Lifestyle Factors Research Articles

Update on the aetiopathogenesis of obstructive sleep apnea: Role of inflammatory and immune mediated mechanisms

Obstructive sleep apnea (OSA) is often a lifestyle disease associated with obesity, which is rapidly evolving as a major health concern with diverse multisystemic implications. To prevent and mitigate its adverse effects and reduce its burden on society, its aetiopathogeneses must be precisely understood. Numerous studies focusing on the range of diverse anatomic, functional, and lifestyle factors have already been carried out to determine the possible contributory roles of these factors in OSA. Recently, evidence to validate the role of inflammatory pathways and immune mechanisms in the aetiopathogeneses of OSA is being developed. This allows for further research and translation of such knowledge for targeted therapeutic and preventive interventions in patients with or who are at risk of developing OSA.

Health and Lifestyle Factors and Dementia Risk Among Former Professional Soccer Players.

Elite-level contact sport participation is associated with increased dementia risk, which may be attributable to sport-related traumatic brain injury and repetitive head impact exposure. However, the contribution of wider, potentially modifiable dementia risk factors remains uncertain. To explore the association of potentially modifiable dementia risk factors with dementia risk among former professional soccer players. This retrospective cohort study used electronic health record linkage to national electronic datasets of general and mental health hospital inpatient and day-case admissions, prescribing information, and death certification in Scotland for male former professional soccer players born between January 1, 1900, and December 31, 1990, who were aged 30 years or older on December 31, 2020, and general population control individuals matched by sex, year of birth, and area socioeconomic status. Database interrogation was performed on November 30, 2021, and data were analyzed between January 16, 2023, and July 8, 2024. History of smoking, depression, alcohol-related disorders, diabetes, hypertension, hearing loss, and obesity coded within electronic health records. Prevalence of dementia risk factors and their association with incident dementia diagnoses were evaluated and compared between former soccer players and matched controls. The final cohort consisted of 11 984 male former professional soccer players and 35 952 matched controls. Over a median 21 years (IQR, 7-34 years) of follow-up from study entry at age 30 years or older, providing a total of 1 039 848 years of follow-up, 434 former soccer players (3.62%) and 453 matched population controls (1.26%) were identified with a dementia diagnosis (hazard ratio [HR], 3.02; 95% CI, 2.54-3.58; P < .001). Overall, rates of general health and lifestyle dementia risk factors were similar or lower among former soccer players compared with matched controls (eg, diabetes: 4.26% vs 6.35%). Dementia risk associated with these factors among soccer players was similar to or lower than among controls (eg, hypertension: HR, 4.62 [95% CI, 3.69-5.78] vs 6.96 [95% CI, 5.64-8.59]). This cohort study found no evidence that high dementia risk among former professional soccer players was associated with potentially modifiable general health and lifestyle dementia risk factors. These data support continuation of measures directed toward reducing exposure to repetitive head impacts and traumatic brain injury in sport.

Factors associated with sleep quality in adolescent pregnant women.

To verify the association of sociodemographic, anthropometric, obstetric, lifestyle factors, and depressive symptoms with sleep quality in pregnant adolescents. This cross-sectional study involved pregnant adolescents aged 10 to 19 who received prenatal care in Recife, Pernambuco, Brazil. Data collection included an individual evaluation form and the administration of the Pregnancy Physical Activity Questionnaire (PPAQ), the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory (BDI). Prevalence and associations were calculated using Pearson's chi-square test or Fisher's exact test, followed by logistic regression analysis. The study included 386 pregnant adolescents with a mean age of 17 ± 2 years. The prevalence of poor sleep quality was 67.5%. Poor sleep quality was associated with moderate to severe depressive symptoms (OR = 2.21; 95%CI 1.27-3.85), higher education levels (OR = 2.26; 95%CI 1.43-3.57), and the presence of gestational physical symptoms (OR = 1.18; 95%CI 1.10-1.27). Pregnant adolescents exhibit a high prevalence of poor sleep quality, which is linked to depressive symptoms, higher education levels, and gestational physical symptoms. These findings highlight the importance of screening for sleep disorders in this population and emphasize the need for guidelines addressing physical symptoms and their impact on sleep, as well as the presence of depression.

Metallic nanoparticles for tumor microenvironment modulation

Cancer is a complex, multifaceted disease influenced by genetic predispositions, lifestyle factors such as nutrition, exercise, and toxin exposure, as well as environmental conditions. A key element in cancer initiation, progression, metastasis, and therapeutic response is the tumor microenvironment (TME). Within the TME, immune cells like T cells, B cells, and immunoglobulins have a profound and direct impact on the growth and spread of tumor cells. As a result, effective regulation of the TME has become crucial for successful cancer treatment. Metal nanoparticles (MNPs), ranging from 1 to 100 nanometers, have shown great potential as agents for modulating the TME, delivering drugs, and improving cancer diagnostics. This discussion explores both the internal and external components of the TME, focusing on how MNPs influence the microenvironment. We highlight their targeting mechanisms and interactions with immune responses and tumor-associated inflammation. Due to their unique properties, MNPs offer distinct advantages in cancer therapy, and their range of applications continues to expand. This review underscores the potential of MNPs as a promising material in the future of cancer treatment.

Neuroinflammation in Alzheimer disease.

Increasing evidence points to a pivotal role of immune processes in the pathogenesis of Alzheimer disease, which is the most prevalent neurodegenerative and dementia-causing disease of our time. Multiple lines of information provided by experimental, epidemiological, neuropathological and genetic studies suggest a pathological role for innate and adaptive immune activation in this disease. Here, we review the cell types and pathological mechanisms involved in disease development as well as the influence of genetics and lifestyle factors. Given the decade-long preclinical stage of Alzheimer disease, these mechanisms and their interactions are driving forces behind the spread and progression of the disease. The identification of treatment opportunities will require a precise understanding of the cells and mechanisms involved as well as a clear definition of their temporal and topographical nature. We will also discuss new therapeutic strategies for targeting neuroinflammation, which are now entering the clinic and showing promise for patients.

The Potential for Lifestyle Intervention Among Patients Undergoing Transurethral Resection of Bladder Tumour Based on Patient Needs Including Smoking and Other Risky Lifestyle Factors: A Cross-Sectional Study

Bladder cancer is the tenth most common cancer worldwide, with non-muscle invasive bladder cancer (NMIBC) accounting for 75% of cases. Transurethral resection of bladder tumours (TURBT) is the standard treatment, but it is associated with significant risks of complications and recurrence. Risky lifestyle factors, including smoking, malnutrition, obesity, risky alcohol use, and physical inactivity (collectively termed SNAP factors), may worsen surgical outcomes and increase cancer recurrence. Prehabilitation programmes targeting these modifiable risk factors could improve patient outcomes. This cross-sectional study assessed 100 TURBT patients at a Danish university hospital to determine the prevalence of SNAP factors and the potential for lifestyle interventions. Data were collected via structured interviews, and intervention scenarios were projected based on efficacy rates of 5–100%. In total, 58% of patients had at least one risky SNAP factor, with smoking (29%) being the most prevalent, followed by physical inactivity (19%) and risky alcohol use (18%). Obesity (7%) and malnutrition (8%) were less common. Seventeen percent had multiple SNAP factors. No significant demographic indicators were associated with the presence of SNAP factors. TURBT patients with NMIBC show a high prevalence of risky lifestyle factors, including smoking and obesity, with over half affected. Systematic screening and targeted interventions could significantly improve patient outcomes and long-term health.

Smoking, alcohol consumption, and risk of recurrent falls in community-dwelling Japanese people aged 40-74 years: The Murakami cohort study.

Evidence is lacking regarding associations between smoking/drinking and falls. This study aimed to determine longitudinal associations between smoking, alcohol consumption, and fall risk in middle-aged and older people. Participants of this cohort study were 7542 community-dwelling Japanese people aged 40-74 years. The baseline self-administered questionnaire survey was conducted in 2011-2013, and the second survey was conducted 5 years later. Predictors were smoking level and alcohol consumption. The outcome was the occurrence of recurrent falls. Information on self-reported falls in the previous year was obtained. Covariates were demographics, lifestyle factors, body mass index, general health status, and disease history. The mean age of participants was 60.3 years. Higher smoking levels were associated with a higher recurrent fall risk (adjusted P for trend = 0.0386), with the ≥20 cigarettes/day group having a higher risk (adjusted odds ratio [OR] = 1.93, 95% confidence interval [CI]: 1.20-3.10) than lifetime non-smokers. The association between smoking and recurrent fall risk tended to be stronger in drinkers than in non-drinkers (adjusted OR = 2.75, 95% CI: 1.57-4.81), suggesting a potential interaction (P for interaction = 0.1035). Although there were no dose-dependent associations between alcohol consumption and recurrent fall risk overall, moderate alcohol consumption (150-299 g ethanol/week) was associated with a lower risk (adjusted OR = 0.57, 95% CI: 0.33-0.98) compared with no consumption in men. Smoking, but not alcohol consumption, is dose-dependently associated with high fall risk. However, moderate alcohol consumption may be associated with a decreased fall risk. Moreover, there may be a potential interaction between smoking and alcohol consumption on fall risk. Geriatr Gerontol Int 2024; ••: ••-••.

Associated Factors of Healthy Lifestyle and Personal Control among Outpatients with Type Ii Diabetes Mellitus in Biliran, Philippines

The study aims to assess the healthy lifestyle and personal control and associated factors among outpatients with type 2 diabetes in Biliran Provincial Hospital: Proposed Plan to Improve Healthy Lifestyle. The study utilized a descriptive-correlational research design. The researcher observes, describes and documents and effect related to the phenomenon which further assess the healthy lifestyle and personal control among patients with Type II Diabetes Milletus. It was conducted in Biliran Provincial Hospital. There were two hundred fifty-three respondents of the study. Majority of the respondents are female belonging to age ranging from 51-61 years old who are considered senior citizens. In terms of civil status, majority are married while single belong to the minority group. Majority of the clients of Type 2 Diabetes Mellitus are College graduates. Many of them are also working in terms of their working status. Consequently, on the health status of the respondents, findings of the study revealed that majority of them are non-smokers while the smokers are few. Besides, they can consume one pack of cigarettes per day. As to the Body Mass Index (BMI), majority of them have high BMI and are considered obese. There was no significant relationship between the gender and working status and the lifestyle of the respondents. There is a significant relationship between the age, educational status, civil status and the lifestyle of the respondents. In the personal control of the respondents, there is no significant relationship between the gender and working status. There is a significant relationship between the personal control and the civil status. Age and educational status. There is no significant relationship between the health-related status and the personal control of the respondents. Lastly, there is a significant relationship between the health-related status and the lifestyle of the respondents. To address the findings of the study a proposed plan of improvement of healthy lifestyle.

Effect of sleep disturbances on depression

This paper explores the relationship between sleep disorders and depression, highlighting the complex interplay between various influencing factors. This article will analyze the influence of sleep disorders on depression from three aspects: pathological mechanisms, different age groups, and lifestyle factors. The analysis began with pathological mechanisms, particularly the role of neurotransmitter systems, including histamine, norepinephrine, dopamine, and serotonin, all of which significantly regulate sleep and mood states. Dysregulation of these neurotransmitters can exacerbate sleep disturbances, thereby increasing the risk of depression. The researchers also examined the age factor and found that sleep deprivation in adolescents impaired emotion regulation and significantly increased the risk of depression. In contrast, older adults with sleep disorders were three times more likely to develop depression over time. In addition, lifestyle factors such as dietary habits, exercise, and use of electronic devices were explored. A balanced diet and regular physical activity have been shown to improve sleep quality and reduce depressive symptoms. In contrast, the use of electronic devices, especially at bedtime, is associated with poorer sleep outcomes and a higher risk for depression owing to the damaging effect of blue light on melatonin secretion.

Microplastic particles in human blood and their association with coagulation markers

Recent studies have indicated potential health risks associated with microplastics (MPs) exposure, including alterations in blood coagulation homeostasis. This cross-sectional study aimed to quantitatively examine MPs in human blood and assess their association with coagulation markers. We recruited 36 healthy adults, collected whole blood samples, and analyzed MPs using Fourier-transform infrared (µ-FTIR) spectroscopy. Lifestyle factors related to MP exposure were assessed, such as the use of plastic food containers. Coagulation and inflammatory markers in blood samples were analyzed, including C-reactive protein, prothrombin time, activated partial prothrombin time (aPTT), antithrombin III, platelet count, erythrocyte sedimentation rate, and fibrinogen. MPs were detected in 88.9% of the participants, with a mean concentration of 4.2 MPs/mL. The predominant types of plastics identified were polystyrene and polypropylene. MPs were significantly higher in participants with a greater use of plastic food containers. A high MP load in the blood (≥ 3 MPs/mL) was significantly correlated with increased aPTT, C-reactive protein, and fibrinogen. We identified MPs in human blood, their association with specific lifestyle factors, and significant alterations in coagulation markers. This underscores the need for strategies to reduce human exposure to MPs, particularly in relation to blood coagulation and potential cardiovascular risks.

Effect of Mediterranean diet and physical activity on healthcare professional depression, burnout and professional fulfillment during COVID-19

Objectives. The mental health of healthcare professionals, especially during the COVID-19 pandemic, is a critical concern. This study investigates the prevalence of burnout and professional fulfillment, depression and the relationship between physical activity and adherence to the Mediterranean diet with depression, burnout and professional fulfillment among healthcare professionals. Methods. Data were collected through a web-based survey of 567 healthcare professionals. Logistic regression analysis with age and sex adjustment was employed to analyze the results. Results. The prevalence of depression was 44%, burnout stood at 66% and professional fulfillment was reported at 28%. Adherence to the Mediterranean diet was linked to a reduced risk of depression (odds ratio [OR] 0.63, 95% confidence interval [CI] [0.41, 0.96], p = 0.033) and physical activity was also associated with a lower risk of depression (OR 0.49, 95% CI [0.32, 0.75], p = 0.001). Furthermore, adherence to the Mediterranean diet was associated with a reduced risk of burnout (OR 0.49, 95% CI [0.25, 0.98], p = 0.045). Conclusion. This study highlights the positive impact of physical activity and the Mediterranean diet as lifestyle factors on depression and burnout. These findings have implications for screening, follow-up and timely interventions to support the mental well-being of healthcare professionals.

A higher global diet quality score is associated with lower risk of obesity among male university students in Lebanon: a pilot study

ObjectiveThis pilot study aims to assess the diet quality amongst Lebanese male university students using the Global Diet Quality Score (GDQS), identify its association with obesity, and determine the key drivers of consumption of foods associated with higher NCDs risk.MethodsA cross-sectional survey was conducted using a convenience sampling approach, comprising 385 male students aged between 18 and 24 years at the American University of Beirut. Dietary data was collected using 24-h recall, where participants detailed all foods and beverages consumed in the past 24 h, including portion sizes. Sociodemographic, anthropometric, lifestyle factors and drivers of food consumption data were also collected. GDQS scores were categorized as high (≥23), moderate (15–23), or low (&amp;lt; 15) indicating low, moderate and high NCD risk, respectively. A multiple logistic regression was applied to assess association of GDQS with sociodemographic and anthropometric variables.ResultsThe results showed that the majority of male university students had low (47%) or moderate (47%) GDQS scores, with only a small proportion (4%) showing high scores. Foods contributing to low GDQS scores were determined, with taste emerging as the primary factor influencing food group consumption. Additionally, individuals in health-related majors and higher academic year of study had higher GDQS scores, and those with higher GDQS scores had a lower risk of obesity. The study findings suggest that a high proportion of the study sample are at a higher risk of NCDs given their dietary quality, demonstrated an association between low GDQS scores and obesity risk, and identified education as a predictor of diet quality.ConclusionThis study calls for larger studies assessing dietary habits and quality amongst Lebanese university students to provide context-specific evidence for the development of targeted interventions aimed at the promotion of healthier eating habits in this population group and curbing the NCDs epidemic in the country.

Progress in the study of metastatic mechanism of colorectal cancer in vivo

The main object of this paper is colorectal cancer (CRC). Colorectal cancer is a malignant tumor that occurs in the colon or rectum. It is one of the most common cancers in the digestive system in the world. Its pathogenesis is complex and is related to many factors, including genetic factors and lifestyle habits. Mild cases can be treated and have a high probability of recovery, but severe tumors can even be fatal. For CRC, this paper includes its pathogenesis, metastasis mechanism, and corresponding intervention measures. Through research on these aspects, it aims to have a more comprehensive understanding of the causes, development process, and treatment strategies of CRC. The pathogenesis of CRC is usually affected by many different factors. This article will mainly discuss the factors of genetics, diet, and lifestyle. In terms of metastasis mechanism, tumor immune microenvironment, epithelial-mesenchymal transition (EMT), and vascular growth factors play a decisive and key role. Then this article also discusses intervention measures for CRC, including inhibiting the formation of new blood vessels, immunotherapy, and the use of chemotherapy agents.

Perceptions and Barriers to Accessing Myopia Management in the UK

Background/Objectives: Perceptions and barriers to myopia management (MM) in childhood have not been fully explored within some countries, including the UK, where there is minimal public health education on myopia. Methods: The aim of this mixed-methods study was to explore perceptions of myopia and MM interventions using focus groups and a survey to obtain qualitative and quantitative data. Topics included the understanding of myopia, perceptions of MM, considerations when initiating MM, lifestyle risk factors, and barriers to uptake of intervention. Results: Parent awareness and understanding of myopia and MM is limited. Many parents felt that they had not been provided with sufficient explicit advice about their child’s diagnosis or treatment. Despite this, parents were aware of some of the protective lifestyle behaviours which may slow myopia progression. The common belief was that myopia can affect a child’s quality of life. The most common reason that MM had been recommended to parents by practitioners was to reduce disease risk. Conclusions: The cost and lack of public awareness that MM interventions are available were the main barriers to the uptake of MM. There is a need to improve practitioner communication of myopia and its management and, subsequently, improve the standard of children’s eyecare.

Mediterranean diet and brain functional connectivity in a population without dementia

IntroductionAdjustable lifestyle factors, such as diet, are associated with cognitive functions, structural and functional brain measures, but the association between the functional connectivity (FC) and the Mediterranean Diet (Medicine) in population without dementia is yet to be explored.MethodsThe association between MeDi and brain FC in 105 individuals without dementia aged 63 (SD ± 8.72) years old who underwent brain MRI including resting-state (rs) functional MRI (fMRI) was examined. Dietary intake was evaluated through four 24-h recalls using the multiple-pass method and adherence to the MeDi was estimated using the MedDietScore, with higher values indicating greater adherence to MeDi. Multivariable linear regression models were used to investigate the associations between FC (both positive and negative associations) and MedDietScore.ResultsRs-fMRI analysis revealed significant associations between FC and MedDietScore. The FC between the medial prefrontal cortex and a cluster located in left postcentral gyrus and in the left supramarginal gyrus was positively associated with MedDietScore. On the other hand, the FC between medial visual and right posterior division of both middle and superior temporal gyrus was negatively associated with MedDietScore. Of note, a temporal negative correlation was detected between above-mentioned FC networks. The FC between superior temporal gyrus and occipital regions was associated with participants' attention, executive functions, and memory scores. Furthermore, the associations for attention and executive functions were pronounced in participants with high adherence to MeDi compared to those with low adherence to MeDi.DiscussionIn conclusion, our study documented an association between higher adherence to MeDi and rs-FC in fronto-parietal and temporo-occipital regions, particularly in areas that are involved in cognitive processes altered across normal and pathological aging. From a clinical point of view, our findings support a favorable role of MeDi on FC which may have significant clinical implications in the rapidly aging population. Rs-fMRI is also proposed as a useful tool in the emerging field of nutritional neuroscience and a candidate non-invasive biomarker of brain aging.

Implications of Modifiable and Non-Modifiable Determinants of Dementia for Public Health Policies and Prevention Strategies

Dementia, characterized by cognitive decline and memory deterioration, poses a significant and growing global health challenge. Alzheimer's disease (AD) is the most common form, with others including Lewy body dementia (LBD), frontotemporal dementia (FTD), and vascular dementia (VaD). The World Health Organization estimates that 55 million people worldwide are affected, a number projected to triple by 2050. This essay explores both non-modifiable and modifiable determinants of dementia and their implications for public health policies and prevention efforts. Non-modifiable determinants include age, genetics, and sex, all of which significantly influence dementia risk. Ageing is the primary risk factor, with genetic factors such as mutations in APP, PSEN1, and PSEN2, and the APOE 4 allele increasing susceptibility. Women, due to their longer lifespan and hormonal differences, are at a higher risk compared to men. Modifiable determinants encompass lifestyle factors and medical conditions, notably diet, physical activity, alcohol and tobacco use, hypertension, and diabetes. Effective public health policies, like the WHO's Global Action Plan, emphasize early intervention and lifestyle modifications. Integrating these determinants into policy making requires a balanced approach, considering the dynamic nature of modifiable factors and the specific needs of an aging population. The essay underscores the need for comprehensive public health education, destigmatization of dementia, and an inclusive healthcare infrastructure to enhance dementia prevention and care, ultimately reducing the societal burden of this condition.

Investigating the Two-Way Interaction Effect of Diet and Lifestyle Factors on Liver Fat Levels: A Controlled Spectroscopic Analysis

Investigating the Two-Way Interaction Effect of Diet and Lifestyle Factors on Liver Fat Levels: A Controlled Spectroscopic Analysis

Which factors influence emotional overeating among workers and students? Is online food delivery consumption involved? Results from the DELIvery Choice In OUr Society (DELICIOUS) cross-sectional study.

Emotional overeating (EO) is a complex behavior that involves consuming excessive food in response to emotions, presenting health risks due to poor dietary choices. Research indicates a notable prevalence of EO, especially among females, and its association with disordered eating behaviors like binge eating (BE). The rise of online food delivery (OFD) services has raised questions about their potential role in exacerbating EO. This study aimed to explore EO behaviors among Italian workers and students, assessing the influence of various personal, socio-demographic, and lifestyle factors, including OFD. This study is a secondary data analysis utilizing the DELICIOUS survey data, conducted nationwide through social media platforms from July 12, 2022, to February 1, 2023. Participants completed validated questionnaires, including the EO Questionnaire (EOQ-5). The sample was stratified according to worker/student status. Statistical analyses, including descriptive statistics (chi-squared tests, Mann-Whitney tests) and multivariable logistic regression, were performed to assess the influence of key variables on EO. The sample comprised 2853 workers and 898 students, with almost 75% exhibiting EO behavior above the threshold. Several factors were significantly related to a higher occurrence of EO. Positive associations included bad health literacy, female gender, occasional smoking, higher BMI, depression risk for students, and low work-life balance, job dissatisfaction, screen time while eating, and depression risk for workers. Surprisingly, OFD usage showed no relationship with EO. While some findings align with previous research, like the depression-EO link, others, such as the absence of a link between OFD and EO, were unexpected. The results suggest that personal, socio-demographic, and lifestyle factors significantly influence EO, with OFD serving more as a means of food access influenced by individual characteristics, rather than a direct EO risk factor.

DNA-methylation age and accelerated epigenetic aging in blood as a tumor marker for predicting breast cancer susceptibility.

DNA methylation (DNAm)-based marker of aging, referred to as 'epigenetic age' or 'DNAm age' is a highly accurate multi-tissue biomarker for aging, associated with age-related disease risk, including cancer. Breast cancer (BC), an age-associated disease, is associated with older DNAm age and epigenetic age acceleration (age accel) at tissue levels. But this raises a question on the predictability of DNAm age/age accel in BC development, emphasizing the importance of studying DNAm age in pre-diagnostic peripheral blood (PB) in BC etiology and prevention. We included postmenopausal women from the largest study cohort and prospectively investigated BC development with their pre-diagnostic DNAm in PB leukocytes (PBLs). We estimated Horvath's pan-tissue DNAm age and investigated whether DNAm age/age accel highly correlates with risk for developing subtype-specific BC and to what degree the risk is modified by hormones and lifestyle factors. DNAm age in PBLs was tightly correlated with age in this age range, and older DNAm age and epigenetic age accel were significantly associated with risk for developing overall BC and luminal subtypes. Of note, in women with bilateral oophorectomy before natural menopause experiencing shorter lifetime estrogen exposure than those with natural menopause, epigenetic age accel substantially influenced BC development, independent of obesity status and exogeneous estrogen use. Our findings contribute to better understanding of biologic aging processes that mediate BC carcinogenesis, detecting a non-invasive epigenetic aging marker that better reflects BC development, and ultimately identifying the elderly with high risk who can benefit from epigenetically targeted preventive interventions.

Adherence to the healthy and sustainable dietary recommendations for the Spanish population and all-cause mortality

Introduction and objectives: The healthy and sustainable dietary recommendations for the Spanish population have recently been launched. We aimed to develop a food-based dietary index to measure adherence to these guidelines and assess its association with all-cause mortality.Methods: Data were drawn from 11 904 individuals, representative of the Spanish population aged 18 and older, recruited between 2008 and 2010, and followed-up until 2022. The Healthy and Sustainable Dietary Recommendations for the Spanish Population Index (HS-DRSI) includes 20 food components, scored dichotomously to reflect adherence to the recommendations. The association between the HS-DRSI and all-cause mortality was examined using Cox proportional hazard models adjusted for sociodemographic, lifestyle, and morbidity factors, within a retrospective cohort design.Results: The mean ± SE age of participants was 46.9 ± 0.3 years and 50.5% were female. After a median follow-up of 12.9 years, 939 all-cause deaths were recorded. Compared with participants in the lowest quartile of adherence (HS-DRSI range: 1-5), those in the highest quartile (HS-DRSI range: 9-17) had a lower risk of mortality (HR, 0.76; 95%CI, 0.60-0.96; P for trend = .02). A 2-point increase in the HS-DRSI was associated with a 7% lower risk of mortality (HR, 0.93; 95%CI, 0.86-1.00; P = .04). This protective association was also observed among participants without chronic diseases at baseline (HR per 2-point increment: HR, 0.80; 95%CI, 0.70-0.92; P = .002). Results were robust in sensitivity analyses.Conclusions: Higher adherence to the healthy and sustainable dietary recommendations for the Spanish population was associated with lower all-cause mortality.