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Does Overall Diet in Midlife Predict Future Aging Phenotypes? A Cohort Study - 12/04/13

Doi : 10.1016/j.amjmed.2012.10.028 
Tasnime Akbaraly, PhD a, b, c, , Séverine Sabia, PhD a, d, Gareth Hagger-Johnson, PhD a, Adam G. Tabak, MD a, e, Martin J. Shipley, MSc a, Markus Jokela, PhD a, f, g, Eric J. Brunner, PhD a, Mark Hamer, PhD a, G. David Batty, PhD a, h, Archana Singh-Manoux, PhD a, d, Mika Kivimaki, PhD a
a Department of Epidemiology and Public Health, University College London, London, UK 
b Inserm, U1061 Montpellier, F-34093 France 
c Université Montpellier I, Montpellier, F-34000, France 
d Inserm U 1018, Assistance Publique-Hopitaux de Paris, France 
e 1st Department of Medicine, Semmelweis, University Faculty of Medicine, Budapest, Hungary 
f Institute of Behavioral Sciences, University of Helsinki, Finland 
g Finnish Institute of Occupational Health, Helsinki, Finland 
h MRC Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK 

Requests for reprints should be addressed to Tasnime Akbaraly, PhD, Inserm U 1061, Hôpital La Colombière, 39 avenue Charles Flahault, BP 34493, 34093 Montpellier cedex 05, France

Abstract

Background

The impact of diet on specific age-related diseases has been studied extensively, but few investigations have adopted a more holistic approach to determine the association of diet with overall health at older ages. We examined whether diet, assessed in midlife, using dietary patterns and adherence to the Alternative Healthy Eating Index (AHEI), is associated with aging phenotypes, identified after a mean 16-year follow-up.

Methods

Data were drawn from the Whitehall II cohort study of 5350 adults (age 51.3±5.3 years, 29.4% women). Diet was assessed at baseline (1991-1993). Mortality, chronic diseases, and functioning were ascertained from hospital data, register linkage, and screenings every 5 years and were used to create 5 outcomes at follow-up: ideal aging (free of chronic conditions and high performance in physical, mental, and cognitive functioning tests; 4%), nonfatal cardiovascular event (7.3%), cardiovascular death (2.8%), noncardiovascular death (12.7%), and normal aging (73.2%).

Results

Low adherence to the AHEI was associated with an increased risk of cardiovascular and noncardiovascular death. In addition, participants with a “Western-type” diet (characterized by high intakes of fried and sweet food, processed food and red meat, refined grains, and high-fat dairy products) had lower odds of ideal aging (odds ratio for top vs bottom tertile: 0.58; 95% confidence interval, 0.36-0.94; P=.02), independently of other health behaviors.

Conclusions

By considering healthy aging as a composite of cardiovascular, metabolic, musculoskeletal, respiratory, mental, and cognitive function, the present study offers a new perspective on the impact of diet on aging phenotypes.

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Keywords : Aging, Cognitive functioning, Dietary patterns, Diet quality indices, Mortality, Nutritional epidemiology, Overall diet, Physical functioning


Esquema


 Funding: The Whitehall II study is supported by grants from the British Medical Research Council (MRC) G8802774; the British Heart Foundation; the British Health and Safety Executive; the British Department of Health; the National Heart, Lung, and Blood Institute (R01HL036310); the National Institute on Aging, National Institutes of Health (R01AG013196 and R01AG034454); and the Agency for Health Care Policy and Research (grant HS06516). MK is supported by an ESRC professorship; TNA was supported by the Languedoc-Roussillon Region (Chercheur d’avenir Grant 2011). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
 Conflict of Interest: None.
 Authorship: TNA, SS, GHJ, AGT, MJS, MJ, EJB, MH, GDB, ASM, MK designed research, TNA and MK conducted research. TNA analyzed data or performed statistical analysis; TNA and MK drafted the manuscript; TNA had primary responsibility for final content and SS, GHJ, AGT, MJS, MJ, EJB, MH, DB, ASM, MK made a critical revision of the manuscript for important intellectual content.


© 2013  Elsevier Inc. Reservados todos los derechos.
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