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Abstract
Healthy diet has been linked to better age-related functioning, but evidence on the relationship of diet quality in late midlife and measures of physical capability in later life is limited. Research on potential sex differences in this relationship is scarce. The aim was to investigate the prospective association between overall diet quality, as assessed by the Healthy Eating Index-2015 (HEI-2015) at 60-64 years and measures of walking speed 7 years later, among men and women from the Insight 46, a neuroscience sub-study of the Medical Research Council National Survey of Health and Development. Diet was assessed at 60-64 years using 5-d food diaries, from which total HEI-2015 was calculated. At 69-71 years, walking speed was estimated during four 10-m walks at self-selected pace, using inertial measurement units. Multivariable linear regression models with sex as a modifier, controlling for age, follow-up, lifestyle, health/social variables and physical performance, were used. The final sample consists of 164 women and 167 men (n 331). Women had higher HEI-2015 and slower walking speed than men. A 10-point increase in HEI-2015 was associated with faster walking speed among women (B 0·024, 95 % CI 0·006, 0·043), but not men. The association remained significant in the multivariable model (B 0·021, 95 % CI 0·003, 0·040). In women, higher diet quality in late midlife is associated with faster walking speed. A healthy diet in late midlife is likely to contribute towards better age-related physical capability, and sex differences are likely to affect this relationship.
Highlights
Life expectancy is increasing in middle- and high-income countries, this is typically accompanied by deterioration in physical and cognitive health[1], with physical capacity decline accelerating up to 20 % per 10 years in 70-year-old people[2]
It further confirms evidence that healthy dietary choices at late midlife, as those reflected by high HEI-2015 scores, may slow down the rate of decline of physical capability in later life, as indicated by faster walking
It is novel in the present study that high diet quality, as indicated by high HEI-2015 scores, was linked to faster walking speed in older women but not men
Summary
Life expectancy is increasing in middle- and high-income countries, this is typically accompanied by deterioration in physical and cognitive health[1], with physical capacity decline accelerating up to 20 % per 10 years in 70-year-old people[2]. Research on diet and physical capability and performance of older people has mainly focused on single nutrients (vitamin D, Ca, protein, carotenoids)(10,11) or food items rich in antioxidants and anti-inflammatory factors, such as greens, vegetables and whole-grain foods[12], which are important for musculoskeletal function and the prevention of sarcopenia[13]; yet nutrients are not consumed in isolation, and it is the synergistic effect of an overall healthy diet[14] which protects against functional decline[15,16] Healthy dietary patterns such as the Mediterranean and Nordic diets have shown an association of higher diet quality and measures of physical performance[17,18,19]; regional dietary patterns may not be appropriate in all contexts due to differences in food preference, availability and accessibility
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