NFI=0.89 and CFI=0.92). Conclusion: The developed Greek version of PSS−14 seems to be a valid instrument for the assessment of perceived stress in the Greek adult population living in urban areas; a finding that supports its local use in research settings as an evaluation tool measuring perceived stress, mainly as a risk factor but without diagnostic properties.

Background: Hypercholesterolemia is one of the most important factors causing cardiovascular disease (CVD). The aim of the present work was to evaluate the relationships between socio-demographic, clinical, lifestyle and depression status and the presence of hypercholesterolemia, among elderly individuals without known CVD.

Apart from traditional risk factors, psychosocial characteristics are increasingly considered as potential predictors of cardiovascular disease (CVD). The concept of stress is relevant when discussing the relationship between psychosocial factors and CVD. Among stress types and definitions (ie, marital stress, work stress), "perceived stress" presents a global and comprehensive stress construct and is based on the concept that individuals actively interact with their environment, appraising potentially threatening or challenging events in the light of available coping resources. However, the role of perceived stress in CVD incidence has not yet been completely elucidated. Thus, we evaluate perceived stress as a CVD risk factor by reviewing the literature. We also discuss the relationship between negative affect and CVD development.

A combined intervention of stress management techniques and Mediterranean diet education seems to be beneficial for BP reduction. Such interventions could possibly serve as a complementary treatment along with drug therapy or in the early treatment of high normal BP. A call to action for designing epidemiological studies and evaluating the efficacy of such non-pharmacological treatment strategies is therefore warranted.