BackgroundMaintaining healthy ageing (HA) is a crucial priority in older adults worldwide, given global population ageing, increased number of years living with disability, and the need for new treatments. Omega-3 polyunsaturated fatty acids (n3-PUFA) from seafood and plants exert favourable physiologic effects that could benefit HA. However, relationships between n3-PUFA and HA are not well-established, especially using serial biomarkers which provide highly objective measures.MethodsWe investigated the longitudinal association between serial circulating n3-PUFAs and maintenance of HA in the Cardiovascular Health Study, evaluating 2342 older U.S. adults with mean age 75 years and successful HA to-date at baseline in 1992–93. Individual plasma phospholipid n3-PUFAs (expressed as% of total fatty acids) including alpha-linoleic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) were quantified using gas chromatography in 1992–93, 1998–99, and 2005–06. HA was defined as survival free of cardiovascular disease, cancer, lung disease, and severe chronic kidney disease, with no difficulties with activities of daily living and intact cognitive function (Mini-Mental State Examination ≥80th percentile); dying with a lifetime meeting this criteria was also considered as HA. Events were centrally adjudicated or determined from medical records and diagnostic tests. Multivariable-Cox proportional hazards models with time-varying covariates evaluated the association between time-varying, cumulative average n3-PUFAs and unsuccessful HA.ResultsDuring 22 years of follow-up, 267 (11%) participants experienced successful HA. After multivariable-adjustments, the interquintile range of total n3-PUFAs and seafood-derived n3-PUFAs was associated with lower risk of unsuccessful HA by 17% (0.74%–0.93 95% CI, p= 0.002) and 16% (0.75%–0.94 95% CI, p= 0.002), respectively. Individually, EPA, DPA and DHA each associated with lower risk of unsuccessful HA by 12% (0.80%–0.97 95% CI, p= 0.009), 14% (0.77%–0.97 95% CI, p= 0.010) and 15% (0.76%–0.96 95% CI, p= 0.009), respectively. Plant-derived ALA levels were not significantly associated with HA. Sensitivity analyses including freedom from atrial fibrillation, milder chronic kidney disease, and diabetes within the HA definition did not appreciably alter results.ConclusionAmong older adults with mean age 75 years and HA to-date, a higher cumulative level of circulating seafood-derived n3-PUFAs (combined and individually), but not plant-derived ALA, was associated with maintainence of HA. These novel findings support guidelines for increased fish intake among older adults; and need for further investigations into plausible biological mechanisms and interventions for effects of n3-PUFAs on maintenance of HA.
Background The Dietary Approaches to Stop Hypertension (DASH) eating plan, developed by the National Institutes of Health in the USA, has been shown in both observational and experimental studies to reduce blood pressure, prevent chronic disease and reduce body weight. Despite its effectiveness it has not been promoted in the UK, although previous work has shown its cultural appropriateness and effectiveness in reducing blood pressure in a UK sample. In this study we characterised accordance with the DASH diet in a representative UK sample for the first time.Methods We analysed the four-day dietary intakes of 1491 adults (650 men, 841 women) included in years 1-3 of the rolling programme of the National Diet and Nutrition Survey (NDNS). We assessed DASH accordance using a score that has been shown to be strongly associated with disease incidence. To derive this accordance score we ranked NDNS participants by intake of eight foods and nutrients, adjusted for energy, and assigned between one and five points for each food/nutrient group based on their consumption quintile. These points were summed to create the final score with a range between eight (least accordant) to 40 (most accordant). We used surveyweighted linear regression to estimate mean age-adjusted accordance scores for men and women and estimated sex-adjusted scores for a range of age-groups. Age-and sex-adjusted accordance scores were estimated for three different indicators of individual-level socio-economic status: household income, occupational class and qualification level. Results The mean DASH accordance score for the population was 24.9 (standard deviation 5.6), and was significantly higher in women (mean 25.8, 95% CI 25.5-26.2) than men (mean 23.6, 95% CI 23.2-23.9). DASH accordance varied by age group, with those aged 19-34 years the least DASH accordant (mean 22.4, 95% CI 21.9-22.9) and those aged 55-64 the most (mean 26.6, 95% CI 25.9-27.2). DASH accordance was significantly higher in higher socio-economic status (SES) groups and lower in lower SES groups across all three measures of SES. The greatest difference between the highest and lowest categories was in occupational class (27.4 vs. 21.5 in the highest versus lowest groups, respectively) and the least in household income (26.5 vs. 23.1). Conclusion Accordance with the DASH diet varies by demographic and socio-economic characteristics in the UK population, revealing a social gradient in diet quality. Promoting the adoption of DASH diets could be part of a broader, population-based approach to prevent chronic disease but the observed gradient indicates that barriers may exist to the adoption of DASH diets.
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