Dietary Patterns in Aging and Disease

Abstract

Dietary pattern habits have a significant effect on aging, chronic disease risk, and longevity but in developed countries like the US mean diet quality scores are only about half of the optimal healthy eating diet score. Healthy dietary patterns include adequate whole-grain cereals, legumes, fruits, vegetables, and nuts, and lower intakes of red and processed meats and sugar-sweetened beverages. Prospective cohort studies with middle aged and older age adults consistently show that high adherence to Western dietary patterns increases cardiovascular disease (CVD), diabetes and cancer, and premature death risk whereas high adherence to healthy/plant-based dietary patterns lowers CVD, diabetes and cancer, and premature mortality risks. Among cancer survivors, healthy diets are associated with reduced overall mortality risk by 20% and Western diets are associated with increased risk by over 40%. For older adults, higher adherence to healthy dietary patterns reduces the odds of unhealthy aging and frailty whereas higher adherence to Western diets increases the odds. Simple dietary rules for healthy aging are to limit the intake of energy dense, low nutrient quality foods, red and processed meats and added salt and sugar, and increase the intake of fiber, and nutrient and phytochemical-rich whole or minimally processed plant foods. Healthy dietary patterns, especially the Mediterranean diet, are associated with reduced risk of age-related decline in cognitive performance and Alzheimer’s disease and longer telomere length compared to Western diets. High adherence to healthy dietary patterns supports healthy aging and reduces chronic disease and mortality risk through beneficial effects on body weight regulation and adiposity, energy metabolism, lipoprotein concentrations and function, blood pressure, glucose-insulin homeostasis, oxidative stress, inflammation, endothelial health, hepatic function, cardiac and cognitive function, telomere length, and the microbiota ecosystem.