To assess the influence of a specific dietary pattern on overall survival.Cohort study.Three rural Greek villages, the data from which were collected as part of an international cross cultural study of food habits in later life.182 elderly residents of the three villages.Overall mortality.Diet was assessed with a validated extensive semiquantitative questionnaire on food intake. A one unit increase in diet score, devised a priori on the basis of eight component characteristics of the traditional common diet in the Mediterranean region, was associated with a significant 17% reduction in overall mortality (95% confidence interval 1% to 31%).A diet meeting currently understood health criteria does predict survival among people.