Good midlife dietary patterns predict healthy aging

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1. In a large cohort of women, greater adherence in midlife to healthy dietary patterns was associated with approximately 40% greater odds of healthy aging.

2. Greater intakes of plant foods, whole grains, and fish or long-chain omega-3 poly unsaturated fatty acids (PUFAs); moderate intake of alcohol; and lower intake of red and processed meats likely contribute to maintaining physical, cognitive, and mental health with aging.

Evidence Rating Level: 2 (Good)

Study Rundown: Dietary patterns have been clearly associated with healthy aging. Studies on the Healthy Eating Index and Alternative Healthy Eating Index, both of which incorporate research on the health benefits of specific foods and nutrients, have demonstrated that diets rich in certain foods predict the risk of chronic disease and mortality rates. This study aimed to further characterize the association between dietary patterns at midlife and prevalence of health aging among women enrolled in the Nurses’ Health Study. Its findings support a robust “healthy diet-healthy aging” association, including an association with some components of healthy aging such as physical function and mental health, which had been less well-characterized by previous studies. This research reinforces and adds to the growing body of evidence that healthy diets (high in plant foods, whole grains, and fish and low in red and processed meats) promote physical, cognitive, and mental health with aging. However, this sample consisted of entirely female, mostly white health care professionals. Further research is necessary to determine whether these findings are generalizable to different populations. Larger, more diverse studies may be able to identify specific healthy aging domains or individual dietary components that contribute substantially to the observed association.

Click to read the study in Ann Intern Med

Relevant Reading: Healthy lifestyle behaviors and all-cause mortality among adults in the United States

In-Depth [Cross-sectional observational study]: This large observational study aimed to determine the association between dietary patterns at midlife and the prevalence of healthy aging decades later among women in the Nurses’ Health Study, simultaneously considering survival, chronic diseases, cognitive function, physical function, and mental health. To assess dietary quality at midlife, the study averaged data from semiquantitative food-frequency questionnaires that study participants completed in 1984 and 1986. Using this data, Alternative Healthy Eating Index-2010 (AHEI-2010) and Alternate Mediterranean diet (A-MeDi) scores were calculated. These scores incorporate current knowledge on foods and nutrients predictive of risk of chronic disease. Sociodemographic, lifestyle, and health-related covariates were ascertained from biennial questionnaires and controlled for. “Healthy” aging (as distinct from “usual” aging) was defined by the absence of 11 chronic diseases, with no impairment in cognition, no physical disabilities, and intact mental health. Using logistic regression models, the authors estimated the odds of healthy versus usual aging, according to AHEI-2010 and A-MeDi scores between 1984 and 1986. Secondary analyses aimed to determine whether associations could be attributed to specific healthy aging domains or to individual dietary components.

Of 10,670 participants followed for an average of 15 years, 1171 (11.0%) were considered healthy and the remaining 9499 (89.0%) were considered usual agers.  Healthy agers had higher baseline AHEI-2010 and A-MeDi scores at midlife, compared with usual agers. Greater adherence at midlife to AHEI-2010 and A-MeDi were both strongly associated with greater odds of healthy aging (P for trend < 0.001 for AHEI-2010; P for trend = 0.002 for A-MeDi) in multivariable analyses. When individually analyzed, most components of the AHEI-2010 and A-MeDi were more weakly associated with healthy aging, though greater intake of fruits and alcohol and lower intake of sugar-sweetened beverages and PUFA remained statistically significant.

By Elizabeth Kersten and Andrew Bishara

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