Want to age without chronic diseases, have a sharp mind, and have vibrant energy? A groundbreaking 30-year study reveals the exact foods to prioritize and the ones sabotaging your chances.
Study: Optimal dietary patterns for healthy aging. Image Credit: monticello / Shutterstock
In a recent study published in the journal Nature Medicine, researchers examined the association between long-term adherence to eight dietary patterns and the consumption of ultra-processed foods (UPF) with healthy aging. Their findings indicate that following a plant-based, nutrient-dense diet with moderate amounts of healthful animal-based food intake, including low-fat dairy, may significantly enhance healthy aging, informing future dietary recommendations.
Background
The number of older individuals in the U.S. has increased, but 80% suffer from one or more chronic diseases, creating significant health challenges. Increasing healthy aging is a priority to improve the quality of life and societal contribution while reducing costs associated with healthcare. Poor diet is an important driver of mortality and noncommunicable diseases worldwide.
The World Health Organization now emphasizes preserving function and preventing decline rather than treating diseases. Studies show that better diets help prevent type 2 diabetes, cardiovascular disease, and early death. Research also links diet to physical and cognitive health, as well as mental well-being, in the aging population.
However, there is little understanding of how overall dietary patterns influence multiple aspects of healthy aging. Understanding these associations can inform public health guidelines, enabling older adults to maintain their mental, physical, and cognitive health while preventing chronic diseases.
About the Study
This study investigated the 30-year association between adherence to eight healthful dietary patterns, UPF consumption, and healthy aging in two large U.S. cohorts, while also analyzing differences by sex, ancestry, socioeconomic status, lifestyle factors, and individual food components.
Data came from the Nurses’ Health Study and the Health Professionals Follow-up Study, which have tracked lifestyle and health outcomes since 1986. Participants with major chronic diseases, missing dietary data, or implausible energy intake were excluded.
Dietary intake was assessed using a validated food frequency questionnaire (FFQ), yielding eight dietary pattern scores: the Alternative Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH), Alternative Mediterranean Diet (aMED), Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), Planetary Health Diet Index (PHDI), Healthful Plant-based Diet Index (hPDI), reversed Empirical Dietary Index for Hyperinsulinemia (rEDIH), and reversed Empirical Inflammatory Dietary Pattern (rEDIP), along with ultra-processed food (UPF) consumption.
Healthy aging was defined as reaching age 70 without major chronic diseases and with good cognitive, physical, and mental health. Covariates such as BMI, smoking, and physical activity were accounted for. Statistical analysis used logistic regression, adjusting for confounders. Sensitivity and subgroup analyses, including E-values, assessed robustness to unmeasured confounding.
Findings
The study analyzed data from 105,015 individuals (34,924 men and 70,091 women). Over 30 years, 9.3% (9,771 individuals) exhibited healthy aging. Among all participants, 37.9% lived to at least 70 years, 22.8% were free from 11 chronic conditions, 33.9% retained cognitive function, 28.1% preserved physical function, and 26.5% maintained mental health.
Those following healthier dietary patterns generally had higher socioeconomic status, more physical activity, lower BMI, and lower rates of past depression.
Strongest associations with healthy aging were found in AHEI, followed by DASH, MIND, hPDI, and PHDI. AHEI showed the strongest effect, while hPDI showed the weakest—possibly due to its stricter plant-food focus without prioritizing quality (e.g., whole vs. refined grains). Adherence to these diets increased healthy aging likelihood by 45% to 86%.
Cognitive health benefited most from PHDI; physical function from AHEI; mental health from AHEI; and chronic disease prevention from rEDIH. PHDI also had the greatest impact on survival to age 70. UPF consumption was associated with a 32% lower odds of healthy aging.
Greater intake of fruits, vegetables, whole grains, nuts, legumes, unsaturated fats (e.g., olive oil), and healthy fats was linked to better aging outcomes. Processed meats, trans fats, and sodium were linked to worse outcomes. Benefits were strongest among women, smokers, individuals with lower socioeconomic status, and those with less physical activity.
Conclusions
This long-term study found that healthier midlife dietary patterns were linked to better odds of healthy aging over 30 years. AHEI was most strongly associated with overall healthy aging, especially mental and physical function. With stricter definitions (e.g., survival to age 75), AHEI's impact was even greater.
PHDI, which integrates sustainability and health, showed the strongest effects on cognitive health and survival to age 70. rEDIH was most effective in chronic disease prevention. Diets rich in plant foods and healthy fats, and low in processed foods and red meat, were consistently associated with improved aging outcomes.
Study limitations include lack of diversity, as most participants were white health professionals. These findings support diet as a key factor in healthy aging and reinforce the need for inclusive, consistent dietary guidelines.
Journal reference:
- Optimal dietary patterns for healthy aging. Tessier, A., Wang, F., Korat, A.A., Eliassen, A.H., Chavarro, J., Grodstein, F., Li, J., Liang, L., Willett, W.C., Sun, Q., Stampfer, M.J., Hu, F.B., Guasch-Ferré, M. Nature Medicine (2025). DOI: 10.1038/s41591-025-03570-5, https://www.nature.com/articles/s41591-025-03570-5