Improving diet quality over time linked with reduced risk of premature death

July 12, 2017, Harvard T.H. Chan School of Public Health
Credit: CC0 Public Domain

People who improve the quality of their diets over time, eating more whole grains, vegetables, fruits, nuts, and fish and less red and processed meats and sugary beverages, may significantly reduce their risk of premature death, according to a new study from Harvard T.H. Chan School of Public Health. It is the first study to show that improving diet quality over at least a dozen years is associated with lower total and cardiovascular mortality, and underscores the importance of maintaining healthy eating patterns over the long term.

The study will be published in the July 13, 2017 issue of the New England Journal of Medicine.

"Overall, our findings underscore the benefits of healthy eating patterns including the Mediterranean and the DASH diet. Our study indicates that even modest improvements in could meaningfully influence mortality risk and conversely, worsening diet quality may increase the risk," said lead author Mercedes Sotos-Prieto, who worked on the study while a postdoctoral fellow in the Harvard Chan School Department of Nutrition and who is currently an assistant professor of nutrition at Ohio University.

Sotos-Prieto and colleagues analyzed the association between changes in diet quality among nearly 74,000 adults over a 12-year period (1986-1998) and their risk of dying over the subsequent 12 years (1998-2010). Data came from two long-term studies, the Nurses' Health Study and the Health Professionals' Follow-up Study, in which participants answered questions about their diets every four years and about their lifestyle and health every two years.

The researchers assessed people's diet quality by using three different scoring methods: the 2010 Alternate Healthy Eating Index, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score. Each of these methods assigns scores to various types of food or nutrients; less healthy foods or nutrients have lower scores and healthier foods or nutrients have higher ones.

The study found that improved diet quality over a 12-year period was associated with reduced risk of death in the subsequent 12 years, no matter which score was used. Food groups that contributed most to an improvement in diet quality were whole grains, fruits, vegetables, and fish or n-3 fatty acids.

A 20-percentile increase in diet-quality scores—the kind of increase that can be achieved by swapping out just one serving of red or processed meat for one daily serving of nuts or legumes—was linked with an 8%-17% reduction in the risk of death, depending on the diet score. In contrast, worsening diet quality was associated with a 6%-12% increase in the risk.

Among those who maintained higher rather than lower scores according to any of the three healthy diet patterns for 12 years, there was a 9%-14% reduction in mortality from any cause. Among those who had relatively unhealthy diets at the beginning of the study but whose diet scores improved the most, the risk of death in subsequent years was also significantly reduced.

"Our results highlight the long-term health benefits of improving diet quality with an emphasis on overall dietary patterns rather than on individual foods or nutrients. A healthy eating pattern can be adopted according to individuals' food and cultural preferences and health conditions. There is no one-size-fits-all diet," said Frank Hu, professor and chair of the Harvard Chan School Department of Nutrition and senior author of the study.

Explore further: Quality of diet linked to risk of T2DM regardless of BMI change

More information: "Association of Changes in Diet Quality with Total and Cause-Specific Mortality," Mercedes Sotos-Prieto, Shilpa N. Bhupathiraju, Josiemer Mattei, Teresa T. Fung, Yanping Li, An Pan, Walter C. Willett, Eric B. Rimm, and Frank B. Hu, New England Journal of Medicine (2017). DOI: 10.1056/NEJMoa1613502

Related Stories

Quality of diet linked to risk of T2DM regardless of BMI change

September 21, 2016
(HealthDay)—Changes in diet quality correlate with subsequent risk of type 2 diabetes, and the association between diet quality changes and diabetes risk is only partly explained by body weight changes, according to a study ...

Healthy plant-based diet linked with substantially lower type 2 diabetes risk

June 14, 2016
Consuming a plant-based diet—especially one rich in high-quality plant foods such as whole grains, fruits, vegetables, nuts, and legumes—is linked with substantially lower risk of developing type 2 diabetes, according ...

Eating for two often doesn't translate into a healthier diet

March 17, 2017
(HealthDay)—Despite the well-known wisdom of eating a healthy diet while pregnant, new research shows that most American women don't.

Western diet may increase risk of death after prostate cancer diagnosis

June 1, 2015
After a prostate cancer diagnosis, eating a diet higher in red and processed meat, high-fat dairy foods, and refined grains—known as a Western diet—may lead to a significantly higher risk of both prostate cancer-related ...

Anti-hypertension DASH diet may reduce the risk of gout

May 9, 2017
The results of a study led by Massachusetts General Hospital (MGH) investigators suggest that following a diet known to reduce the risk of hypertension and cardiovascular disease may also reduce the risk of gout. The team's ...

Eating a diet rich in fruit and vegetables could cut obesity risk

May 19, 2017
Pro-vegetarian diets (with a higher consumption of plant-based foods compared to animal-based foods) could provide substantial protection against obesity, according to new research presented at this year's European Congress ...

Recommended for you

India launches 'Modicare', world's biggest health scheme

September 23, 2018
India on Sunday launched the world's biggest health insurance scheme which Prime Minister Narendra Modi said would cover some 500 million poor people.

Patient-centered visual aid helps physicians discuss risks, treatments with parents

September 21, 2018
A series of illustrations and charts designed as decision aids for parents of children with minor head injuries helped them communicate with emergency medicine physicians and make informed decisions about their child's care, ...

Alcohol responsible for one in 20 deaths worldwide: WHO

September 21, 2018
Alcohol kills three million people worldwide each year—more than AIDS, violence and road accidents combined, the World Health Organization said Friday, adding that men are particularly at risk.

Smart pills dumb down medical care, experts warn

September 21, 2018
Enthusiasm for an emerging digital health tool, the smart pill, is on the rise but researchers at the University of Illinois at Chicago have published a paper in the American Journal of Bioethics that cautions health care ...

Crunched for time? High-intensity exercise = same cell benefits in fewer minutes

September 20, 2018
A few minutes of high-intensity interval or sprinting exercise may be as effective as much longer exercise sessions in spurring beneficial improvements in mitochondrial function, according to new research. The small study ...

China's doctor shortage prompts rush for AI health care

September 20, 2018
Qu Jianguo, 64, had a futuristic medical visit in Shanghai as he put his wrist through an automated pulse-taking machine and received the result within two minutes on a mobile phone—without a doctor present.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.