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Midlife eating patterns tied to health decades later

Your eating patterns can affect your risk of many chronic diseases, such as diabetes and heart disease. BearFotos / Shutterstock

As the U.S. population ages, there’s growing interest in finding ways to protect physical, mental, and cognitive health in later years. Several studies have shown links between healthy eating and prevention of chronic diseases, like diabetes or heart disease. Others have found ties between a high-quality diet and longer life. But less common are studies that examine the links between various dietary patterns and healthy aging overall, including the long-term impact of midlife food choices.

A research team led by Drs. Frank Hu of the Harvard T.H. Chan School of Public Health, Anne-Julie Tessier of the University of Montreal, and Marta Guasch-Ferré of the University of Copenhagen decided to take a closer look. They examined data gathered in two long-term studies of health and lifestyle. The Nurses’ Health Study enrolled women ages 30 to 55 years, and the Health Professionals Follow-Up Study enrolled men ages 40 to 75 years.

The team assessed participant data every four years beginning in 1986 for up to 30 years. Participants were excluded if they had a serious chronic disease at the start. The final study population included about 70,000 women and 35,000 men, for a total of more than 105,000 participants. Results appeared in Nature Medicine on March 24, 2025.

The researchers first examined how closely each participant’s self-reported eating patterns adhered to eight different healthy diet patterns. Among these were the Alternative Healthy Eating Index, the NIH-supported DASH diet (Dietary Approaches to Stop Hypertension), the MIND diet, the Planetary Health Diet Index, and a Mediterranean diet. All the diets encourage eating plant-based foods, unsaturated fats, nuts, and legumes while reducing the amount of red or processed meats and added sugars. Some also include healthy animal-based foods like fish and low-fat dairy products.

The scientists also looked at consumption of ultra-processed foods. Such foods typically contain industrially manufactured ingredients like high-fructose corn syrup, flavoring agents, unhealthy fats, and emulsifiers.

The team then assessed the associations between adherence to each eating pattern and healthy aging at age 70 or older. They found that over 9% of participants, about 9,800 people, had achieved healthy aging. That is, they were free of major chronic disease and had positive measures of cognitive, physical, and mental health.

The participants who had most closely followed the Alternative Healthy Eating Index were most likely to have healthy aging by age 70. The same held true by age 75. Participants who mostly closely adhered to any of the other healthy eating patterns also boosted their odds of healthy aging.

Regardless of specific diet, people who ate more fruits, vegetables, whole grains, unsaturated fats, nuts, legumes and low-fat dairy were more likely to have healthy aging. Healthy aging was less likely in those who ate more trans fats, salt, sugary drinks, and red or processed meats. In addition, people who ate more ultra-processed foods had a 32% reduced chance of healthy aging.

“Studies have previously investigated dietary patterns in the context of specific diseases or how long people live,” Hu explains. “Ours takes a multifaceted view, asking, how does diet impact people’s ability to live independently and enjoy a good quality of life as they age?”

—by Vicki Contie