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Original Research |

The Association Between Dietary Patterns at Midlife and Health in Aging: An Observational Study

Cécilia Samieri, PhD; Qi Sun, MD, ScD; Mary K. Townsend, ScD; Stephanie E. Chiuve, ScD; Olivia I. Okereke, MD; Walter C. Willett, MD, DrPH; Meir Stampfer, MD, DrPH; and Francine Grodstein, ScD
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From Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health, Boston, Massachusetts, and INSERM, Centre INSERM U897-Epidémiologie-Biostatistiques, and Université Bordeaux, Bordeaux, France.

Grant Support: By the National Cancer Institute (P01 CA87969). Dr. Samieri was supported by a Fulbright Research Scholar award and a grant from the PRES Université de Bordeaux. Dr. Okereke was supported by the National Institutes of Health (K08 AG 029813). Dr. Sun was supported by the National Heart, Lung, and Blood Institute (R00HL098459).

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0408.

Reproducible Research Statement: Study protocol: Available at www.nurseshealthstudy.org. Statistical code and data set: Available from Dr. Samieri (e-mail, cecilia.samieri@channing.harvard.edu).

Requests for Single Reprints: Cécilia Samieri, PhD, Institut pour la Santé Publique et le Développement, Case 11, Université Bordeaux Segalen, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France; e-mail, cecilia.samieri@channing.harvard.edu.

Current Author Addresses: Dr. Samieri: Institut pour la Santé Publique et le Développement, Case 11, Université Bordeaux Segalen, 146 Rue Léo Saignat, 33076 Bordeaux Cedex, France.

Drs. Sun and Willett: Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115.

Drs. Townsend, Okereke, Stampfer, and Grodstein: Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115.

Dr. Chiuve: Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue, Boston, MA 02215.

Author Contributions: Conception and design: Q. Sun, M.K. Townsend, O.I. Okereke, W.C. Willett, F. Grodstein.

Analysis and interpretation of the data: C. Samieri, Q. Sun, M.K. Townsend, S.E. Chiuve, M. Stampfer, F. Grodstein.

Drafting of the article: C. Samieri.

Critical revision of the article for important intellectual content: Q. Sun, M.K. Townsend, S.E. Chiuve, O.I. Okereke, W.C. Willett, M. Stampfer, F. Grodstein.

Final approval of the article: C. Samieri, Q. Sun, M.K. Townsend, S.E. Chiuve, O.I. Okereke, W.C. Willett, M. Stampfer, F. Grodstein.

Provision of study materials or patients: F. Grodstein.

Statistical expertise: Q. Sun, F. Grodstein.

Obtaining of funding: W.C. Willett, F. Grodstein.

Collection and assembly of data: W.C. Willett, M. Stampfer, F. Grodstein.

Ann Intern Med. 2013;159(9):584-591. doi:10.7326/0003-4819-159-9-201311050-00004
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Chinese translation

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.





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