The association between dietary patterns at midlife and health in aging: an observational study

Ann Intern Med. 2013 Nov 5;159(9):584-91. doi: 10.7326/0003-4819-159-9-201311050-00004.


Background: Maintaining health and well-being in aging populations is critical.

Objective: To examine the association between dietary patterns in midlife and prevalence of healthy aging.

Design: Cross-sectional observational study.

Setting: Nurses' Health Study.

Participants: 10 670 women with dietary data and no major chronic diseases between 1984 and 1986, when they were in their late 50s and early 60s (median age, 59 years). Women provided information on health an average of 15 years later.

Measurements: Diet quality in midlife was ascertained using the Alternative Healthy Eating Index-2010 (AHEI-2010) and Alternate Mediterranean diet scores, averaged from 2 food-frequency questionnaires (1984 to 1986). "Healthy" aging was defined as survival to 70 years or older with maintenance of 4 health domains: no major chronic diseases or major impairments in cognitive or physical function or mental health.

Results: After multivariable adjustment, greater adherence to the AHEI-2010 (upper vs. lower quintiles) in midlife was related to 34% (95% CI, 9% to 66%; P for trend < 0.001) greater odds of healthy versus usual aging. Greater adherence to Alternate Mediterranean diet was related to 46% (CI, 17% to 83%; P for trend = 0.002) greater odds of healthy aging. When the 4 components of healthy aging were analyzed separately, the AHEI-2010 and Alternate Mediterranean diet were significantly associated with greater likelihood of no major limitations in physical function and mental health.

Limitations: Residual confounding was possible, although many confounding factors were considered. Bias due to complex patterns of measurement error within diet scores cannot be excluded.

Conclusion: Better diet quality at midlife seems to be strongly linked to greater health and well-being in persons surviving to older ages.

Primary funding source: National Cancer Institute, National Institutes of Health.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aging*
  • Chronic Disease / epidemiology
  • Cognition Disorders / epidemiology
  • Cross-Sectional Studies
  • Diet*
  • Diet, Mediterranean
  • Disease-Free Survival
  • Female
  • Health Status*
  • Humans
  • Mental Health / statistics & numerical data
  • Middle Aged
  • Surveys and Questionnaires