Blog | Monday, April 22, 2013

QD: News Every Day--Western diet linked to less than ideal health in old age


A study put some specific numbers to the generally accepted concept that a lifelong healthy diet can influence health in old age, a study found.

Low adherence to the Alternative Healthy Eating Index (AHEI) was associated with an increased risk of cardiovascular and noncardiovascular death, and the Western diet of fried, sweetened and processed food, red meat, refined grains and high-fat dairy products were more likely to place people in the bottom third than the top (odds ratio, 0.58; 95% confidence interval [CI], 0.36 to 0.94), independent of other health behaviors.

Results appeared in the May issue of The American Journal of Medicine.

Data were drawn from the Whitehall II cohort study of 5,350 London-based office staff, aged 35-55 years, who worked in civil service departments that included 3,775 (70.6%) men and 1,575 (29.4%) women with baseline mean age 51.3 (SD 5.3) years of age.

Diet was assessed at baseline from 1991 to 1993. Mortality, chronic diseases and functioning were followed to derive 5 outcomes: ideal aging free of chronic conditions and with high performance in physical, mental, and cognitive functioning tests, nonfatal cardiovascular events, cardiovascular death, noncardiovascular death and normal aging for people who didn't fit into the four previous groups.

At follow-up, 4% met the ideal aging criteria, 12.7% developed a nonfatal cardiovascular disease, 2.8% died from cardiovascular disease, and 7.3% from noncardiovascular causes over the mean 16-year follow-up. The remaining 73.2% followed a natural aging course.

A diet of vegetables, fruits, and fish was inversely associated with noncardiovascular mortality after adjusting for sex, age, total energy intake (OR per 1-SD increment, 0.76; 95% CI, 0.68 to 0.84). However, this association was attenuated after further adjustment for health behaviors such as smoking status and physical activity (OR, 0.90; 95% CI, 0.79 to 1.01).

Participants in the top tertile of the Western diet had substantially lower odds for ideal aging compared with participants in the bottom tertile after adjustment for age, sex, and total energy intake (OR, 0.52; 95% CI, 0.33 to 0.82) and health behaviors (OR, 0.58; 95% CI, 0.36 to 0.93). The Western diet was associated with higher odds of both cardiovascular mortality (ORs per 1-SD increment, 1.53; 95% CI, 1.16 to 2.01) and noncardiovascular mortality (OR, 1.36; 95% CI, 1.14 to 1.61) in the age, sex, and total energy intake-adjusted model, but those associations were attenuated after further adjustments.

Also, those in the highest tertile of "Western-type" dietary pattern, compared with those in the bottom tertile, were more likely to have poorer musculoskeletal (OR for below-median walking speed , 1.45; 95% CI, 1.14-1.84) and cognitive functioning (OR for below-median test score, 1.58; 95% CI, 1.27 to 1.97).

That a Western diet in middle age may be a risk factor for less than ideal health in old age is a novel finding, the authors noted. "We showed that specific dietary recommendations such as the one provided by the AHEI may be useful in reducing the risk of unhealthy aging, while avoidance of the "Western-type foods" actually might improve the possibility of achieving older ages free of chronic disease and remaining highly functional."