Homeostatic dysregulation (HD), the measure of aging-related physiological dysregulation, serves as an essential intervenable indicator of aging.

To explore the associations of three healthy dietary patterns with HD, investigate the most recommended dietary patterns, and identify the significant beneficial and harmful food groups

This prospective cohort study included 8,288 participants aged 30–79 years from the China Multi-Ethnic Cohort (CMEC), with a female majority (61.6%). Dietary information was obtained through the baseline food frequency questionnaire (FFQ). Three dietary patterns were constructed: Dietary Approaches to Stop Hypertension (DASH), alternative Mediterranean diets (aMED), and Healthy Diet Score (HDS). HD was constructed based on clinical biomarkers and anthropometric measurements. Follow-up analyses adjusted for baseline data were employed to assess the longitudinal associations of three dietary patterns at baseline with HD at follow-up. Additionally, quantile G-computation was utilized to evaluate the relative contribution of each food group to the association with HD.

Over a follow-up period of 2.0 years, all healthy dietary patterns exhibited negative associations with HD, with β_Q5/Q1 = −0.112, 95%CI (−0.172, −0.051) for HDS, with β_Q5/Q1 = −0.073, 95%CI (−0.134, −0.012) for aMED, with β_Q5/Q1 = −0.047, 95%CI (−0.107,0.014) for DASH. The results of the component analyses revealed that soybean products were the most significant beneficial food group (relative contribution of 24.0%), while alcohol was identified as the major harmful food group (relative contribution of 76.9%).

Healthy dietary patterns, especially HDS, are negatively associated with HD. Additionally, soybean products and alcohol are the most significant beneficial and detrimental food groups respectively. Developing appropriate nutritional strategies may help reduce the burden of disease and promote healthy aging.