Greater Adherence to the Alternative Healthy Eating Index Is Associated with Lower Incidence of Physical Function Impairment in the Nurses’ Health Study

Hagan, Kaitlin; Chiuve, Stephanie E.; Stampfer, Meir J.; Katz, Jeffrey N.; Grodstein, Francine

doi:10.3945/jn.115.227900

Cited by 41 publications

(40 citation statements)

References 26 publications

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“…Several studies showed a protective association of a MDS diet with chronic disease morbidity and mortality, cognitive decline and dementia, and decline in mobility . Similarly, the aHEI and DASH diet are associated with reduced mortality and lower rates of several chronic diseases . A healthy diet is also associated with concomitant positive lifestyle factors, such as those seen in our study: less smoking and increased physical activity, both of which are associated with a lower risk of frailty …”

Section: Discussionsupporting

confidence: 76%

“…[33][34][35] Similarly, the aHEI and DASH diet are associated with reduced mortality and lower rates of several chronic diseases. [9][10][11][12][13][14][15] A healthy diet is also associated with concomitant positive lifestyle factors, such as those seen in our study: less smoking and increased physical activity, both of which are associated with a lower risk of frailty. 1 Because weekly vigorous exercise was included in the frailty index as a proxy for physical inactivity, we did not examine it as a potential confounder.…”

Section: Discussionsupporting

confidence: 60%

“…[5][6][7][8] The aHEI was associated with lower rates of mortality and chronic disease as well as better physical functioning among older Americans. [9][10][11][12][13] However, its relationship with frailty has not been established. Similarly, the Dietary Approaches to Stop Hypertension (DASH) score has not been evaluated in terms of its relationship with frailty, despite being associated with lower chronic disease and mortality risk.…”

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confidence: 99%

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Association between Diet Quality and Frailty Prevalence in the Physicians’ Health Study

Ward

Orkaby

Chen

et al. 2019

J American Geriatrics Society

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OBJECTIVES Limited data suggest that a healthy diet is associated with a lower risk of frailty. We sought to assess the relationship between three measures of diet quality and frailty among male physicians. DESIGN Cross‐sectional analysis of a cohort study. SETTING Physicians’ Health Study. PARTICIPANTS A total of 9861 initially healthy US men, aged 60 years or older, who provided data on frailty status and dietary habits. MEASUREMENTS A cumulative deficit frailty index (FI) was calculated using 33 variables encompassing domains of comorbidity, functional status, mood, general health, social isolation, and change in weight. Diet quality was measured using the Alternative Healthy Eating Index (aHEI), Mediterranean Diet Score (MDS), and Dietary Approaches to Stop Hypertension (DASH). RESULTS The FI identified 38% of physicians as non‐frail, 44% as pre‐frail, and 18% as frail. Multinomial logistic regression models adjusted for age, smoking status, and energy intake showed that compared with the lowest aHEI quintiles, those in the highest quintiles had lower odds of frailty and pre‐frailty compared with non‐frailty (odds ratio [OR] for frailty = .47; 95% confidence interval [CI] = .39‐.58; for pre‐frailty: OR = .75; CI = .65‐.87). Exercise did not modify this association (P interaction >.1). Similar relationships were observed for DASH and MDS quintiles with frailty and pre‐frailty. Restricted cubic splines showed an inverse dose‐response relationship of diet quality scores with odds of frailty and pre‐frailty. CONCLUSION Cross‐sectional data show an inverse dose‐response relationship of diet quality with pre‐frailty and frailty. Future longitudinal studies are needed to investigate whether healthier diet is a modifiable risk factor for frailty. http://clinicaltrials.gov identifier: NCT00000500. J Am Geriatr Soc 68:770–776, 2020

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Section: Discussionsupporting

confidence: 76%

Section: Discussionsupporting

confidence: 60%

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confidence: 99%

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Association between Diet Quality and Frailty Prevalence in the Physicians’ Health Study

Ward

Orkaby

Chen

et al. 2019

J American Geriatrics Society

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“…Consistent with this evidence on vascular disease, nut consumption was incorporated into the 2013 ACC/AHA lifestyle management guidelines [11]. In addition to the primary prevention of cardiovascular diseases, there is increasing epidemiologic evidence that nut consumption is related to better cognitive health [12][13][14], and initial studies suggest that nuts are related to better physical function in aging as well [15]. However, to our knowledge, the issue of whether long-term nut consumption relates to healthy aging as a broader concept remains unexplored.…”

Section: Introductionmentioning

confidence: 99%

Consumption of Nuts at Midlife and Healthy Aging in Women

Freitas-Simoes

Wagner

Samieri

et al. 2020

Journal of Aging Research

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Background. Nut consumption may reduce age-related diseases and lead to better health and well-being in aging. Many conditions of aging develop over decades, and thus earlier lifestyle factors may particularly influence later health. Methods. In 1998 and 2002, we administered food frequency questionnaires to assess nut consumption (peanuts, walnuts, and other nuts and peanut butter) in women in the Nurses’ Health Study in their 50 s/early 60 s. In 2012, those who survived beyond 65 years with no chronic diseases, no reported memory impairment, no physical disabilities, and intact mental health were considered “healthy agers.” We used multivariable logistic regression to estimate odds ratios for healthy versus usual aging, controlled for sociodemographic, behavioral, dietary, and other potential confounding factors. Results. Of 33,931 participants at midlife, 16% became “healthy agers.” After age adjustment, we observed a significant association between total nut consumption at midlife and higher odds of healthy aging, with strongest associations observed excluding peanut butter (odds ratio (OR) = 1.46, 95% confidence interval (CI) 1.32–1.62, ≥3 servings/week versus none). Findings were attenuated after further control for covariates, including overall diet quality (OR = 1.14, 95% CI 1.02–1.28, P trend = 0.05). For nut types, we found statistically significantly higher odds of healthy aging across peanuts, walnuts, and other nuts after age adjustment. After full control for confounders, only walnut consumption remained associated with healthy aging (P trend = 0.0001); for example, the OR was 1.20 (95% CI 1.00–1.44) for ≥2 servings/week versus none. Conclusions. Women consuming nuts at midlife have a greater likelihood of overall health and well-being at older ages. Nut consumption may represent a simple intervention to explore and promote healthy aging.

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“…16 Fewer than 2% of rural residents have healthy diets defined as a Healthy Eating Index score above 80. 17,18 Although a variety of diet quality measures have been used, evidence links higher diet quality scores to favorable health outcomes including better physical functioning 19 and lower risk for type II diabetes, cardiovascular disease (CVD), cancer, and mortality. 20 Rural residents are more likely to be obese than urban residents, 21,22 and consequently they are at greater risk for weight-related chronic conditions.…”

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confidence: 99%

Body Mass Index Category Moderates the Relationship Between Depressive Symptoms and Diet Quality in Overweight and Obese Rural‐Dwelling Adults

Abshire

Lennie

Chung

et al. 2017

The Journal of Rural Health

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Greater Adherence to the Alternative Healthy Eating Index Is Associated with Lower Incidence of Physical Function Impairment in the Nurses’ Health Study

Abstract: In this large cohort of older women, a healthier diet was associated with a lower risk of developing impairments in physical function.

Cited by 41 publications

References 26 publications

Association between Diet Quality and Frailty Prevalence in the Physicians’ Health Study

Association between Diet Quality and Frailty Prevalence in the Physicians’ Health Study

Consumption of Nuts at Midlife and Healthy Aging in Women

Body Mass Index Category Moderates the Relationship Between Depressive Symptoms and Diet Quality in Overweight and Obese Rural‐Dwelling Adults

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